Running Head: ANALYSIS OF DR.

SUSAN LIM CASE 1

Analysis of Dr. Susan Lim Case

Subject
Professor’s Name
Date
Word Count: 2000
Running Head: ANALYSIS OF DR. SUSAN LIM CASE 2

1. Introduction
Counseling psychology labels the emotional, social, work, school, and physical
health that analyzes and discusses the expected life distress and more serious matters in the
different stages in their lives (APA Org, n.d.). Counselors take a ton of trial and error of
decision-making to assess, clarify, categorize, and respond to the client's concerns who use
professional skills and knowledge (Dietz n.d.). They supervise and take peer consultation
that concern ethics, which are the standards of behaviors given by the American Counseling
Association (ACA) or American Psychological Association (APA). Thoroughly, the ethical
dilemma concerning the case of Dr. Susan Lim can be assessed through the ethical and
professional decision-making process. Thus, her unethical actions towards her patients
cause her to be found guilty of professional misconduct, which made her fined $10,000 and
been suspended for three years in her medical career (Khalik 2014).

2. Evaluation of Moral Theories

2.1. Deontology Theory
The word "deontology come from the Greek words duty (deon) and science (or study)
of (logos)" (Barrow & Khandhar 2020). It is a kind of normative theory that requires
choices that shall adhere to the moral standards and forbidden or permitted, which are being
assessed and guided with moral theories. It is associated with the philosopher, Immanuel
Kant who believed in the universal law, "don't lie, don't steal, don't cheat" it is wrong to kill
innocent people, to steal, tell lies, and right to keep promises (Ethics Unwrapped, n.d.). It is
really simple to apply, which requires people to follow the rules and do their duties and
responsibilities, thus, judging actions about what isn't ethical.

2.2. Limitations
Just like any other theory, deontology also has limitations. First, this theory does not
require weighing in the costs of the situation and the benefits being given (Barrow &
Khandhar 2020). In short, the consequences of the doings cannot be minded in this theory.
Second, this theory ignores the part of the community in ethics (Barrow & Khandhar 2020).
Lastly, it does not support the significance of emotions, such as empathy, which is
important in showing morality by people (Barrow & Khandhar 2020).
Running Head: ANALYSIS OF DR. SUSAN LIM CASE 3

2.3. Application of Deontology Theory on ‘Dr. Susan Lim Case’

Thoroughly, the application of deontology theory on Dr. Susan Lim's case is
morally correct without the fact that her patient died eventually. Also, there is no
reasonable and fair fee charge mentioned by the Singapore Medical Council (SMC) about
her treatment, and so, there is no real "fair price" for the service she conducted (Khalik,
2014). Because of this, Dr. Susan can still be considered not guilty because all she ever
wanted is to treat her patient in any circumstances.

2.4. Limitations of Deontology Theory on ‘Dr. Susan Lim Case’

Hence, there are also limitations that deontologists can see in the case of Dr. Susan
Lim. First, deontology never considers the emotions of anyone; that is why the theory does
not mind the emotions being shown by the patient; it is being disregarded. The second
limitation that can be perceived in deontology theory was regardless of the patient's death,
Dr. Susan Lim still treats the patient, Pengiran Anak Hajah Damit. The theory is all about
the professionalism of Dr. Lim and her eagerness to treat the patient, but regardless of the
emotions.

2.5. Teleology Theory

On the other aspect, teleology theory is about "rational human actions in the sense
that we reason about the means of achieving certain ends." (Ismail & Benlahcene 2018).
Unlike the deontology theory, the teleology theory takes the consequences of actions
seriously; it makes the actions good or bad, right or wrong. For example, stealing can only
be declared right or wrong depending on whether the outcomes are right or wrong.

2.6. Limitations
Although teleology theory analyzes the acts for whether these are bad or good by
how the consequences will be, anyone cannot really assure that the action can come up with
a positive result. Of course, doctors and not even other medical professionals can't assure
anyone if the results will favor anyone. The counselor can only assist the patient with their
emotions but cannot assure any good results. And so, the session cannot be helpful, not
destructive.
Running Head: ANALYSIS OF DR. SUSAN LIM CASE 4

2.7. Application of Teleology Theory to ‘Dr. Susan Lim Case’

In the case of Dr. Susan Lim, the application of the theory can be acceptable by
analyzing the results and outcomes of the service and treatment done by Dr. Susan Lim.
Her rightness of action can be determined in the quality of treatment she provides as a
doctor, in the hopes of treating the patient with the best she can. But, the extra charges that
have become the main issue is the patient had no guarantee that she will receive successful
treatment. In the end, the doctors and other medical professionals give their best efforts to
successfully help their patients recover regardless of the extra or excessive fees they can
charge from it.

