This paper argues against the continued practice of Confucian familism, even in its moderate form, in East Asian hospitals. According to moderate familism, a physician acting in concert with the patient's family may withhold diagnostic information from the patient, and may give it to the patient's family members without her prior approval. There are two main approaches to defend moderate familism: one argues that it can uphold patient's autonomy and protect her best interests; the other appeals to (...) cultural relativism by construing the principle of ‘family autonomy’ to be incommensurable with that of individual autonomy. We respond to the first approach by explaining how the familist arguments either depend on some unreasonable assumptions or simply fail to articulate. The critique of the second approach is based on our recent survey showing that there is no dichotomy of relevant values between the East and the West: we believe that the result can effectively block the familist's reliance on certain traditional or cultural values to explain their resistance to the incorporation of pluralist values. Despite our disagreement with familism, we consider the Eastern emphasis on the family to be conducive to the communication between patient, family members and medical personnel, which is indispensible to the patient's well being and autonomy. We conclude that respect for patient autonomy is perfectly consistent with the involvement of the family in making medical decision as long as the family plays a merely consultant role. (shrink)

This paper argues against the continued practice of Confucian familism, even in its moderate form, in East Asian hospitals. According to moderate familism, a physician acting in concert with the patient's family may withhold diagnostic information from the patient, and may give it to the patient's family members without her prior approval. There are two main approaches to defend moderate familism: one argues that it can uphold patient's autonomy and protect her best interests; the other appeals to (...) cultural relativism by construing the principle of ‘family autonomy’ to be incommensurable with that of individual autonomy. We respond to the first approach by explaining how the familist arguments either depend on some unreasonable assumptions or simply fail to articulate. The critique of the second approach is based on our recent survey showing that there is no dichotomy of relevant values between the East and the West: we believe that the result can effectively block the familist's reliance on certain traditional or cultural values to explain their resistance to the incorporation of pluralist values. Despite our disagreement with familism, we consider the Eastern emphasis on the family to be conducive to the communication between patient, family members and medical personnel, which is indispensible to the patient's well being and autonomy. We conclude that respect for patient autonomy is perfectly consistent with the involvement of the family in making medical decision as long as the family plays a merely consultant role. (shrink)

Modern Western medical individualism has had a significant impact on health care in China. This essay demonstrates the ways in which such Western-style individualism has been explicitly endorsed in China’s 2010 directive: The Basic Norms of the Documentation of the Medical Record. The Norms require that the patient himself, rather than a member of his family, sign each informed consent form. This change in clinical practice indicates a shift toward medical individualism in Chinese healthcare legislation. Such individualism, however, is incompatible (...) with the character of Chinese familism that is deeply rooted in the Chinese ethical tradition. It also contradicts family-based patterns of health care in China. Moreover, the requirement for individual informed consent is incompatible with numerous medical regulations promulgated in the past two decades. This essay argues that while Chinese medical legislation should learn from relevant Western ideas, it should not simply copy such practices by importing medical individualism into Chinese health care. Chinese healthcare policy is properly based on Chinese medical familist resources. (shrink)

This paper reports two cases in Hong Kong involving two native Chinese adolescent cancer patients (APs) who were denied their rights to consent to necessary treatments refused by their parents, resulting in serious harm. We argue that the dynamics of the ‘AP‐physician‐family‐relationship’ and the dominant role Chinese families play in medical decision‐making (MDM) are best understood in terms of the tendency to hierarchy and parental authoritarianism in traditional Confucianism. This ethic has been confirmed and endorsed by various Chinese writers from (...) Mainland China and Hong Kong. Rather than giving an unqualified endorsement to this ethic, based more on cultural sentimentalism than rational moral reasoning, we warn that a strong familism in MDM, which deprives ‘weak’ family members of rights, represents the less desirable elements of this tradition, against which healthcare professionals working in this cultural milieu need to safeguard. Specifically for APs, we suggest that parental authority and family integrity should be re‐interpreted in terms of parental responsibility and the enhancement of children's interests respectively, as done in the West. This implies that when parents refuse to consent to necessary treatment and deny their adolescent children's right to consent, doctors, as the only remaining advocates of the APs' interest, have the duty to inform the state, which can override parental refusal to enable the doctors to fulfill their professional and moral obligations. In so doing the state exercises its ‘parens patriae’ power to defend the defenseless in society and the integrity of the medical profession. (shrink)

Charles Taylor criticizes many liberal theories based on a kind of atomism that assumes the individual self-sufficiency outside the polity. This not only causes soft-relativism and political fragmentation but also undermines the solidarity of the community, that is, the very condition of the formation of autonomous citizens. Taylor thus argues for communitarian politics which protects certain cultural common goods for sustaining the solidarity of the community. However, Brenda Lyshaug criticizes Taylor’s communitarianism as suppressing plurality and enhancing hostility among cultural groups. (...) In the face of such controversies, I argue for modern Confucian familism which emphasizes the family as a common good that provides a safe, stable, and nurturing environment for nurturing children and cultivating civility for future generations with a sense of community and autonomy. I also defend Confucian familism from four possible criticisms: insufficiency of familism, hierarchical relationship in the family, the danger of nepotism, and challenge from postmodern families. I argue that unlike traditional Confucianism, modern moderation of the Confucian family can greatly reduce the hierarchical problem; its emphasis on the family as one of the foundations of politics can avoid the danger of being atomistic liberalism and suppressive communitarianism. (shrink)

