Science, Health and
Policy - relevant Ethics in Singapore (SHAPES)

Science, Health and Policy-relevant Ethics in Singapore (SHAPES) is an initiative of the Centre for Biomedical Ethics (CBmE), NUS, supported by the Singapore Ministry of Health’s National Medical Research Council under its Science Health, and Policy Relevant Ethics, Singapore (SHAPES) Programme (MOH-000951)

SHAPES supports Singapore’s goals in research on Human Health and Potential (HHP) through the development of Singapore bioethics capacity, as well as support for local institutions, national regulators and policy-makers, in upholding compliance with ethics and regulatory requirements for research.

Our key stakeholders include clinician-scientists, Institutional Review Board (IRB) members, other researchers, policymakers, and the public.

• Build bioethics capability that supports and facilitates research excellence,
• Work with other enablers to support development and implementation of policy
related to the ethical conduct, governance, and translation of clinical research, and
• Develop scholarship and thought leadership related to innovative technologies and
therapies.

SHAPES aims to support three priority Human Health Potential thematic areas that are
fundamental for the rapidly changing and digitally enhanced health system and economy of
the future: (1) Clinical Trials and Clinical Research, (2) Ethics of Clinical Innovation and (3)
Artificial Intelligence and Trust Technologies.

3 Thematic Areas

1. Clinical Trials and Clinical Research

We aim to provide IRBs and policymakers with the means to address ethical issues
encountered in the process of bringing innovative therapies and technologies to the
bedside. SHAPES also intends to facilitate research excellence through building research
ethics capacity amongst key enablers.

2. Artificial Intelligence and Trust Technologies

Artificial Intelligence (AI) is being developed to aid and support clinical decision-making for
primary care doctors and to profile patients for the risk of developing chronic diseases.
Addressing the ethical, legal and social issues that underlie such innovations is critical for
their development and to engender trust in AI-driven technologies.

SHAPES will collaborate with key stakeholders, and international and local expertise to
produce ethical guidance for the adoption of AI-assisted decision-making tools in healthcare
settings within Singapore.

3. Ethics of Clinical Innovation: Neuroethics

Novel therapeutic approaches based on neuroethics create significant challenges for studying safety and efficacy of novel therapies within and without clinical trial settings. To guide policymaking in Singapore, SHAPES will translate
ethical guidelines developed from international research into guidance that is applicable to
regulatory and health law context of Singapore.

Stakeholder engagement workshops and symposiums

SHAPES frequently convenes workshops that engage experts as well as key stakeholders in Singapore on key bioethical issues and real-world problems in bioethics. In addition, we have hosted educational symposiums which offered clinician scientists, healthcare professionals, policymakers, academics, and other participants with valuable insights on cutting edge technologies such as current AI medical research projects.

Academic and guidance papers

Through stakeholder engagement and research, we develop and publish papers in leading academic journals as well as publish guidance documents to help guide the practice and oversight of emerging bioethical challenges as they arise locally.

Training

Informed by research and needs of stakeholders, we provide training and capacity-building both for clinician-scientists and other researchers in their research, graduate students, as well IRBs and regulators in their crucial oversight role. We do this through our professional educational seminars which educate medical professionals on a wide array of bioethical issues according to their needs.

The Ethics of Big Data in Health & Research
In 2018, SHAPES convened an international interdisciplinary Working Group to develop a framework that provides ethical guidance to decision-makers who work with big data in health and research. A general overview of the resulting Framework can be found here. The Framework and other recent publications on big data ethics by members of the Working Group are available here.

The Ethics of Gene-Modifying Technologies
In 2019, SHAPES convened an international interdisciplinary Working Group to explore ethical issues arising in gene modifying technologies.

Research on Local Ethics Review Processes
In 2020, the SHAPES Initiative has completed a research project that contributes to a general understanding of perceptions around IRB functions and characteristics in Singapore. The project findings can be found here.

• AI Working Group
In 2023, SHAPES convened an AI working group, inviting experts from several countries to collaborate on developing guidance documents on a variety of issues in the AI bioethics space. This has led to the publication of several academic papers as well as a guidance document for biomedical research involving AI. The guidance document can be found here.