2.8. Limitations of Teleology Theory on ‘Dr. Susan Lim Case’

Thus, Dr. Lim ignores the consequences that her "unfair fee charges" can make to
her personal and professional life. Her actions are only judged as wrong because the
consequences take her to be fined $10,000, and worst she is being suspended for three years
as a surgeon (Khalik 2014). As a result, Dr. Lim faces many challenges as she did not
think about the future result of overcharging her patient, regardless of its status in life.

3. Ethical/ Moral Dilemma

Dr. Susan Lim has faced two main ethical dilemmas, as I found in my assessment
from her case. First is overcharging the Bruneian patient, Pengiran Anak Hajah Damit,
followed by the second one fighting the lawsuit against her. As stated above, overcharging
the patient goes against the professional code of conduct of the American Counseling
Association (ACA), which governs the supervision of the standard of medical ethics.
Similarly, on the other aspect, charging her patient with such an amount reflects that she is
trying to earn just for her personal choices and earnings. Thus, it is between the choice of
following the professional ethics or her personal best. The second one is when she was
fighting against the lawsuit being charged to her. Hence, her plan to reveal some of the
confidential information about the Brunei family added to the weight of the file being
charged to her.
Running Head: ANALYSIS OF DR. SUSAN LIM CASE 5

4. Ethical Decision-Making
4.1. Gathering the facts
Afterward is the first step of ethical decision-making, gathering the facts based on
Dr. Susan Lim's case. Dr. Susan Lim is one of Singapore's finest doctors who was allowed
to privately treat the Bruneian royalty, Pengiran Anak Hajah Damit, for her breast cancer
(Khalik 2014). She treated her patient for a span of seven months and charged her with a
whopping amount of $24.8million (ASEAN Plus News, 2011). But despite all the
treatments she received, Pengiran died in August 2007. Regardless of this fact, the Royal
family paid her bills in full, which are submitted until March 27, 2007 (Asean Plus News,
2011). After this incident, Dr. Lim was interrogated with the rest of the bill in the year
2007, which has cost the patient over $26 million (ASEAN Plus News, 2011).
Accordingly, the truth has been revealed that Dr. Lim is extremely overcharging the
patient for about $29,600 to $660,000 each day (Asiaone n.d.).

4.2. Defining the Ethical Issue

It was followed by the second ethical decision-making, defining the ethical issue.
Relatively, the biggest ethical issue that Dr. Susan Lim has faced is the fact that she
overcharged her patient—overcharging the royal patient and being consistent with pursuing
her personal benefits on earning a livelihood. Even if the Royal Family has extreme power
and a huge amount of money, her overcharging is not really reasonable, despite the fact that
there is no ethical code of charging fees to the patient.

4.3. Identifying the affected parties

Come after is the third step of ethical decision-making, identifying the affected
parties. According to the case, there are main and minor stakeholders that have been
affected by the problem. The Singapore Medical Council (SMC) and Dr. Susan Lim are
both main stakeholders that have been directly affected by the problem. Meanwhile are the
minor stakeholders that are composed of the Royal Family and the Brunei Government.
Running Head: ANALYSIS OF DR. SUSAN LIM CASE 6

4.4. Identifying the Consequences

Moreover is the fourth step of ethical decision-making, identifying the
consequences. The main stakeholders are Dr. Susan Lim and the Singapore Medical
Council (SMC). Both parties have taken positive and negative consequences. Dr. Susan
Lim was punished with three year-suspension to her medical field and a fined of $10,000
(Khalik 2014). Thus, the Singapore Medical Council (SMC) has been interrogated by other
doctors' ethics practice in Singapore. As part of its positive consequences, the board council
implemented a probable ceiling of giving fees to the patients, which can be agreed upon by
the medical professionals.

4.5. Identifying the relevant principles, rights, and justice issues.

Continually is the fifth step of ethical decision-making, identifying relevant
principles, rights, and justice issues. The relevant principle, in this case, would be the
principles of Guo (2020), which is businesses who utilize ethical pricing strategies to sell
their products and earn a profit are far more respected than those that defraud competitors
and consumers. Following are the rights of ‘Respecting,' which Dr. Lim loses because of
her unethical action. Last, of all, the case is judged on procedural justice since it has
undergone legal judgment under Singapore Medical Council (SMC).

4.6. Considering character and integrity.

Furthermore is the six-step of ethical decision-making, considering character and
integrity. Thus, the virtue that applies to the said issue is professional integrity. Professional
integrity is an act of showing strong adherence to moral and ethical principles such as
dependebality, honesty, and many more (Ericksen 2015). Nonetheless, Dr. Susan Lim failed to
showcase her professional integrity as she has chosen to pursue her personal benefit of earning,
taking advantage of the fact that her client is a Royal Family, over her professional reputation.

