THE TRADITIONAL CHINESE MEDICINE CODE OF ETHICS IN SINGAPORE : PROCESS OF CONSTRUCTION AND IMPACT ON PRACTITIONERS

Abstract

A code of ethics is many things. It is a statement and coordination of occupational role-set obligations and values. It can contribute to practitioners' ethical behavior as a guide to action or as a means of moral socialization. It is an ideological tool used by a profession to advance its interest in acquiring status, prestige and market control over the provision of its services. The "Singapore Chinese Physician's Professional Regulations and Code of Ethics" is the first traditional Chinese medicine code of ethics to be formulated for the entire TCM community. This thesis examines the social construction process of the TCM code and its impact on practitioners. The thesis begins by tracing the development of TCM in Singapore within its particular social and historical context and the problems it encountered which accounted for its failure to acquire professional status in the past. With increasing state participation and encouragement, TCM began various efforts at raising its standards and modernizing its practices. The TCM code of ethics is but one of the more recent efforts at seeking legitimation within Singapore. The nature and characteristics of the code of ethics that emerged is due to a confluence of various forces. The code of ethics is the direct effort of the leaders of the community and it reflects their 'professional' and ethical norms and values. Because TCM was imported from China, and works on a different ontological framework, the nature of TCM ethics emphasizes harmony, responsibility, familism and a strong paternalism. This is different from biomedical ethics, which emphasizes autonomy, individual rights and self-determination. The 'TCM ethics' of practitioners in Singapore also showed similar emphasis on familism, paternalism, and various other ethical values with an affinity to Confucian philosophy. The notion of 'yi ze fu mu xin', a clearly cultural artifact is included in the code, attesting to the impact of Chinese culture on the ethical values of the TCM community and subsequently, on ethical codes. The other major objective of this thesis is an exploration of the TCM code's impact on practitioners. Three aspects are explored, the impact on ethical behavior; the impact on TCM ethics of practitioners; and the impact on professionalization.