This volume explores Confucian views regarding the human body, health, virtue, suffering, suicide, euthanasia, `human drugs,' human experimentation, and justice in health care distribution. These views are rooted in Confucian metaphysical, cosmological, and moral convictions, which stand in contrast to modern Western liberal perspectives in a number of important ways. In the contemporary world, a wide variety of different moral traditions flourish; there is real moral diversity. Given this circumstance, difficult and even painful ethical conflicts often occur between (...) the East and the West with regard to the issues of life, birth, reproduction, and death. The essays in this volume analyze the ways in which Confucian bioethics can clarify important moral concepts, provide arguments, and offer ethical guidance. The volume should be of interest to both general readers coming afresh to the study of bioethics, ethics, and Confucianism, as well as for philosophers, ethicists, and other scholars already familiar with the subject. (shrink)

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. (shrink)

Human dignity is a crucial concept in contemporary ethical, political and legal studies. However, people have different, even opposite understandings of human dignity, which has caused lots of confusion in related discourses. The Confucian notion of human dignity provides an important perspective for reflecting various theories of human dignity. In Confucian ethics, the basis of human dignity is the moral potential that every human being naturally has. Moral potential grants everyone universal dignity, while the development of moral potential (...) grants people acquired dignity. Since all human beings have moral potential to the same extent, everyone owns universal dignity equally. Different people develop their moral potential to different extents. One’s acquired dignity is positively associated with the development of her moral potential. Universal dignity is a moral status but acquired dignity is not. To pursue acquired dignity is the moral demand of universal dignity and protects people’s universal dignity. Confucian discussions on human dignity provide not only a way to justify the equality of human moral status, but also a way to justify the moral obligation of protecting and developing human nature, thereby constituting a reliable theoretical basis for coping with ethical issues caused by biomedical technologies today. (shrink)

To understand the gaps between current bioethics education and the requirements of practicing nurses, a semistructured questionnaire was used to invite the directors of nursing departments at all 82 teaching hospitals in Taiwan to participate in this survey. The response rate was 64.6%. Through content analysis we obtained information about previous bioethical training, required themes and content, recommended teaching strategies, and difficulties with education and its application. The results suggest that Taiwanese nursing personnel need to be instilled with both (...) self-cultivation of morality and mental cultivation to acquire nursing virtues and the right attitudes toward bioethical issues. Good communication skills to prevent damage to the harmonious relationships between patients, their families and medical team members, policies that support the provision of systematic formal knowledge of ethics, small group training, and clarification of values were also shown to be important in bioethics education. (shrink)

This paper focuses on Confucian formulations of personhood and the implications they may have for bioethics and medical practice. We discuss how an appreciation of the Confucian concept of personhood can provide insights into the practice of informed consent and, in particular, the role of family members and physicians in medical decision-making in societies influenced by Confucian culture. We suggest that Western notions of informed consent appear ethically misguided when viewed from a Confucian perspective.

Drawing upon Confucian ethical insights extracted from the Analects, this essay argues that principlism suffers from fundamental theoretical flaws. Its four principles do not genuinely capture universal principles, because they distort the practice-embedded nature of authentic moral norms found within actual moral cultures, as elucidated by Confucian insights. Specifically, Confucianism highlights the importance of a reflective equilibrium between constitutive rules and regulative principles. Principlism, in reality, represents an abridged version of modern Western liberal ethical norms, as it retains (...) their significant regulative principles while excluding their specific constitutive rules. The essay also employs prominent examples to illustrate the practical ineffectiveness of principlism. Given that diverse cultures either adhere to different regulative principles that diverge from the four principles or are obligated to specify them with their distinct constitutive rules, relying on the four principles as a uniform starting point falls short in providing and justifying universal solutions to the bioethical dilemmas confronting contemporary societies. In addition, the essay delves into the underlying factors that have led to the seemingly widespread adoption of the four principles across different regions worldwide. Lastly, the essay introduces the concept of regioglobal bioethics as an alternative to principlism for global bioethics, outlining a general Confucian endorsement of this proposal and providing a brief response to potential objections, aiming to pave the way for further research. (shrink)