This paper reports two cases in Hong Kong involving two native Chinese adolescent cancer patients (APs) who were denied their rights to consent to necessary treatments refused by their parents, resulting in serious harm. We argue that the dynamics of the 'AP-physician-family-relationship' and the dominant role Chinese families play in medical decision-making (MDM) are best understood in terms of the tendency to hierarchy and parental authoritarianism in traditional Confucianism. This ethic has been confirmed and endorsed by various Chinese writers from (...) Mainland China and Hong Kong. Rather than giving an unqualified endorsement to this ethic, based more on cultural sentimentalism than rational moral reasoning, we warn that a strong familism in MDM, which deprives 'weak' family members of rights, represents the less desirable elements of this tradition, against which healthcare professionals working in this cultural milieu need to safeguard. Specifically for APs, we suggest that parental authority and family integrity should be re-interpreted in terms of parental responsibility and the enhancement of children's interests respectively, as done in the West. This implies that when parents refuse to consent to necessary treatment and deny their adolescent children's right to consent, doctors, as the only remaining advocates of the APs' interest, have the duty to inform the state, which can override parental refusal to enable the doctors to fulfill their professional and moral obligations. In so doing the state exercises its 'parens patriae' power to defend the defenseless in society and the integrity of the medical profession. (shrink)

The family could be mobilized as a political resource for economic 'development'. What kind of family would be compatible with a knowledge-based economy? We argue that authoritarian Confucian familism is incompatible with the knowledge-based economy; but it is possible to construct a different model of the ideal Confucian family which will be compatible with such an economy: a family ideal that emphasizes internal strengths of relationships rather than building barriers to keep out 'undesirable influences', that advocates a respect for (...) authority that is authoritative rather than authoritarian. (shrink)

This paper examines the practice of informed consent in Hong Kong by drawing on structured interviews conducted with eleven physicians, three patients, and four family members primarily at a well-established public hospital in Hong Kong. The findings of this study show that the Hong Kong approach to medical decision-making lies somewhere between that of America on the one hand, and mainland China on the other. It is argued that the practice of medical decision-making in Hong Kong can be modeled by (...) a moderate familism that is directed towards achieving the best interests of the patient (1) as understood by the physician, (2) in consultation with the family, (3) under the prima facie presumption that consent is not required for disclosure of information to the family, (4) while aiming at an eventual albeit frequently partial and vague disclosure to the patient. (shrink)

유가전통(儒家傳統)과 유가정치사상(儒家政治思想)은 한국정치 후진성의 원인으로 줄곧 지목된다. 이 통념에서 주로 지적되는 폐단은 유가적 정치원리가 가족적 질서를 국가 영역으로 확대·적용함으로써 궁극적으로 공공 영역 확립을 방해한다는 것이다. 이는 소위 “유교 가족주의”의 폐단이다. 본고는 이 폐단이 나올 수밖에 없는 그 사상 내적인 요인이 무엇인지 살펴본다. 특히 그 문제점이 파벌과 권위주의의 중첩에 있음을 지적하고, 이를 “유교 가족주의의 이중성”이라고 편의상 명명한다. 본고가 주목하는 요인은 유가정치사상의 특징 중 하나인 “의제(擬制)적 확대”이다. 이 기제가 유가전통의 두 중핵인 인(仁)과 의(義)에 연관되어 어떻게 작동하는지 살펴봄으로써, 파벌과 권위주의의 유교 내적 원인에 (...) 좀 더 체계적으로 접근한다. 이를 바탕으로 그 폐단을 극복할 수 있는 가능성이 유가정치사상에 이미 내재하는지, 그리고 만일 내재한다면 어떤 한계를 노정하는지도 또한 고찰한다. (shrink)

This essay argues that the Chinese Mental Health Act of 2013 is overly individualistic and fails to give proper moral weight to the role of Chinese families in directing the process of decision-making for hospitalizing and treating the mentally ill patients. We present three types of reactions within the medical community to the Act, each illustrated with a case and discussion. In the first two types of cases, we argue that these reactions are problematic either because they comply with the (...) law but undermine the patient’s interests by refusing the family’s request to have the patient hospitalized, or violate the law by hospitalizing patients in response to the real concerns of their families. In the third type of situation, psychiatrists inappropriately encourage families to produce evidence of the patient’s behavior that is harmful to self or others in order legally to commit the patient. Each of these problems, we conclude, should be tackled by supplementing Article 30 of the Act with the stipulation that a psychiatrist may authorize the involuntary hospitalization of a patient, who is not at risk of causing physical harm to self or others, with the consent of all major family members. Drawing on the deeply culturally embedded moral traditions of Confucian medical familism, this proposal would facilitate the proper treatment of a significant number of Chinese mentally ill patients under the care of their families. (shrink)

The ethnic-Chinese business is often characterised by a central role of the family both in the structure of the firm and in its corporate culture. This has political, social as well as cultural reasons. The centrality of the family in business has its advantages and disadvantages. On the one hand, it enables a fast, efficient and flexible process of decision-making. On the other hand, it often contradicts modern business professionalism. The younger generation of ethnic-Chinese business actors tend to preserve crucial (...) elements of such family-centred characteristics. Yet, globalisation drives them to transform their business style, lessening its dependence on family resources and adopting more-modern professional ideas. Changes in current political situation, religious-cultural trend, demography and education contribute to making possible the transformation. (shrink)