  • Ethics of Deep Brain Simulation Workshop 10 May 2025 (poster)



    2024

    • Singapore Research Ethics Conference: Navigating the Ethical & Regulatory Challenges with Technological Advances in Research, 23-25 October 2024 (poster)
    • Hot Topics in Consent for Research: AI and Risk in Clinical Trials, 28 June 2024 (poster)
    • The Ethics of Human Challenge Studies, 8 April 2024 (poster)

    2023

    • Understanding Risks of AI in Biomedical research, 7 November 2023 (poster)
    • The Ethics and Practice of Patient Engagement in Research, 28 July 2023 (poster)
    • Exploring the Acceptability of Patient and Public Involvement (PPI) in Singapore Context, 27 July 2023 (poster)
    • Seminar on Ethical AI in Healthcare, 17 Apr 2023 

      2022

      • Webinar: Translational health research on AI: A roundtable to identify new ethical challenges on the front line

      • Webinar: New Research Practices in the wake of  COVID-19: Remote Consent and Remote Data Gathering, online, 8 July 2022 (organised by SHAPES, CBmE, NUS)

      Aim: In this workshop, participants will learn through lectures, facilitated discussion and case studies, how to tackle ethical aspects of remote consent and remote study visits conducted in Singapore.

      Panellists (in alphabetical order, by last name): Dr Austin Ang, Mr Markus Labude, Ms Sumitra Sachidanandan, Dr Owen Schaefer, Dr Aaron Tan

      Facilitators (in alphabetical order, by last name): Dr Chan Hui Yun, Dr Victor Cole, A/Prof Michael Dunn, A/Prof Roy Joseph, Mr Markus Labude, Dr Tamra Lysaght, Dr Anantharaman Muralidharan, Ms Serene Ong, Dr Owen Schaefer, Dr Voo Teck Chuan

      2021

      • Webinar: Singaporean perspectives on actual and ideal IRB review functions and characteristics, online, 5 February 2021

      Aim: This webinar presented SHAPES’ research findings on Singaporean perspectives on IRB functions and characteristics. The discussion session gave participants the opportunity to contribute their views and pose questions about this novel research. 

      Authors Present:  Markus K. Labude, Liang Shen, Owen Schaefer, Catherine Ong, Vicki Xafis

      • Workshops: Ethics Framework for Big Data in Health and Research – Learning to Apply the Framework, online, 13 & 15 January 2021

      Aim: These workshops aimed to facilitate a deeper understanding of the Framework and its application. The case-based activity enabled attendees to apply the Framework and discuss the issues and values relevant to the case.

      Facilitators (in alphabetical order): A/Prof Angela Ballantyne, Mr Markus Labude, Prof Graeme Laurie, Dr Tamra Lysaght, Dr Owen Schaefer, Dr Vicki Xafis.

      2020

      • Webinar: Conceptual Issues Impeding Uses & Sharing of Big Data in Biomedicine, online, 25 November 2020
        (by invitation – organized by SHAPES, CBmE, NUS, in collaboration with FHT, ETH Zurich)

      Aim: The aim of this webinar was to discuss and elucidate how different understandings of certain concepts across disciplines, different interpretations, and different prioritisation of issues impede the use and sharing of big data in biomedicine.

      Panellists: A/Prof Mark J Taylor, Dr Reza Shokri, Clinical A/Prof Yeo Khung Keong, Ms Agata Ferretti, Dr Michael Chapman, Dr Natalie Banner, Dr Shona Kalkman and A/Prof Josip Car

      2019

      • Symposium on Gene-Modifying Technologies: current ethical issues, Hotel Fort Canning, Singapore, 29-30 April 2019
        (by invitation – organized by SHAPES, CBmE NUS)
      • Gene-Modifying Technologies Working Group Meeting, CBmE, NUS 1-3 May 2019 (organized by SHAPES, CBmE NUS)

      2018

      • Big Data Ethics Symposium, Hotel Fort Canning, Singapore, 5-6 March 2018
        (by invitation – organized by SHAPES, CBmE NUS)
      • Big Data Ethics Working Group Meeting, CBmE, NUS, 7-9 March 2018
        (organized by SHAPES, CBmE, NUS)
      • Gene Editing: Ethics and Regulation Symposium, University of Manchester, 16-17 July 2018 (organized by the Centre for Social Ethics and Policy (CSEP), University of Manchester, in collaboration with SHAPES, CBmE, NUS)
      • Ethics of Big Data in Health and Research Conference, Kent Ridge Guild House, NUSS, 30 Nov-1 Dec 2018 (organized by SHAPES & financially supported by CENTRES, CBmE, NUS)
      1. Nord-Bronzyk, A., Savulescu, J., Ballantyne, A. et al. Assessing Risk in Implementing New Artificial Intelligence Triage Tools—How Much Risk is Reasonable in an Already Risky World?. ABR 17, 187–205 (2025). https://doi.org/10.1007/s41649-024-00348-8

      2. Muyskens, K., I. Z. Y. Teo, J. Menikoff, and G. O. Schaefer, “The Ethical Case for Decentralized Clinical Trials,” Ethics & Human Research 46, no. 6 (2024): 14-24. https://doi.org/10.1002/eahr.500229

      3. Muyskens, K., Ballantyne, A., Savulescu, J. et al. The Permissibility of Biased AI in a Biased World: An Ethical Analysis of AI for Screening and Referrals for Diabetic Retinopathy in Singapore. ABR (2024). https://doi.org/10.1007/s41649-024-00315-3