With the rapid development of biotechnology, the physician is now more able to keep a patient's life going indefinitely on a life support system. The question of whether we should switch off the machine often arises when, according to the medical prognosis, there is no hope of recovery, or in a no-win situation where you are 'damned if you do and damned if you don't'. In a case which seems without hope, the dilemma of whether to prolong a life or (...) let it go disturbs many people, including health professionals as well as the family of the patient. In this painful situation, an ethics consultant who has received intensive training can help the concerned parties to arrive at what may be the best decision. How do Asians, especially those living in countries influenced by Confucian teachings, reach their answers? Three aspects are usually considered: (1) motivation and situation; (2) reasonableness and propriety; and (3) lawfulness and legality. More specifically, three questions are deliberated, as follows. (1) Where an action has already been taken, what motivated it and in what situation? Or, where a decision has still to be made, what should motivate it, and what are the relevant features of the situation? (2) Was the attempted resolution of the dilemma, or is its prospective resolution, reasonable and in accordance with traditional principles of ethical behaviour? (3) Was the action taken lawful, or would the intended action be lawful? This approach to finding an answer has been practised for centuries in Confucian society. But what is legal may not always be reasonable, what is reasonable may not always be compassionate, and what is compassionate may not always be either legal or reasonable. Principles to guide decision-making are therefore called for. This article, written by Michael Cheng-tek Tai in collaboration with Donald Hill, discusses the Confucian method of solving a problem and examines its principal features and how they are applied in ethics consultations. The article is followed by a series of questions and answers and a commentary by Donald Hill. (shrink)

This chapter attempts to build a Confucian conception of public reason for Confucian-influenced East Asian societies to adopt and tackle political and bioethical issues. The chapter first indicates that public reason is present at various levels of human collectives, namely, communitarian, national, and international. It concentrates on constructing a proper Confucian notion of public reason at the national level given that only the sovereign states are able to make effective public policy and laws to govern their people, (...) although such a Confucian notion can be shared by the peoples across East Asian countries and regions, such as mainland China, Hong Kong, and Taiwan. Then I lay out Rawls’ liberal conception of public reason and explicate why it is not suitable for an East Asian country like China to accept. This is followed by two sections addressing the two Confucian conceptions of public reason that have been proposed, respectively, by Joseph Chan and Sungmoon Kim. I indicate how each of them faces a dilemma that cannot be adequately resolved. In Sect. 4, I outline a new Confucian conception of public reason based on the view developed in my book Reconstructionist Confucianism, including a Confucian account of basic liberty, equality, and individual rights consistent with the central requirements of the Confucian virtues that are still vibrant in East Asian societies. The values of political justice under this Confucian conception integrate both Confucian virtues and basic rights. Finally, the chapter appeals to this conception to review the bioethical issue of medically assisted suicide and argues why it should not be legalized in East Asia according to this conception of public reason. (shrink)

본 논문은 배아연구와 관련된 당대 생명윤리 문제에 유가적 사유가 어떤 입장을 개진 할 수 있을까 하는 문제의식에서 집필되었다. 당대 생명공학과 의료기술의 발전은 기존의 윤리적 담론으로 해결할 수 없는 여러 문제들을 야기 시키고 있는데, 인간복제나 유전자 조작 등의 문제가 그것이다. 배아연구와 관련된 논의의 핵심은 본문에서 밝혀지듯이 배아가 인간인가 하는 점인데, 현대의 분자생물학적인 접근이나 철학적, 종교적 접근에 의한 인문학적 해석이 구구하며 여전히 합의에 이르지 못하고 있는 상황이다. 유가철학도 배아가 인간인지 아닌지를 밝혀주지 못한다. 하지만 우리정서에 맞는 생명윤리를 정초해야 한다는 의미에서 유가철학을 포함한 전통철학이 (...) 배아연구를 포함한 당대 생명윤리의 문제에 어떤 방향을 제시해 줄 수 있는가를 검토해 보는 것은 필요한 일이다. 혹 그 길이 우리가 기대한 바에 못 미친다하더라도, 걸어 가 볼만한 가치가 있다. (shrink)