In the past 20 years, Latinas have begun to outperform Latinos in high school completion and college enrollment, tracking the overall “gender reversal” in college attainment that favors women. Few studies have examined what factors contribute to Latinas’ increasing educational success. This article focuses on gender differences in college-going behavior among a cohort of 50 Latino/a college aspirants in the San Francisco East Bay Area. Through 136 longitudinal interviews, I examine trends in Latinos/as’ postsecondary pathways and life course decisions over (...) a two-year period. Findings suggest evidence for gendered familism, in which gender and racial/ethnic beliefs intersect to differentially shape Latinos/as’ attitudes, behaviors, and college choices. Gendered familism encouraged Latinas to seek a four-year degree as a means of earning independence, while Latinos expressed a sense of automatic autonomy that was not as strongly tied to educational outcomes. (shrink)

This article examines the recent transformations of the Italian welfare state from a familist welfare model to what I term transnational market familism. In this model, families buy in care labour, commonly provided by migrant workers. There is now a growing literature exploring both the transformations of the Italian welfare model and the experiences of migrant workers providing care in Italy. However, what has been overlooked in the current literature is the ethical aspect of this model of welfare provision, (...) which is part of the transnational political economy of care. The article analyses the ethical implications of the migrant-in-the-family model, which transforms the care relationship between the caregiver and care receiver into a complex relationship between the family member organising care, the migrant caregiver and the dependent care receiver. The context of such welfare provision is transnational. Examining this care triangle, I draw on care ethics and individualization perspective for an analysis of how social policies safeguard, or overlook, human interaction and care relationships in the context of global hierarchies. The article draws on ethnographic data gathered in Naples, Italy, during 2004–2005, including interviews with Neapolitan employers and elderly care-receivers, interviews with migrant workers, as well as participant observations. (shrink)

In Conditions of Liberty, Ernest Gellner defines civil society as a unique modern condition in which a "modal self"—a moral agent liberated from "the tyranny of cousins or of rituals"—entertains an unprecedented amount of personal freedom.1 Otherwise stated, moral individualism is the foundation of a modern civil society where people encounter each other qua individuals (i.e., strangers). In line with this view, the predominant, formal-judicial, understanding of civil society in the recent social sciences2 is too limited, because its exclusive emphasis (...) on the notion of society as standing between the family and the state obliterates the moral significance of civil society as a home for individual agency and .. (shrink)

본 연구는 조폭영화가 오늘날 한국 사회의 사회문화적 맥락 속에 침잠되어 있는 가족주의 습속규범과 어떤 관계가 있는지를 살펴보고자 한다. 또한 조폭영화를 통해 2000년대 이후 이 시대의 사회문화적 맥락 속에서 살아 숨쉬고 있는 왜곡된 가족주의를 드러내고자 한다. 조폭영화에 드러난 가족주의는 도덕적 가족주의나 정서적 가족주의의 형태로 피상적으로 표층에 보이기도 한다. 그러나 도구적 가족주의, 이기적 가족주의, 유사 가족주의 등의 보다 심층적 형태가 기층에서 나타남을 보여주고 있다. 2000년대 초창기의 조폭영화들, 예컨대 이나 가 이기적 가족주의나 유사 가족주의를 기층으로 가지면서 가족주의를 풍자반영하면서도 피상적으로 옹호하는 성향을 가졌다면 는 (...) 가부장적 가족주의를 표층으로 반영하면서도 극복되지 못함을 보여주고 있다. 또한 나 등은 도구적 가족주의나 이기적 가족주의 또는 유사 가족주의를 기층에서 보여주면서 왜곡된 가족주의를 깊이있게 비판하고 있음을 알 수 있다. 문제는 우리 사회에서 해악을 준다고 볼 수 없는 도덕적 가족주의나 정서적 가족주의 대신에 도구적, 이기적, 유사 가족주의 등 왜곡된 가족주의가 지배적으로 반영풍자비판되어진다는 점이다. 조폭영화는 왜곡된 가족주의가 횡행하는 시대에 그를 대체할 새 관계 유형을 만들어내려는 규범이 필요함을, 지속적으로 공적 정의와 신뢰를 허물고 있는 왜곡된 가족주의가 보다 나은 사회규범과 정의로운 사회제도를 위해 청산되어야 함을 보여주고 있다. (shrink)

This paper seeks to explore the limits of individualizing parenthood in Serbia, gleaned from the example of gender socialization of children. The main thesis is that the noted limits to individualization of parenthood in contemporary society have a particular Serbian manifestation due to the country’s familism. The study traces the ideology of familism through normative aspects of gender structures within contemporary Serbian society, that is, by analyzing the presence and forms of expression of the patriarchal matrix in upbringing (...) practices of parents, the most significant element of which is the ethics of good parenthood. The analysis shows that individualization of parenthood and more egalitarian patterns of gender socialization occur above all due to the dynamic within the marital relationship, one which abandons the concept of sacrificial parenthood. The analysis presented here is based on data collected in empirical research of upbringing practices in contemporary Serbia. (shrink)

Corporate social responsibility (CSR) has become increasingly popular in advanced economies in the West. In contrast, CSR awareness in Asia is rather low, both on the corporate and state level. However, recent events have shown that the CSR is receiving more attention by corporations in Asia. Recent development in CSR in Taiwan is one example of such a trend. A 2005 survey on the 700 publicly listed companies in Taiwan on␣CSR has highlighted the current CSR situation. Concurrently, the numbers of (...) corporate scandals and corruption have dramatically increased over the past 6 years. Corporate CSR activities co-existing with pervasive corporate scandals create a phenomenon of contradictions. This article aims to report via the survey findings the current development of business ethics in corporate Taiwan; and to interpret the findings in context of Taiwan’s business ethos, especially its Confucian familism and crony capitalism. (shrink)

