Do we really need consent in Singapore for the use of de‑identified bio‑specimens in research?
Published: 02 May 2025
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As it should be in all modern and advancing societies today, consent in research is a highly debated topic, particularly regarding when it is necessary, and when it may become counterproductive. At its most optimum, consent critically balances patient welfare with research progress. However, a key issue is that informed consent may not always be in the patient’s best interest. In Singapore, there is much discussion that the current legislation on consent procedures for the secondary research use of de-identified bio-specimens is counterintuitive to the progress of medical research. Consent requirement in some contexts such as this, creates an unnecessary and even prohibitive obstacle to research, disproportionately affecting minority populations, and increasing privacy risks for participants.
Medical students Shaun Loong (NUS Medicine Class of 2024, now House Officer, National University Hospital), Kylie Heng (NUS Medicine Class of 2026), and Gini Wong (Duke-NUS Medical School Class of 2027) led by Professor Jerry Menikoff from the Centre for Biomedical Ethics (CBmE) at the Yong Loo Lin School of Medicine, National University of Singapore (NUS Medicine), evaluated Singapore’s consent procedures for using de-identified bio-specimens in secondary research. The work argues that Singapore should relax its regulations to foster more effective research, and ultimately decrease the barrier for impactful outcomes. Contrary to popular belief, obtaining informed consent may not always be in the interest of all patients. When informed consent is inappropriately mandated, the advancement of important life-saving medical research is unnecessarily impeded.
Prof Menikoff said, “We advocate for loosening Singapore’s rules regarding when research can be done with de-identified biospecimens. The requirement of informed consent may even prove to be harmful by creating additional barriers to minority research participation, potentially exacerbating inequalities in research representation and, paradoxically, increasing privacy risks by serving as an unnecessary link to participants.”
The article argues that the current Singapore rules for secondary research with de-identified biospecimens are too strict in requiring informed consent from a person before their biospecimen can be used for research—a process which is not in the best interests of Singaporeans. Published in Asian Bioethics Review, the paper is a joint effort in examining ethics and social science.
Kylie Heng, the first author of the study, said, “Through this paper, we aim to surface the discussion on policies that govern the use of biospecimens for research in favour of further liberties. We discuss an alternative “opt-out” system, which is similar to the regulations for organ donation in Singapore, that removes consent-taking procedures, and enables significant research progress and improves outcomes for patients overall.”
Shaun Loong, a co-author of the study, added, “Revising our consent procedures would mean more flexibility to boost medical research that will directly benefit the local population and improve healthcare quality. Mandating consent is not the best or only way to protect participants when it comes to research using de-identified biospecimens. Instead, we can focus on stronger de-identification processes and establish oversight bodies to regulate the use of these biospecimens in research, which would go far in ensuring appropriate protection for our participants, at a limited cost to the progress of local research.”
Both Kylie and Shaun also work with Prof Roger Foo, Vice-Dean (Research) and Director of the Cardiovascular Metabolic Diseases Translational Research Programme at NUS Medicine—who is also a senior author of the paper.