4.7. Thinking Creatively about Potential Actions

The second to the last step of ethical decision-making is thinking creatively about
potential actions. Given the case of Dr. Lim, as a counselor, I will suggest the five potential
actions for her case: seeking to apologize from the Royal family, publicly admit her
Running Head: ANALYSIS OF DR. SUSAN LIM CASE 7

wrongdoings, giving her license up, rebuilding the treatment fees, and/or repaying the
treatment fees back to the Royal family in full. Thus, Dr. Susan Lim is more likely to
choose the more favorable actions of rebuilding the treatment fees and apologizing to the
royal family.

4.8. Checking the gut

Finally,, is the last step of ethical decision-making, checking the gut. The actions
suggested above seem to resolve the issue. The doctor can seek an apology and rebuild the
treatment fees for a fair charge. If the Royal Family accepted her apology and considers her
rebuilding treatment fees, she can avoid three years suspension of her professional license
and a fine of $10,000.

5. Personal Reflection on Applying Ethics in Personal Life

As a person, Dr. Susan Lim's case concerning ethical issues has made me aware of
my understanding of ethics and even moral dilemmas. Being greedy and being hungry for
money instead of considering the reputation and the care can bring serious damages and
consequences to anyone. People shall be fulfilled with what they have, whether they are
professional or not. But if we want to have more, then we shall learn to work harder and
earn it reasonably from working hard. By this, no one will have to suffer, and even our
reputation can even gain more demand instead of being degraded.

6. Personal Reflection on Applying Ethics in Professional Life

In the case of Dr. Lim, I have learned to ask for references or even ask queries from
others. We should not take it all like we know everything but rather accept that we still
need guidance and assurance from other people, even if we have been in the field for so
long. Also, being fair and working harder for better and more income can help me earn
more and attain more. It has been reasonable for me to work part-time in F&B Retail for
years (waiting for the client confirmation here, don't mind it). Success can only be attained
if we try to seek advice from others and hard work.
Running Head: ANALYSIS OF DR. SUSAN LIM CASE 8

7. Conclusion
In conclusion, the Code of Ethics being involved in the above case are counseling
interaction and discretion. Thus, counselors must always consider the well-being of their
clients while creating limitations to build up a better professional relationship. For the final
verdict, Dr. Susan Lim's unprofessional and unethical behavior that causes ethical issues
can be resolved through various ethical decision-making steps.
Running Head: ANALYSIS OF DR. SUSAN LIM CASE 9

6. References
APA Org. (n.d.). Counseling Psychology. American Psychological Association Updates.

https://www.apa.org/ed/graduate/specialize/counseling

ASEAN Plus News. (2011). Surgeon defends Brunei royal's medical charges for seven-month

treatment. ASEAN Plus News Updates.

Asian. (n.d.). Surgeon billed Brunei patient $40m over 4 years. Asiaone Updates.

https://www.asiaone.com/health/surgeon-billed-brunei-patient-40m-over-4-years

Barrow, J., & Khandhar, P. (2020). Deontology. National Center for Biotechnology Information, U.S.

National Library of Medicine.

Dietz, S. (n.d.). Counselor Role, Function, and Job Satisfaction. Wiley Online Library, 12(2), pp. 150-

155. https://onlinelibrary.wiley.com/doi/abs/10.1002/j.1556-6978.1972.tb01943.x

Ericksen, A. (2015). What is professional integrity? Nordic Journal of Applied Ethics, 9(2), pp. 3-17.

Ethics Unwrapped. (n.d.). Deontology. Ethics Unwrapped Updates.

https://ethicsunwrapped.utexas.edu/glossary/deontology

Guo, V. (2020). Ethics and Pricing: 5 Must-Know Pricing Ethics Issues and How to Avoid Them. Price

Intelligently Updates.https://www.priceintelligently.com/blog/bid/164830/5-must-know-

pricing-strategy-ethics-issues?fbclid=IwAR29urYTuc3znoYJp_gmyFSXSfK5NY-

J7HOPcekKW83wAo4VQbQSk5SDr_0

Ismail, N. S. A., & Benlahcene, A. (2018). A Narrative Review of Ethics Theories: Teleological &

Deontological Ethics. Journal of Humanities and Social Science, 28(7), pp. 31-38.
Running Head: ANALYSIS OF DR. SUSAN LIM CASE 10

Khalik, S. (2014, November 7). Brunei health ministry wants a “fair” bill, not a discount from Dr.

Susan Lim. The Straits Time. https://www.straitstimes.com/singapore/health/brunei-health-

ministry-wants-a-fair-bill-not-discount-from-dr-susan

limhttps://plato.stanford.edu/entries/ethics-deontological/