      4. Muyskens, K., Ma, Y., Menikoff, J. et al. When can we Kick (Some) Humans “Out of the Loop”? An Examination of the use of AI in Medical Imaging for Lumbar Spinal Stenosis. ABR (2024). https://doi.org/10.1007/s41649-024-00290-9

      5. Porsdam Mann, S., Earp, B. D., Møller, N., Vynn, S., & Savulescu, J. (2023). AUTOGEN: A Personalized Large Language Model for
        Academic Enhancement—Ethics and Proof of Principle. The American Journal of Bioethics, 23(10), 28–41. https://doi.org/10.1080/15265161.2023.2233356

      6. Vandersluis, R., & Savulescu, J. (2024). The selective deployment of AI in healthcare. Bioethics, 38, 391–400. https://doi.org/10.1111/bioe.13281

      7. Muyskens K, Ma Y, Dunn M. Can an AI-carebot be filial? Reflections from Confucian ethics. Nursing Ethics. 2024;31(6):999-1009. https://doi.org/10.1177/09697330241238332

      8. Kataoka, M., Gyngell, C., Savulescu, J. et al. The Ethics of Human Brain Organoid Transplantation in Animals. Neuroethics 16, 27 (2023). https://doi.org/10.1007/s12152-023-09532-3

      9. Zohny H, Savulescu J. When Two Become One: Singular Duos and the Neuroethical Frontiers of Brain-to-Brain Interfaces. Cambridge Quarterly of Healthcare Ethics. 2024;33(4):494-506. https://doi.org/10.1017/S0963180124000197

      10. Shlobin, N.A., Savulescu, J. & Baum, M.L. The ethical landscape of human brain organoids and a mindful innovation framework. Nat Rev Bioeng 2, 785–796 (2024). https://doi.org/10.1038/s44222-024-00211-3

      11. Xafis V, Schaefer GO, Labude MK, Zhu Y, Holm S, Foo RS-Y, et al. (2021) Germline genome modification through novel political, ethical, and social lenses. PLoS Genet 17(9): e1009741. https://doi.org/10.1371/journal.pgen.1009741

      12. Kaan T, Xafis V, Schaefer GO, Zhu Y, Labude MK, Chadwick R (2021) Germline genome editing: Moratorium, hard law, or an informed adaptive consensus? PLoS Genet 17(9): e1009742. https://doi.org/10.1371/journal.pgen.1009742

      13. Zeps N, Lysaght T, Chadwick R, Erler A, Foo R, Giordano S, San Lai P, Schaefer GO, Xafis V, Chew WL, Sugarman J. Ethics and regulatory considerations for the clinical translation of somatic cell human epigenetic editing. Stem Cell Reports. 2021 Jun 29:S2213-6711(21)00310-6. doi: https://doi.org/10.1016/j.stemcr.2021.06.004. Epub ahead of print. PMID: 34214486.

      14. Chen Q, Ma Y, Labude M, Schaefer GO, Xafis V, Mills P. Making sense of it all: Ethical reflections on the conditions surrounding the first genome-edited babies [version 2; peer review: 2 approved]. Wellcome Open Res 2021, 5:216 (https://doi.org/10.12688/wellcomeopenres.16295.2)

      15. Markus K. Labude, Liang Shen, Yujia Zhu, G. Owen Schaefer, Catherine Ong, Vicki Xafis. Perspectives of Singaporean biomedical researchers and research support staff on actual and ideal IRB review functions and characteristics: A quantitative analysis. PLOS ONE. 31 Dec 2020.https://journals.plos.org/plosone/article id=10.1371/journal.pone.0241783

      16. Schaefer, G.O., M.K. Labude, Y. Zhu, R.S.-Y. Foo, and V. Xafis, International Reporting Mechanism for Unethical Germline Gene Editing Experiments Is Needed. Trends in Biotechnology, 2020. http://www.sciencedirect.com/science/article/pii/S0167779920302614.

      17. Lysaght, T., A. Ballantyne, V. Xafis, S. Ong, G.O. Schaefer, J.M.T. Ling, A.J. Newson, I.W. Khor, and E.S. Tai, “Who is watching the watchdog?”: ethical perspectives of sharing health-related data for precision medicine in Singapore. BMC Medical Ethics, 2020. Vol. 21(1). https://doi.org/10.1186/s12910-020-00561-8

      18. Xafis, V., G.O. Schaefer, M.K. Labude, Y. Zhu, and L.Y. Hsu, The Perfect Moral Storm: Diverse Ethical Considerations in the COVID-19 Pandemic. Asian Bioethics Review, 2020. 12(2) pp. 65-83. https://doi.org/10.1007/s41649-020-00125-3.

