SPEECH BY PROFESSOR KENNETH MAK, DIRECTOR-GENERAL OF HEALTH, MINISTRY OF HEALTH, AT THE OPENING OF THE ASIAN BIOETHICS NETWORK CONFERENCE 2025

Emeritus Prof Lee Eng Hin, Chair of the Bioethics Advisory Committee,

Prof Julian Savulescu and Dr Sumytra Menon, Head and Director from the NUS Centre for Biomedical Ethics, Organising Committee of the Asian Bioethics Network Conference,

Distinguished delegates and members of the Asian Bioethics Network,

Ladies and gentlemen,

1.            A very good morning to all of you. I am pleased to join you at the opening of the inaugural Asian Bioethics Network (ABN) Conference 2025. Today, we are joined by participants from healthcare, academia, the bioethics community, and government sectors from around the world to discuss the theme, “Navigating the Ethical Maze for Tomorrow’s Medicine”.

2.            This theme is timely and relevant. We are witnessing rapid advances in biotechnology and biomedical sciences, from artificial intelligence (AI) to precision medicine, gene editing, and innovations that advance human longevity. These breakthroughs bring us closer to what was once unimaginable – personalised treatments with the possibility of curing hereditary diseases through editing the human genome and novel approaches that could enhance population health and extend healthy lifespan.

The Importance of Ethics

3.            Yet, these technological advances also raise complex ethical concerns. The increasing use of data analytics and AI, particularly agentic technologies, requires us to redefine, or at least reaffirm, what constitutes a duty of care. This includes determining the extent to which patient data may be disclosed, now and in the future, in ways that truly serve the patient’s best interests.

4.             Precision medicine promises accelerated diagnoses and targeted prevention but also challenges us to manage data disclosure and confidentiality. Healthcare providers must navigate whether, when, and how to disclose genetic information, especially when variants of uncertain significance may only gain clinical meaning in the future.

5.            Telehealth has expanded access to healthcare, but raises concerns about whether clinicians can adequately assess patients before prescribing treatments. Recent cases of licensing breaches in Singapore, such as the inappropriate issuing of medical certificates, show how other motivations may subvert the delivery of good clinical care.

6.            In this evolving biomedical landscape, we find ourselves in a maze. New technologies illuminate new paths, but these are not without risks and challenges. As we navigate this maze, ethics serves as our compass. Ethics protects patients’ safety, dignity, and autonomy, preserves public trust, and upholds the integrity of medicine and science.

7.            These examples remind us that ethical principles cannot remain abstract. They must guide practice and their application must evolve with the introduction of healthcare innovations.

Ethics in the International Context

8.            The recognition of ethics as a cornerstone of healthcare and research is shared globally. The UNESCO Bioethics Programme, for example, facilitates international dialogue and consensus on life science ethics, underscoring the importance of shared principles and the global commitment to responsible science.

9.            Regionally, the Bioethics Advisory Committee, or BAC for short, established the ABN in 2021. And now with 15 member states across Asia Pacific, the ABN facilitates exchange of knowledge and experiences to keep members abreast of the latest bioethics developments whilst building and strengthening partnerships.

10.         Within the ABN, member states have taken important steps to integrate ethics into their healthcare and research landscapes. Thailand’s “Genomics Thailand” programme, which sequenced 50,000 genomes from 2019 to 2023, raised concerns about donor privacy, data ownership, and discrimination. Thailand addressed these by engaging insurers and introducing informed consent processes that gave donors control over communication of significant findings from their genomes.

11.         In Australia, the National Health and Medical Research Council developed guidance for Human Research Ethics Committees reviewing studies involving emerging technologies, and public education resources. These ensure rigorous ethical oversight and public understanding of biomedical innovation.

Ethics in the Local Context

12.         Closer to home, Singapore has sought to integrate ethics into healthcare and research. Let me highlight three aspects:

a.  Firstly, building ethics into our regulatory framework;

b.  Establishing governance structures; and

c.   Adapting approaches to keep pace with evolving technologies.

13.         First, we embed ethics upstream in regulation, ensuring new technologies advance innovation responsibly while safeguarding human rights, safety and public trust.

14.         For example, in human genetic and stem cell research, the cloning of Dolly the sheep sparked global discussion on the importance of bioethics governance. To provide ethical guidance for researchers and institutions, the BAC issued guidelines for human stem cell and biomedical research in 2010 and 2015 respectively. These were instrumental in shaping policies such as the Human Biomedical Research Act of 2015.

15.         Another example is AI. Similarly, ethics forms the basis for guidelines such as MOH’s “Artificial Intelligence in Healthcare Guidelines (AIHGle)”, which we produced in 2021, and the BAC’s “Ethical Use of Big Data and AI (BDAI) in Biomedical Research” advisory, issued this year in 2025. These ensure the responsible use of AI to support patient safety, and ensure that AI systems are deployed ethically and do not perpetuate existing disparities because of incomplete or biased datasets.

16.         Second, we establish governance structures to ensure healthcare and research decisions are grounded in sound ethics. In clinical settings, the National Medical Ethics Committee (NMEC) and Clinical Ethics Committees (CECs) support practitioners and ensure a high ethical standard. CECs review complex ethical cases such as surgical separation of conjoined twins, where ethical considerations, including balancing beneficence and non-maleficence for both twins, communication of the risks, and accessible post-operative support, should be carefully reviewed.

17.         In research, Institutional Review Boards (IRBs) in the public health sector ensure the ethical oversight of studies, safeguarding human research subjects and maintaining rigorous standards. Such structures ensure that ethics-based regulations are translated into ground practice.

18.         Third, we adapt approaches to keep pace with evolving technologies. As technologies evolve, so too must our approaches.

19.         One field that is evolving rapidly is human gene editing, which offers the potential to eliminate disease. However, without due consideration for ethics, it can lead to harm. The 2018 Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) babies’ case that was reported in China, where germline editing produced two genetically modified babies, was a cautionary tale of the consequence of applying such technologies without adequate safeguards. The attempt to reduce susceptibility to Human Immunodeficiency Virus (HIV) infection instead introduced a harmful mutation and violated established safety norms, underscoring the need for responsible governance to protect patients and sustain public trust.

20.         In this regard, I am pleased to announce the BAC’s new advisory publication on the “Ethical, Legal and Social Issues Arising from Human Nuclear Genome Editing (HNGE)”. Developed through extensive public consultation, it provides guidance for the responsible use of HNGE in biomedical research and clinical practice. By adhering to ethical principles outlined, researchers, clinicians and institutions can navigate the complex landscape of HNGE and make balanced and fair decisions to promote advancements that align with societal values and ethical standards. Copies are available on the BAC website and to all conference participants today.

Closing

21.         As we enter this new era of medicine, we must innovate responsibly with ethics at the heart of biomedical progress. The emerging technologies and ethical considerations we face transcend borders, presenting opportunities to work together, and share knowledge and best practices.

22.         To this end, I am glad to announce the launch of the ABN digital repository, which promises to facilitate knowledge sharing and enhance collaboration on bioethics initiatives across our region. This inaugural conference also builds on such efforts and marks the start of a tradition – one that I hope we can continue through future bi-annual conferences. I encourage fellow ABN members in hosting these gatherings and welcome others to join this growing network in this vital work.

23.         Over the next two days, you will hear from distinguished speakers on the ethics of healthcare digitalisation, AI, genomics, human longevity, and traditional, complementary, and integrative medicine. I am confident these discussions will be fruitful and engaging, strengthening the foundations of ethical practice in healthcare and research across Asia and beyond.

24.         Thank you very much.