This study is a contribution to Chinese-Western dialogue of bioethics but perhaps the first one of its kind. From a Chinese-Western comparative ethical perspective, this work brings Chinese ethical theories, especially Confucian ethics, into a contemporary context of the epidemic of HIV/AIDS, and to see how the deeply-rooted thoughts of Confucius interact, compete, or integrate with concepts from Western ethical traditions. An underlying belief is that some ideas in Confucian ethics are important and insightful beyond their cultural (...) and historical origins in China and other Confucianism influenced societies.Methodologically, this thesis employs two approaches, conceptual normative analysis combined with critical interpretation. The ‘interpretive’ approach I employ, as an important methodology supplementing my normative analysis, not only deals with Chinese ancient texts, but also explains specific beliefs and practices in China.With a critical eye, this thesis carefully examines a number of key topics in the ethics of AIDS in China from a cross-cultural perspective. Topics including: views on personhood and the vulnerability of People Living with HIV/AIDS; prioritising and balancing the role of ‘harm reduction’ and the role of ‘eradication of deviant behaviour’ in AIDS policy in China; rights-based opt-out approach and duty-based family-centred approach in HIV testing and Biobanking; blood donation; moral responsibility and personal responsibility for health; and the popular rhetoric of ‘innocent infection’ versus ‘guilty infection’ in AIDS. My overall aim in this work is to present a cross-cultural bioethics study through the investigation of some ethical issues in AIDS in China from a Chinese-Western comparative perspective and also attempt to suggest a humane and effective policy for HIV/AIDS which I believe is appropriate to both traditions. I believe this work has contributed to our knowledge in three related but independent areas: the control of the epidemic of HIV/AIDS in China; medical ethics in China; and to both the methods and the utility of cross-cultural study of bioethics between China and the West. (shrink)

: The Confucian relational concept of the person has been proposed as an epistemically more cogent and ethically more attractive alternative to that of liberal individualism. Two arguments are raised against this proposal without defending liberal individualism. Ethically, Confucianism is vitiated by certain unattractive features that cannot be removed without reducing the Confucian relational concept of the person to an abstract and not very helpful notion of human relatedness. Epistemically, Confucianism commits the essentialist fallacy of treating its own (...) concept of human relations as reflecting the nature of things. In view of these limitations, the Confucian relational concept of the person does not provide a viable framework for dealing with social issues including bioethics. (shrink)

Morphine is usually preferred to treat moderate or severe pain for late‐stage cancer patients. However, medically unindicated or excessive morphine use may result in respiratory depression and death. This essay contends that a clear distinction between relieving pain and performing active euthanasia in the use of morphine should be made in practice. By drawing on Confucian virtue resources, we construct a Confucian conception of human dignity, including both intrinsic and acquired dignity, to analyze the circumstances of morphine use (...) in current China. We argue that not only the Confucian view of intrinsic dignity but also that of acquired dignity would not support morphine euthanasia. (shrink)

Article 14 of the UNESCO Declaration on Bioethics and Human Rights sets forth a few basic principles regarding social responsibility for health. It states in part that 14.1 The promotion of health and social development for their people is a central purpose of governments that all sectors of society share. 14.2 Taking into account that the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political (...) belief, economic or social condition, progress in science and technology should advance: access to quality health care and essential medicines, especially for the health of women and... (shrink)

The coming of bioethics to Singapore / W. Calvin Ho and Sylvia S.N. Lim -- The impact of the bioethics advisory committee on the research community in Singapore / Charmaine K.M. Chan and Edison T. Liu -- Engaging the public : the role of the media / Chang Ai-Lien and Judith Tan -- Confucian trust and the biomedical regulatory framework in Singapore / Anh Tuan Nuyen -- The clinician-researcher : a servant of two masters? / Alastair V. (...) Campbell, Jacqueline Chin, and Teck Chuan Voo -- The US model for oversight of human stem cell research / Lindsay Parham and Bernard Lo -- Genetics and stem cell research : models of international policy-making / Bartha Maria Knoppers, Emily Kirby and Rosario Isasi -- Public engagement and bioethics commissions / Thomas H. Murray and Ross S. White -- Norm-making on human-animal chimeras and hybrids in Singapore, the United Kingdom and the international domain / W. Calvin Ho and Martin Bobrow -- How will future bioethical issues engage Singapore? / John Elliott. (shrink)