      19. Xafis, V. ‘What is Inconvenient for You is Life-saving for Me’: How Health Inequities are playing out during the COVID-19 Pandemic. Asian Bioethics Review, 2020. Vol 12(2), pp.223–234 (2020). https://doi.org/10.1007/s41649-020-00119-1.

      20. Xafis V., Brombley K. (2020) Ethical Concepts in Neonatal Palliative Care. In: Mancini A., Price J., Kerr-Elliott T. (eds.) Neonatal Palliative Care for Nurses. Springer, Cham. https://doi.org/10.1007/978-3-030-31877-2_6.

      21. Laurie, Graeme; Tai, E Shyong; Ballantyne, Angela; Brassington, Iain; Labude, Markus; Lim, Hannah; Lipworth, Wendy; Lysaght, Tamra; Stewart, Cameron; Sun, Shirley; Xafis, Vicki. (2019) Delivering a Practical Framework for Ethical Decision-Making Involving Big Data in Health and Research, Asian Bioethics Review, Vol.11(3), pp.223-225. https://doi.org/10.1007/s41649-019-00098-y.

      22. Vicki Xafis, G. Owen Schaefer, Markus K. Labude, Iain Brassington, Angela Ballantyne, Hannah Yeefen Lim, Wendy Lipworth, Tamra Lysaght, Cameron Stewart, Shirley Sun, Graeme T. Laurie, E Shyong Tai. (2019) An Ethics Framework for Big Data in Health and Research, Asian Bioethics Review, Vol.11(3), pp.227-254. https://doi.org/10.1007/s41649-019-00099-x.

      23. Vicki Xafis, Markus K. Labude. (2019) Openness in Big Data and Data Repositories: The Application of an Ethics Framework for Big Data in Health and Research, Asian Bioethics Review, Vol.11(3), pp.255-273. https://doi.org/10.1007/s41649-019-00097-z.

      24. Owen Schaefer, Tai E Shyong, Shirley Sun. 2019. Precision Medicine and Big Data: The Application of an Ethics Framework for Big Data in Health and Research, Asian Bioethics Review, Vol.11(3), pp.275-288. https://doi.org/10.1007/s41649-019-00094-2.

      25. Tamra Lysaght, Hannah Yeefen Lim, Vicki Xafis, Kee Yuan Ngiam. (2019) AI-assisted Decision Making in Healthcare: The Application of an Ethics Framework for Big Data in Health and Research, Asian Bioethics Review, Vol.11(3), pp.299-314. https://doi.org/10.1007/s41649-019-00096-0.

      26. Markus K. Labude, Vicki Xafis. (2019) Ethically Justified Restrictions on Citizen Science: A Perspective from Singapore, The American Journal of Bioethics, Vol. 19(8), pp.38-40. https://doi.org/10.1080/15265161.2019.1619872.

      27. Owen Schaefer (2019) Ethics in the Era of Big Data, Asian Bioethics ReviewVol.11(2), pp.169-171. https://doi.org/10.1007/s41649-019-00092-4.

      28. Duszynski, Katherine; M. Pratt, Nicole L. Lynch, John W. Braunack‐Mayer, Annette; Taylor, Lee K.; Berry, Jesia G.; Xafis, Vicki; Buttery, Jim; Gold, Michael S. (2019) Process trumps potential public good: better vaccine safety through linked cross‐jurisdictional immunisation data in Australia. Australian and New Zealand Journal of Public Health, October 2019, Vol. 43(5), pp.496-503.

      29. Vicki Xafis, Dominic Wilkinson. (2019) Treating ambiguity in the clinical context: Is what you hear the doctor say what the doctor means? Cambridge Quarterly of Healthcare Ethics, Vol 28(3), pp.422-432. https://doi.org/10.1017/S0963180119000343.

      30. Merner  B, Hill  S, Colombo  C, Xafis  V, Gaulden  CM, Graham‐Wisener  L, Lowe  D, Walsh  L, Biggar  S, Bourke  N, Chmielewski  R, Gill  M, Martin  F, Martinek  N, McKinlay  L, Menzies  D, Mussared  A, Refahi  N, Smith  L, Sonawane  R, Wardrope  C. Consumers and health providers working in partnership for the promotion of person‐centred health services: a co‐produced qualitative evidence synthesis. Cochrane Database of Systematic Reviews 2019, Issue 2. Art. No.: CD013274. https://doi.org/10.1002/14651858.CD013274.

      31. Owen Schaefer, Markus K Labude and Harisan Unais Nasir. 2018. Big Data: Ethical Considerations. In: David Boonin (ed.), Handbook of Philosophy and Public Policy (Palgrave McMillan).

        SHAPES values engagement with the scientific community. Please contact us at SHAPES