Evolving legal responses to dependence on families in New Zealand and Singapore healthcare.

Healthcare decision-making has traditionally focused on individual autonomy, but there is now a change occurring in which the involvement of families is gaining prominence. This appears to stem from an increasing emphasis on relational aspects of autonomy which recognises the individual's connectedness to their family, and also state reliance upon families to share the burdens and costs of caring for elderly and disabled dependents. Such a reorientation calls for similar legal emphasis on patient autonomy as understood in relational terms, and one that offers more adequate conceptions of independence, confidentiality and decision-making authority in the light of this change. This paper outlines how two common law jurisdictions, New Zealand and Singapore, have accommodated, or are responding to, these changes.