Theoretical Medicine and Bioethics 32 (5):301-313 (2011)

Authors
Ruiping Fan
City University of Hong Kong
Abstract
The family is the exemplar community of Chinese society. This essay explores how Chinese communitarian norms, expressed in thick commitments to the authority and autonomy of the family, are central to contemporary Chinese bioethics. In particular, it focuses on the issue of surrogate decision making to illustrate the Confucian family-grounded communitarian bioethics. The essay first describes the way in which the family, in Chinese bioethics, functions as a whole to provide consent for significant medical and surgical interventions when a patient has lost decision-making capacity. It is argued that the practice of not having an established order for surrogate decision makers (e.g., spouse, children, and then parents), as it is done in the United States, reflects the acknowledgment that the family as a social reality cannot be reduced to a stereotype of the appropriate order of default decision makers. This description of the family as being in authority to make surrogate decisions for an incompetent family member is enriched by an elaboration of the differences among the concepts of patient autonomy, family autonomy, and moral autonomy. The Chinese model, as well as the Confucian communitarian life of families, engages a family autonomy that is supported by a Confucian understanding of moral autonomy, rather than individual autonomy. Finally, the issue of possible conflicts between patient and family interests in relation to a patient’s past wishes in the Chinese model is addressed in light of the role of the physician
Keywords Bioethics  Communitarianism  Confucianism  Family  Surrogate decision making
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DOI 10.1007/s11017-011-9191-z
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References found in this work BETA

Moral Autonomy, Civil Liberties, and Confucianism.Joseph Chan - 2002 - Philosophy East and West 52 (3):281-310.
Truth Telling in Medicine: The Confucian View.Ruiping Fan & Benfu Li - 2004 - Journal of Medicine and Philosophy 29 (2):179 – 193.
Doctor-Family-Patient Relationship: The Chinese Paradigm of Informed Consent.Yali Cong - 2004 - Journal of Medicine and Philosophy 29 (2):149 – 178.
Informed Consent in Texas: Theory and Practice.Mark J. Cherry & H. Tristram Engelhardt - 2004 - Journal of Medicine and Philosophy 29 (2):237 – 252.

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