In this review of Fan Ruiping’s book, I am concerned first of all about how representative his account of Confucianism/Ruism is in relationship to the multiform traditions associated with that teaching through more than two thousand years of its existence. Fan emphasizes pre-imperial forms of Confucian traditions, but neglects many alternatives from later sources. Secondly, his account of “familism” lends itself to questions related to the problem of revenge that is associated with traditional Confucianism. This raises further ethical doubts (...) about the effectiveness of his reconstructed Confucianism within contemporary Chinese society. Finally, his “familism” appears to focus on extended family structures, but whether this is suitable and relevant for the structures of modern family transformations in mainland China is questioned. (shrink)

The ’new familists’ argue that sociological evidence on the relation between traditional two‐parent nuclear family and positive outcomes for their children justifies public‐policy measures aimed at promoting this type of family. But the success of such families is due to the fact that many other institutional arrangements advantage this type of family. Such a family typically involves a sexist division of domestic labour. A ’critical theory of family structure’ identifies the developmental needs of children and examines the ways in which (...) various family structures can function to meet these needs. (shrink)

ABSTRACTThe discursive analysis of criminal organizations’ family dynamics and ideological devices may provide important insights into the inner functioning of these groups. In this article, we describe and analyze a specific set of discursive strategies and the thematic narratives emerging from a TV interview with Giuseppe Riina, a member of Cosa Nostra and the son of one of the most important mafia bosses. Our analyses demonstrate the existence of recurring ideological devices such as reductionism, amoralism, familism, verticalism, normalism, victimism (...) and religious relativism. The results are discussed in light of previous research that examines how discursive strategies and narratives may represent powerful tools for understanding criminal organizations. Family-related discourses, in particular, reveal meanings, values and ideas that contribute to constructing criminal organizations’ internal structure, as well as their relationship with the external world. (shrink)

The rise in the recent Western pattern of surrogate decision making is not a necessary result of an increase in the number of elderly with decreased competence; it may rather manifest the dominant Western vision of human life and relations. From a comparative philosophical standpoint, the Western pattern of medical decision making is individualistic, while the Chinese is familistic. These two distinct patterns may reflect two different comprehensive perspectives on human life and relations, disclosing a foundational difference that can be (...) seen in the Aristotelian account of friendship and the Confucian account of humanity. The contemporary development of surrogate decision making in the West may illustrate a general tendency toward the Aristotelian account, while the Chinese approaches are congruent with the Confucian view. Also explored are some merits of the Chinese approach to family decision making for health care. (shrink)

Truth-telling to competent patients is widely affirmed as a cardinal moral and biomedical obligation in contemporary Western medical practice. In contrast, Chinese medical ethics remains committed to hiding the truth as well as to lying when necessary to achieve the family's view of the best interests of the patient. This essay intends to provide an account of the framing commitments that would both justify physician deception and have it function in a way authentically grounded in the familist moral concerns of (...) Confucianism. It reflects on the moral conditions and possibilities for sustaining a Confucian understanding of truth-telling and consent in mainland China. (shrink)

BackgroundMedical professionalism has been developing in the Peoples’ Republic of China as one way to better address perennial and new challenges in healthcare in an ever-changing society. Among many recent developments in this area is promotion by the national Chinese Medical Doctor Association of the principles and values contained in the international document, “Medical Professionalism in the New Millennium: A Physician Charter.”ObjectiveTo discover Chinese physicians’ attitudes toward and understanding of medical professionalism.MethodologyThe authors distributed a self-reporting questionnaire that included 34 statements (...) and four case scenarios concerning the general principles of medical professionalism: the primacy of patients’ welfare, respect for patients’ autonomy, promotion of social justice, and professional self-regulation. The questionnaire included controversial issues such as the role of the family in decision making and reporting medical errors. A total of 2,966 practicing physicians, randomly selected from the Chinese Medical Association database, were surveyed, and 1,198 valid questionnaires were returned. Our sample covered 23 provinces and 51 cities throughout the Peoples’ Republic of China.ResultsMore than 80 percent of the physicians who responded agreed that the physician-patient relationship should be a relationship of trust founded on professional altruism, and that informed consent is necessary. More than 95 percent agreed that physicians should promote professional self-regulation as well as social justice. More than half agreed with the principle of the primacy of patients’ welfare (62.8 percent), and that physicians have a responsibility to report medical errors and incompetent colleagues (51.0 percent). In certain cases, a great majority of Chinese physicians favored familism and paternalism.LimitationsThe study does not include data on how Chinese physicians practice medical professionalism, or the perspectives of physicians working in smaller cities and in rural areas.ConclusionsBased on responses to the survey, Chinese physicians strongly support the majority of the fundamental principles and responsibilities of medical professionalism, including dedication, altruism, social justice, self-regulation, and informed consent. However, their support for the primacy of patients’ welfare as a general principle, and the physician’s responsibility to report medical errors and incompetent colleagues, is relatively low. To help advance medical professionalism in the People’s Republic of China, professional development programs and medical ethics education should not only emphasize the general principles involved, but also formulate guidelines on how these principles can be carried out in practice. (shrink)