This essay addresses a moral and cultural challenge facing health care in the People’s Republic of China: the need to create an understanding of medical professionalism that recognizes the new economic realities of China and that can maintain the integrity of the medical profession. It examines the rich Confucian resources for bioethics and health care policy by focusing on the Confucian tradition’s account of how virtue and human flourishing are compatible with the pursuit of profit. It offers (...) the Confucian account of the division of labor and the financial inequalities this produces with special attention to China’s socialist project of creating the profession of barefoot doctors as egalitarian peasant physicians and why this project failed. It then further develops the Confucian acknowledgement of the unequal value of different services and products and how this conflicts with the current system of payment to physicians which has led to the corruption of medical professionalism through illegal supplementary payments. It further gives an account the oblique intentionality of Confucian moral psychology that shows how virtuous persons can pursue benevolent actions while both foreseeing profit and avoiding defining their character by greed. This account of Confucian virtue offers the basis for a medical professionalism that can function morally within a robustly profit-oriented market economy. The paper concludes with a summary of the characteristics of Confucian medical professionalism and of how it places the profit motive within its account of virtue ethics. (shrink)

The modern doctor-patient relationship displays a patient-centred, mutual-participation characteristic rather than the former active-passive or guidance-cooperation models in terms of medical decision making. Respecting the wishes of patients, amounting to more than mere concern for their welfare, has become the feature central to certain modern bioethics theories. A group of ethical principles such as respect for autonomy, beneficence, non-maleficence, and justice has been proposed by bioethicists and widely adopted by many medical societies as an ethical guide to how doctors, (...) in their daily practice, should treat their patients. However, seeing patients as persons who are rational, self-conscious beings capable of valuing their own lives, and who are consequently entitled to the liberty and rights to choose for themselves, is in general the backbone of Western bioethical principles.Since Confucian philosophy has long been a representative of the East-Asia cultural tradition and Confucian bioethics has recently been developed as a theory of applied ethics, examining Confucius's idea of “persons” may shed some light on the current bioethical debates. Confucius's concept of persons, which is best interpreted via his theories of “chun-tze”, (the morally ideal person) encapsulating a two-dimensional approach, (the “autonomous person” and the “relational person”), provides a more comprehensive model regarding what a person is and how he/she should be treated. This two-dimensional approach sees a person not only as a rational, autonomous agent but also as a relational, altruistic identity whose self actualisation involves incessant participating in and promoting of the welfare of his fellow persons. Hence this may balance the current bioethical trend whereby “respect for autonomy” often triumphs. (shrink)

In the West, mainstream bioethicists tend to appreciate intimate relationships as a hindrance to individual autonomy. Scholars have even argued against approaching a mother to donate a kidney to save the life of her child; the request, they claim, is too manipulative and, thereby, violates her autonomy. For Chinese bioethicists, such a moral analysis is absurd. The intimate relationship between mother and child establishes strong mutual obligations. It creates mutual moral responsibilities that often require sacrifices for each other. This paper (...) argues that while aiding others is a moral duty, helping one’s family is a much stronger duty and poses no threat to one’s autonomy. For Confucianism, empathetic intimate feelings, the heart and mind of ren, rest at the root of morality. It requires that we, as moral beings, assume duties to relieve the suffering of others. The more intimate the relationship the stronger the obligation to assist. The family is a closely knitted moral community. Family members often share living resources, mutual experiences, and a sense of identity. Family members act as a social unit, and, ordinarily, mutual obligations among members have priority over duties to those outside of the family. For Confucian bioethics, family-based consent to medical treatment is regarded as natural and reasonable. Family-based decision making is a taken-for-granted norm of social life. While close family members have priority, Confucianism extends such obligations outward toward members of the extended family and the society at large. There is a general principle of gradation of love, which reflects different degrees of personal intimacy and, therefore, of moral obligation. In this fashion, Confucianism seeks to treat the whole of society as one extended family. Hence, in bioethics, mutual responsibility and family-based consent are regarded as basic principles. Through a series of case discussions, this paper illustrates that atomistic individual-based autonomy offers but a poor response to bioethical issues. (shrink)

This essay explores a proper Confucian vision on genetic enhancement. It argues that while Confucians can accept a formal starting point that Michael Sandel proposes in his ethics of giftedness, namely, that children should be taken as gifts, Confucians cannot adopt his generalist strategy. The essay provides a Confucian full ethics of giftedness by addressing a series of relevant questions, such as what kind of gifts children are, where the gifts are from, in which way they are given, (...) and for what purpose they are given. It indicates that Confucians should sort out different types of enhancement and bring them to the test of the Confucian values in terms of both Confucian virtue principles and specific ritual rules. It concludes that Confucians can accept some types of enhancement but must reject others. (shrink)

