Wai-King Tsui

By Ka-Huen Yip, Mei-Kuen Chow, Yuk-Chiu Yip and Wai-King Tsui

As new mothers are understandably concerned about COVID-19 and its high rate of infection, they are often unsure if they should breastfeed their infants. In general, hospitals do not allow direct breastfeeding by mothers with an active infection of SARS-CoV-2. Some neonatal units in Hong Kong maintain safe practices by isolating infants and mothers for at least 7 to 14 days, even if the infant remains SARS-CoV-2 negative. During isolation, mothers encourage the expression of milk to maintain milk duct patency and to prepare for lactation when they and their infants are discharged. Infants are fed formula milk by cup feeding with added supplements based on the recommended daily feeding volume for neonates and their appetite during hospitalization. At present, data that indicates COVID-19 could be transmitted from mother to infant postnatally through breastfeeding are insufficient. Major organizations recommend that mothers should breastfeed exclusively for the first 6 months, and thereafter continue to provide their infants with breast milk up until the age of two or beyond. With new findings arising from research, updated information is important to reassure mothers that breastfeeding at home during the COVID-19 pandemic is safe and recommended for both the mother and the infant.

Part of the book: Selected Topics on Infant Feeding

By Yuk-Chiu Yip, Ka-Huen Yip and Wai-King Tsui

This chapter aims to explore the key developments in palliative care for patients with lung cancer. Lung cancer has high morbidity and mortality rates and is a leading cause of cancer-related death in the United States. Substantial evidence supports the adoption of a palliative care approach for patients with lung cancer. Palliative care aims at preventing and relieving suffering by identifying and treating debilitating symptoms early, supporting patients and their relatives to optimize coping and active living, and addressing any physical, psychosocial, and spiritual problems. An increasing number of studies show that introducing palliative care at an early stage can be beneficial for patients with advanced malignancies, including advanced lung cancer. Currently, newer palliative care approaches are being adopted, including multidisciplinary clinics and home- or community-based care. Furthermore, alternative care delivery models, such as telephone and telehealth-based approaches and outpatient palliative care, are becoming increasingly popular. However, further research is required to determine the best palliative care approach for patients with lung cancer. This chapter is a valuable contribution for both researchers and clinicians in this field, providing a more profound understanding of the existing findings in many key areas, from the developmental milestones to the adoption of holistic approaches in palliative care services for patients with lung cancer.

Part of the book: Supportive and Palliative Care and Quality of Life in Oncology

By Wai-King Tsui, Yuk-Chiu Yip and Ka-Huen Yip

Non-invasive prenatal testing (NIPT) demonstrates superior performance compared to conventional screening methods currently available within Hong Kong’s public healthcare system. Nevertheless, the substantial costs associated with NIPT render it inaccessible for much of the population, leading to ethical debates surrounding public funding. A conflict emerges between the imperative to allocate limited resources efficiently and the obligation to uphold ethical principles of equity and reproductive autonomy within the public healthcare system. Adopting a utilitarian-based approach, this chapter initially presents three central arguments suggesting that NIPT can be ethically integrated into the public healthcare system. Subsequently, the discussion examines the challenges associated with incorporating NIPT into Hong Kong’s strained public healthcare system. To address these challenges, we propose two potential solutions: (1) introducing NIPT as a second-tier screening test for high-risk pregnancies, or (2) offering NIPT through public-private partnerships, which would alleviate the demand on public sector resources. Implementing a nominal fee for NIPT adheres to the principle of impartiality in public resource allocation, ensuring equitable decision-making without favoring specific population groups. Ultimately, the future of NIPT in Hong Kong necessitates expanding its availability, enhancing its accuracy, and incorporating it into comprehensive prenatal care. This approach will support the reproductive autonomy of pregnant women and promote accessible healthcare.

Part of the book: Contemporary Issues in Clinical Bioethics [Working title]