This essay indicates that Confucian family-based ethics is by no means a stumbling block to organ donation in China. We contend that China should not change to an opt-out consent system in order to enhance donation because a “hard” opt-out system is unethical, and a “soft” opt-out system is unhelpful. We argue that the recently-introduced familist model of motivation for organ donation in mainland China can provide a proper incentive for donation. This model, and the family priority right that this (...) model supports, is ethically justifiable in terms of Confucian family-based ethics. (shrink)

The article considers the processes of subjectivation of youngsters in poverty condition of a neighborhood of Cordoba. From a Foucauldian analytic standpoint, it analyzes the ways in which subjects constitute themselves through a historical development and within a framework of practices of government and resistance. Therefore, the purpose of the article is to understand how the youngsters of the neighborhood built their subjectivities within a context of social exclusion. Particularly, it analyzes the relevance of kinship and the consequences for women. (...) The fieldwork was undertaken between 2013 and 2017 by means of observation record and analysis of newspapers and government communications. The way of subjectivation that was observed in the youngsters reinforces kinship as a possible way to maintain social bonds despite the social fragmentation and stigmatization that they experience throughout their lives. In turn, this familist retreat fosters a space in which women are reduced to the role of mothers or caretakers, and because of that, are overwhelmed by everyday demands. These features occurred within a context of State policies that made nuclear family their aim of intervention and, also because of neoliberalism, the only providers of care. It concludes with some questions regarding the possibilities of such familism to become the foundation for broader community processes. (shrink)

Higher education, a key driver of women’s empowerment, is still segregated by gender across the world. Agricultural higher education is a field that is male-dominated, even though internationally women play a large role in agricultural production. The purpose of this study was to understand the experience, including challenges and coping strategies, of women from 10 Latin American countries attending an agricultural university in Latin America. The participants were 28 women students with a mean age of 20.9 ± 1.8 years. Following (...) informed consent and assurance of confidentiality, four focus group sessions (one for each year of study with a mean duration of 81 min) were conducted in Spanish. The central question was, “what has been your experience at the university?” Sessions were recorded and transcribed. Thematic coding was performed independently by two teams of researchers (from Latin America and North America), with the resulting schemas combined through mutual discussion. Member checking, auditing, and reflexivity contributed to trustworthiness of the process. Students reported that the personal qualities needed for success included determination, persistence, and self-efficacy. Many described an empowerment process, including increased discipline and self-efficacy from the first to fourth year of study. University life encompassed six themes: university structure and discipline (part of the exosystem), two supportive microsystems (friends and classmates and institutional support) as well as three challenges (academics, peers, and machismo). Cultural influences instantiated in students’ daily experiences included familism, machismo, and religious faith. Students anticipated futures involving further education and contributions to society. We conclude that higher education in agriculture can serve as an effective means of empowering women to feed the world. (shrink)

Individual health savings accounts are an important part of the current basic medical insurance system for urban workers in China. Since 1998 when the system of personal medical insurance accounts was first implemented, there has been considerable controversy over its function and significance within different social communities. This paper analyzes the main problems in the practical implementation of individual medical insurance accounts and discusses the social and cultural foundations for the establishment of family health savings accounts from the perspective of (...) Chinese Confucian familism. Accordingly, it addresses the direction of the reform and the development of the current system of individual health insurance accounts in China. (shrink)

The forced marriage of minors is child abuse, consequently duties exist to stop them. Yet over 14 million forced marriages of minors occur annually in developing countries. The American Bar Association concludes that the problem in the US is significant, widespread but largely ignored, and that few US laws protect minors from forced marriages. Although their best chance of rescue often involves visits to health care providers, US providers show little awareness of this growing problem. Strategies discussed to stop forced (...) marriages include recommendations from the UN, the ABA, and the UK. The author anticipates and responds to criticisms that first, no duty to intervene exists without better laws and practice guidelines; and second, that such marriages are not child abuse in traditions where parental rights or familism allegedly justify them. (shrink)

One of the main concerns of New Institutional Economics is to explain the pervasive existence of inefficient political or economic arrangements. However, quite different explanations of this phenomenon are offered. Some authors consider it a result of formally established rules, others think it is caused by traditional cultural beliefs, yet others ascribe it to evolved social relations. But each of these approaches can only cover part of the truth. In this paper I suggest that societal development and endurance can only (...) be explained if we consider the dynamic interactions between formal, cultural and social institutions. In applying this theoretical framework to the development of the Chinese economy during the past thirty years, I will argue that the special relations between the socialist political system, Confucian familist culture and social relationships namely Guanxi have contributed to the rise and concomitant problems of the Chinese economy. On this basis it might be possible to answer two questions that have troubled scholars for decades: How could the Chinese private economy flourish without well-defined property rights? Why did the Chinese entrepreneurs fail to lead China to further political reform after having achieved huge success on the market? (shrink)

