Volume 23, Number 3: March 2022
Dr. Cynthia Goh (photo used with permission)
Tribute to Dr. Cynthia Goh
Dr. Cynthia Goh, a palliative care pioneer, was inducted to the Singapore Women’s Hall of Fame in 2014 for her tireless work in furthering pain relief and hospice and palliative care in Singapore and beyond. She founded the Lien Centre for Palliative Care, Asia’s first palliative care research and training center, and she headed the Department of Palliative Medicine at Singapore’s National Cancer Centre—which led to palliative medicine being recognized in Singapore as a medical sub-specialty. Her death was unexpected, as her illness had been kept private.
On February 13, 2022, the palliative care community in Singapore and beyond said goodbye to Associate Professor Dr. Cynthia Goh, a pioneer and champion of hospice and palliative care. Graduating in medicine at St. Batholomew’s Hospital, University of London, in 1974, she was not just an astute clinician but also a researcher with a PhD in molecular biology.
She became interested in caring for the terminally ill from 1986 when she volunteered her services to St. Joseph’s Home and Hospice in Singapore, then worked in other charitable sectors. Cynthia was convinced that to make real change, palliative care must be brought into the main health care system. An appointment to start palliative care at the National Cancer Centre Singapore followed and, subsequently, she influenced many more services and training, firmly establishing palliative care in Singapore, where it has continued to thrive.
Cynthia’s influence soon spread. In 1995 at the request of Japan’s Chair of the Life Planning Centre, Dr. Shigeaki Hinohara, Cynthia and several other leaders of palliative care in the region met for a series of meetings that eventually gave birth to the Asia Pacific Hospice Palliative Care Network (APHN) in 2001. By linking together, those working in isolation could derive support from regional colleagues and, in doing so, cultivate hospice and palliative care services aligned with their region’s values.
She worked tirelessly both in Singapore and across the region, teaching, communicating, and pushing the palliative care agenda with donors, governments, and policy makers. A visionary and strategic planner, she was able to get others to share her vision and work with her. She saw potential in many younger health care workers and sought to nurture them in their careers. She led from the front. An astute clinician, she modelled palliative care in the way that it should be practiced, and those who learned from her cherish the lessons handed down.
Cynthia served as Chair of APHN from 2009 to 2021, overseeing and influencing the development of palliative care in many countries. She was instrumental in the formation of the Worldwide Hospice Palliative Care Alliance and was its first co-chair with David Praill. She also contributed greatly in the areas of pain and cancer control both regionally and globally.
With her leadership, palliative care in the Asia Pacific region grew. A highlight of her achievements with APHN include establishing a Graduate Certificate and Diploma in Palliative Care, a project involving Flinders University, Australia, and the Lien Collaborative.
It has been such a privilege to have worked with her over the past 25 years. Initially it was about honing clinical skills, then teaching, and subsequently about strategic planning and advocacy.
Even when she was diagnosed with pancreatic cancer, she continued to work tirelessly and selflessly. She leaves behind more than just a legacy of work that is enshrined in the services throughout the region. She cultivated values that she has lived by, taught, and encouraged in all who spent some time with her in this world of hospice and palliative care. She will be missed, but not forgotten.
— Dr. Ednin Hamzah, CEO of Hospis Malaysia and
Chair of the Asia Pacific Hospice Palliative Care Network
Dr. Cynthia Goh was a palliative care pioneer and internationally well known for her significant contributions within the Asia Pacific region and across the world. She was instrumental in getting palliative medicine recognized as a medical subspecialty in Singapore in 2006. Dr. Goh served as the Chair of the Board of the Asia Pacific Hospice Palliative Care Network (APHN), and under her leadership the organization grew to become a force for palliative care development in the region. Her efforts as a clinician, leader, teacher, mentor, and care provider helped transform health care in the region and improved the quality of life of many patients and their families.
We are saddened by Dr. Goh’s passing and are grateful to have had the opportunity to collaborate with her and with the APHN to advance palliative care and hospice care in the world. Dr. Goh will be missed by many.
— Lukas Radbruch, Chair of the IAHPC, and
Liliana De Lima, Executive-Director of the IAHPC
Cynthia Goh became an intrinsic part of the palliative care scene in India. We always looked forward to her informative and well-delivered talks at the annual conference of the India Association of Palliative Care. When I thought of starting home-based palliative care in New Delhi, I visited Singapore on a Union for International Cancer Control [UICC] Fellowship. It was an opportunity to acquaint myself with the pioneering work of both Cynthia Goh and Rosalie Shaw, as well as meet my compatriot Akhileswaran Ramaswamy, who had just taken over Dover Park Hospice. It was a memorable visit that helped shape my ideas on hospice and home-based palliative care. All of us at CanSupport deeply mourn Cynthia’s passing. Her dedication will continue to inspire us.
— Harmala Gupta, Founder-President of CanSupport, India
Cynthia and I worked together in Singapore in the 1980s. WHO had just published and distributed its Cancer Pain Relief guideline, which described the three-step analgesic ladder. The Ministry of Health held a public meeting about it that we all attended. The anesthesiologists were opposed to using morphine, saying that people would get addicted, but the Minister of Health—President Lee Kuan Yew’s son—allowed it. Cynthia talked to him because he had seen his sister die in agony without the benefit of morphine, and he wished she had it then!
The only morphine-based pain reliever that pharmacists had access to at that time was the Brompton cocktail. The problem was that the sedatives would put patients to sleep: the morphine dosage wasn’t titrated and didn’t necessarily control the pain.
So we worked on making a pure morphine solution, with the powder, distilled water, and a preservative. We didn’t add dye to show the different strengths. Patients did not have to pay for it. Every time I visited Singapore after I had moved to Africa, Cynthia and I went out to a restaurant. She took me to the best restaurants and fed me well! The last time I met her there was 2018.
She did for Singapore what I am doing here in Africa. She carried on with training for doctors and other health professionals and went to South Asian countries to get them started. I was amazed at what they did. Every time I met with Cynthia, I was more impressed with what she was doing and what she had become. She spoke beautifully and she was a member of the World Hospice Palliative Care Alliance. The last time I saw her, she had come to say goodbye to [her son] Charles and his family. She said, “I know I’m going to die. I’m OK but I just need to say goodbye to the family.” And then we talked about Mary Baines and the people she knew who had died and who she was going to meet in heaven. She was a very spiritual person.
— Dr. Anne Merriman, Founder of Hospice Africa Uganda