LANGUAGE NOTE | Document text in Chinese; abstract also in English. 傳統意義下的臨終關懷，以全面的身心照料為中心，為瀕臨離世的病患及其家屬提供涵蓋生理、社會及心靈方面的支援及照護服務，使其消除焦慮和對死亡的恐懼，最終幫助病人有尊嚴地、舒緩平和地抵達人生盡頭，也慰藉患者 家屬走出失去至親的傷痛。然而，在「新冠」疫情的影響下，臨終關懷面臨著倫理困境，善終的意義也一度受到挑戰。本文以香港疫情下受限的探訪和殯葬安排為例，通過儒家思想中的以人文本、家庭主義和臨終禮儀，分析防疫 政策對臨終關懷和善終的影響並探究其倫理正當性，為今後突發公共衛生事件下臨終關懷必要性、執行過程和發展提供思考。 End-of-life care aims to provide supportive physical, social, mental, and spiritual care for terminally ill patients and their family members. Not only does it help patients approach the end of their lives with dignity and peace, but it also helps family members overcome the grief of losing a loved one. In the context of the COVID-19 pandemic, ethical dilemmas have emerged within the field of end-of-life care, and it (...) has been challenging to help people experience a good death. This article takes the example of the pandemic-related restrictions in Hong Kong that affected visiting and funeral arrangements. It analyzes the impact of anti-pandemic measures on end-of-life care and the provision of a good death. It examines the ethical justifications of these measures through the Confucian themes of human-orientedness, familism, and death rituals, and it outlines practical implications for end-of-life care under similar circumstances. (shrink)

This chapter gives an outline of the development of the human organ transplant system in Hong Kong, whose key features are a soft opt-in system and strict prohibitions on commercial dealings in human organs for transplant. It is argued that under such a system, there is a lack of incentives for either cadaveric or living organ donations and for family members to endorse deceased donation. This argument is followed by an investigation of the shortage of organ donations in Hong Kong, (...) the limited success of the government promotion to improve the number of donations, and a discussion of new alternatives for improvement that have been initiated or proposed. It is argued that the feasibility and effectiveness of these alternatives are limited and uncertain. More radical reform of the existing system in terms of honorary, compensationalist, and familist incentives is needed and they all need to be taken into consideration. (shrink)

This chapter provides conceptual and ethical comments on Hong Kong’s interview findings and survey results regarding the three types of incentive for organ donation. It focuses on three particular conceptual and ethical issues. First, it shows that there is not always a clear-cut distinction between an honorary and a compensationalist incentive measure for organ donation. Instead, a measure such as offering a public columbarium niche to a deceased donor in Hong Kong carries both honorary and compensationalist elements and can, as (...) a mixed type of incentive measure, be ethically justified for adoption in that society, even if purely monetary incentives cannot be similarly ethically justified. Moreover, in relation to the proposal to offer a familist incentive in Hong Kong (namely, to give patients with a first-degree family member who was a cadaveric donor, or who have themselves previously been live donors, a priority right for a transplant over other medically similar patients), it is argued that no proposed opposing reason is ethically convincing. Finally, the chapter demonstrates that there are legitimate considerations to support maintaining Hong Kong’s familist decision-making model regarding organ donation. (shrink)

This study focuses on women who define themselves as being undecided about becoming mothers. It addresses the question of how these women navigate their lives between two main conflicting cultural directives and perceptions: pronatalism and familism entwined in perception of linear time on one hand; and individualism and its counterpart, the notion of flexible liquid society, on the other. The research is based on group meetings designated for these women, which were facilitated by the first author. Ten women participated (...) in the study—of whom, most were heterosexual, half were single, and half were partnered. Data were collected using questionnaires completed during individual interviews that preceded the group encounter; transcripts of the discussions held during the ten group sessions; and questions regarding the status of the women’s doubts about motherhood asked 4 years after participating in the group. Our findings expand the existing typology of women’s reproductive decision-making, and demonstrate how categories that are commonly perceived as binary intersect when one challenges the rigid classifications of “active decisions” and “passive decisions”; “motherhood” and “non-motherhood,” and “want to be a mother” and “do not want to be a mother.” The findings also suggest that after becoming mothers, women can change their maternal status from “non-mother” to “mother,” yet still continue to view themselves as indecisive regarding motherhood. Based on our findings, we will argue that while indecisiveness about motherhood derives from individualized neoliberal rhetoric, it simultaneously undermines that same rhetoric and contradicts the injunction to “know, to decide, to strive.” It opposes the expectation in post-feminist discourse, that women will make choices about their bodies and exert them, while also opposing the pronatalist rhetoric, and the temporal linear discourse positing that women should “move forward” toward motherhood along with the ticking of the “biological clock.” Whereas some women sought to resolve their indecisiveness, other women found that the indecisiveness leaves all options open in a manner that expands their boundaries of autonomy in a society that seeks to limit it. (shrink)

This essay is a comparative analysis of results reported in this volume from studies in mainland China, the United States, Iran, and Hong Kong regarding organ donation incentives. They reveal widespread (but not unanimous) support for honorary incentives (such as notes or ceremonies of gratitude) and significant support for familist incentives (offering a donor’s family members priority should they need an organ transplant in the future). Opinions on financial incentives were much more mixed, with significant worries expressed regarding potential exploitation (...) and unfairness. These interviews also reinforce the importance of culturally appropriate constructions of any steps to increase organ donation rates. And, in addition to their comments on various types of incentive, interviewees in these chapters also offer insight into other measures that could be taken to increase organ donation. (shrink)

This book provides the first systematic study on three types of incentives for organ donation. It covers extensive research conducted in four culturally different societies: Hong Kong, mainland China, Iran and the United States, and shows on the basis of the research that a new model of incentives can be constructed to enhance organ donation in contemporary societies. The book focuses on three types of incentives: honorary incentives, commonly adopted in the United States and other Western countries by offering things (...) such as a thank-you card and a memorial park for donors to encourage donations motivated by pure altruism; compensationalist incentives, adopted in the Islamic Republic of Iran to encourage donation by providing monetary compensation to unrelated living donors for appreciating their altruistic contribution of donation; and familist incentives, implemented in Israel and mainland China to provide priority to organ transplantation to donors and/or their family members. The book demonstrates that a new model of incentives must go beyond offering only one type of incentives and should rather include different types of incentives that are practically effective, politically legitimate and ethically justifiable for particular societies. This implies that suitable incentive measures may vary from society to society to optimize organ donation. This book provides a clear reference for both the scholars and practitioners in the field of organ transplantation, as well as for general readers interested in bioethics and health care policy. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 61.1 (2000) 75-95 [Access article in PDF] "Not heretofore extant in print": Where the Mad Ranters Are Kathryn Gucer In 1654 Ephraim Pagitt published the fifth edition of Heresiography, subtitled "a Description of the Hereticks and Sectaries of these latter times." On the title page Pagitt promoted this latest edition of the catalog by stressing the "Additions" he had made. Among the new (...) targets of his anti-sectarian polemic were the Ranters, whom he introduced in a pithy character sketch as "an unclean beast much of the make with our Quaker." 1 But although Pagitt claimed to introduce the sect, Ranters had been around in print since Gerrard Winstanley attacked them in defense of his group, the Diggers, in 1649. 2 In fact writers had been attacking the sects generally--Anabaptists, Seekers, Brownists, Familists--in brief pamphlets like Winstanley's Vindication and in tome-like catalogs of sectarian "errours" since the outbreak of the Civil War. The anti-Ranter pamphlets were thus an incursion into an ongoing printed dialogue about the sects in general. Pagitt himself had been an interlocutor in this dialogue, having published four previous editions of his list. Why had he not marked the Ranters in 1649 and 1650 when Winstanley and others first noticed them?This essay will answer this question by arguing that the Ranters arose in dialogue across time, that they did not emerge spontaneously in Pagitt's 1654 text. When Pagitt introduced the sect in 1654, he was in fact responding to a heated discussion about the Ranters that had been developing for four years. He thus entered the debate a moment after "Ranters" and "ranting" had been defined by other pamphleteers. In this debate about the Ranters we can see the process by which pamphleteers invented a linguistic means of talking about religious diversity before it was an accepted feature of English society. At the same time that writers were exposing the Ranters' blasphemous excesses, they were also crafting a political identity for the group by attaching characteristic words and [End Page 75] behaviors to them in print. The printed controversy over the Ranters thus raises interesting questions about the relation between textual signification and actual politics. What were the processes by which pamphleteers invented new ways of talking about groups--sects and parties--in the period? What did labeling have to do with political identity?In fact the collective dialogue about the Ranters centered on a label that pamphleteers consistently attached to the group, their "madness." Although each writer identified the Ranters with a variety of creeds and practices, anti-Ranter pamphleteers all told their readers to view the group as an absence of reason. They claimed that Ranters were incapable of recognizing and conveying God's truth to their audience. Pagitt himself participated in the cooperative assault on Ranter madness. He consistently borrowed this language from his fellow interlocutors, branding the Ranters with terms such as "nonsensicall" and "absurd." Yet I argue that the label itself was largely a red herring. Writers shrewdly focused on Ranter unreason in order to persuade their readers not to use their own reason to consider the sectarian claims to authority. Moreover, writers shaped and reshaped what they meant by Ranter unreason in order to modulate its rhetorical effect on their readers. Thus it is not surprising that the precise construction of Ranter unreason shifted with the various responses these writers wanted to elicit from their readers. 3The explosion of anti-Ranter tracts, many of which had sensational titles showcasing the word "Ranters," indicated that the sect had particular rhetorical purchase on the public in the early 1650s: The Ranters Religion (11 October 1650), The Routing of the Ranters (19 November 1650), The Ranters Bible (9 December 1650), The Ranters Recantation And their Sermon (20 December 1650), The Joviall Crew, or the Devill turn'd RANTER (6 January 1651), Ranters of both Sexes, Male and Female (3 June 1651), RANTERS MONSTER (30 March 1652). 4 Although talk about Ranters was neither confined to print nor to... (shrink)

With the advancement of China’s economic transformation, the impact of economic policy uncertainty on family firms has become increasingly significant. The “familism” of family firms makes them more motivated to maintain family harmony, pursue innovative activities, and the long-term development of enterprises when faced with economic policy uncertainty. In this paper, we employed the data of listed Chinese family firms from 2010 to 2018 to analyze the impact of economic policy uncertainty on family business innovation activities, analyze the inherent (...) characteristics of family firm innovation, and find the path that enables the innovative activities of family firms and provides a valuable experience for the innovation of private enterprises in economic policy uncertainty. We provide evidence that economic policy uncertainty positively relates to family firm innovation. Moreover, the relationship is affected by factors such as directors’ executive background and access to state-owned equity. Further analysis indicates that economic policy uncertainty can promote family firms’ innovation activities by improving their risk-taking, internal capital market circulation, and reducing political connections. (shrink)

This study aims to determine the motive that led to the establishment of Juche by Kim Il Sung amidst the influence of communism and its transformation into religion in North Korea. North Korea is a communist country dictated by Kim Jong-Un of the Kim dynasty and known for its cruelty. The country underwent several changes from Marxism-Leninism to familism to determine its strength in Juche. This ideology that acts as a religion was influenced and strengthened Kim Jong Il to (...) Kim Jong-Un and built by shifting the concept of marxism-Leninism to construct a new understanding of Juche. It will be demonstrated that this ideology was influenced by Confucianism, Christianity, Nationalism, Chinese Communism, and Russian Communism. In the modern era, imperialism was used as an ideological tool to restrict backwardness. This theory allegedly helped Kim Il-Sung establish a unitary, one-person rule over North Korea. ‘It will be examined whether Juche ideology is a tool the state has used to convince people of their government. Pronouncements, an intentional religion in which the people were to believe that their Ruler was a supreme human or an ideology that morphed into a religion’. It will be demonstrated that, when they started honoring Kim as their god, no other religion was permitted.Contribution: This research offers readers an understanding of the value of humanity in the binding ideology of Juche. However, the Juche Ideology can serve as a missiological bridge towards mission goals, which require the experience of spiritual, physical, and social liberation. (shrink)

This chapter makes further ethical commentaries in response to the findings as described in Chaps. 2 and 3. We contend that it is not the case that only one type of incentive can be justified to motivate organ donation in mainland China. In particular, we argue that while each of the three types of incentive (honorary, compensationalist, and familist) can work, some particular incentive measures can be ethically justified and be the most motivating in the context of mainland China. Based (...) on our findings and arguments, we revisit the orientation of China’s organ donation reform and attempt to provide some recommendations for future policy considerations. (shrink)

As in other societies, medical professionalism in the Peoples’ Republic of China has been rapidly evolving. One of the major events in this process was the endorsement in 2005 of the document, “Medical Professionalism in the New Millennium: A Physician Charter,” by the Chinese Medical Doctor Association (hereafter, the Charter). More recently, a national survey, the first on such a large scale, was conducted on Chinese physicians’ attitudes toward the fundamental principles and core commitments put forward in the Charter. Based (...) on empirical findings from that study and comparing them to the published results of a similar American survey, the authors offer an in-depth interpretation of significant cross-cultural differences and important transcultural commonalities. The broader historical, socio-economic, and ethical issues relating to salient Chinese cultural practices such as family consent, familism (the custom of deferring decisions to family members), and the withholding of medical information, as well as controversial topics such as not respecting patients’ autonomy, are examined. The Chinese Survey found that Chinese physicians supported the principles of the Charter in general. Here we argue that Chinese culture and traditional medical ethics are broadly compatible with the moral commitments demanded by modern medical professionalism. Methodologically and theoretically—recognizing the problems inherent in the hoary but still popular habit of dichotomizing cultures and in relativism—a transcultural approach is adopted that gives greater (due) weight to the internal moral diversity present within every culture, the common ground shared by different cultures, and the primacy of morality. Genuine crosscultural dialogue, including a constructive Chinese-American dialogue in the area of medical professionalism, is not only possible, but necessary. (shrink)

Social science researchers often definefilial pietyas a set of norms, values, and practices regarding how children should behave toward their parents. In this article, we trace the conceptual development of filial piety research in Chinese and other societies to highlight the assumptions underlying this traditional approach to filial piety research. We identify the limitations of these assumptions, including the problem of an evolving definition and lack of cross-cultural applicability. We then advocate an alternative framework that overcomes these limitations by focusing (...) on the deep structure of filial piety: the dual filial piety model (DFPM). The DFPM applies the concept of contextualized personality to reconceptualize filial piety in terms of authoritarian and reciprocal psychological motivations particular to the parent-child context. Because the focus is on a universal psychological mechanism rather than cultural norms, values, and behavior, the DFPM may be applied for investigation of filial piety at individual, social, and cultural levels within and across various societies. We discuss application of the DFPM in relation to existing filial piety and intergenerational relations research from several societies and conclude with a comparison to other recent proposals for measuring Chinese filial piety. (shrink)

이 글의 주된 내용은 한국을 대표하는 기업가 몇 사람의 정신을 유교적 경영이념의 시각에서 살펴보는 것이다. 이병철을 비롯한 상당수 대기업의 창업자들이 그들의 사상 근간으로 유교를 내세우고, 경영이념 또한 유교에 입각한 人本主義的경영가족주의를 표방하였다. 이러한 사례는 경영윤리로서 유교사상이 상당한 가치를 가지고 있다는 점을 보여준다. 근대 학문이 수용되기 이전의 한국사회는 거의 전적으로 유교 이념에 충실히 따르는 교육을 행했고, 이러한 유교적 분위기가 지금까지도 한국사회에 강하게 남아 있다. 근대 學制가 수용된 일제식민시기에도 전통유학의 경전을 가르치는 ‘서당’ 교육이 존재했고, 상당수의 한국인들은 이곳에서 기초한문과 유교의 경전을 배웠다. 그러므로 이 (...) 시기에 학업을 연마했던 상당수의 기업 창업자들도 유교의 영향을 강하게 받았다. 이들은 유교의 이념에 따라 인간제일주의를 표방하고, 경영가족주의를 기업정신으로 내세웠다. 이러한 정신은 기업을 성장시키는 데에 큰 기여를 하기도 했지만, 개인의 능력과 창의성을 무시하고 전체 속에 개인을 가두어 두며, 기업 자체를 창업자 가족의 사유물로 여기는 부정적인 측면을 드러내기도 하였다. (shrink)