Based on an analysis of a landmark case Lim Mey Lee Susan v Singapore Medical Council in Singapore where a doctor was professionally disciplined for over-charging a wealthy patient, a judgement upheld by the Singapore High Court, this paper will discuss the notion of an ‘ethical price’ (EP) and its determination with respect to the provision of healthcare services. It will first examine the limitations of a legal approach for setting an ethical limit to pricing. From there, it will argue (...) that Confucian philosophy provides a useful ethical framework to explore EP, with focus on the context of Singapore. The following question is addressed: What is an ethical pricing standard for medical practice from a Confucian perspective? The strengths and limitations of a Confucian value base as regards the determination of an objective EP will be analysed through an examination of the shortcomings of the doctor’s behaviour in the Susan Lim case as well as other case scenarios. The paper will conclude with some practical suggestions on how Confucian-based ideas can be applied to decision-making on pricing and the importance of this for medical professionalism and ethics teaching. (shrink)

In this article, combining the Confucian notion of relationality with the republican principle of non-domination, I will shed new light on the ethics of civil compliance in an emergency situation. More specifically, first, by exploring the culturally biased distinctions between individualism and collectivism in the current debates on ‘pandemic’ nationalism, I will put forward the need for a relationality through which civil cooperation with emergency governance can facilitate the enhancement of both individual freedom and democratic commonality in the long (...) run. Then, by supplementing the moral vision of role-constituted relationality in Confucian role-ethics with the principle of liberty as non-domination in neo-Roman republicanism, I will suggest an ethics of civil compliance which can steer emergency governance toward the consolidation of democratic accountability. (shrink)

What about Confucian bioethics should compel our interest? Apart from the fact that Confucianism grounds the belief system of a great number of people, a Confucian bioethics poses a profound challe...

Death with dignity is a significant issue in modern bioethics. In modern healthcare, the wide use of new technologies at the end of life has caused heated debate on how to protect human dignity. The key point of contention lies in the different understandings of human dignity and the dignity of death. Human dignity has never been a clear concept in Western ethical explorations, and the dignity of death has given rise to more confusions. Although there is no such (...) term as “dignity” in Confucian ethics, there are discussions of a number of ideas related to human dignity and the dignity of death. Therefore, Confucian bioethics can offer a new perspective for understanding the theoretical difficulties associated with the dignity of death and new methods for solving them. In this article, we attempt to reconstruct Confucian views on human dignity and the dignity of death and, based on those views, to analyze the following issues: the relationship between the dignity of death and biological life, the relationship between the dignity of death and suffering, the relationship between the dignity of death and the autonomy of human beings, and the relationship between the dignity of death and social justice. This article will also compare the Confucian views on these issues with the views of Western philosophers. Confucian ethics can offer distinct answers to the above issues and help resolve some confusions concerning concepts and theories in Western research on the dignity of death. (shrink)

The unique mix of modern Western and traditional Confucian values in Singapore presents young people with contradictory views on duties to aging parents. It remains to be seen whether the changing demands of modern life will result in new generations giving up Confucian family ethics or whether the Confucian dynamic will find a way to adapt to the new pressures. It is the opinion of this author that the Confucian family structure has mixed potential for the (...) growing crisis of elder care. Alone, both Confucian traditions and typical Western institutional approaches toward elder care fall short of what is necessary for intergenerational social justice, yet a hybrid of the two has great potential for the growing aging crisis. To demonstrate this, I first give a brief account of the history of filial piety in Confucianism as well as the social environment from which it originated. Then I turn my attention to the present issues of an aging population and elder care that face much of the developed world in the twenty-first century. Finally, I show how adherence to Confucian filial traditions can both help to address many of these issues and how it can potentially leave unjust gaps in elder care. Ultimately, I conclude that the crisis of elder care may be best dealt with through a hybrid of Confucian values and Western approaches. (shrink)

This paper examines whether the modern bioethical principles of respect for autonomy, beneficence, non-maleficence, and justice proposed by Beauchamp and Childress are existent in, compatible with, or acceptable to the leading Chinese moral philosophy—the ethics of Confucius. The author concludes that the moral values which the four prima facie principles uphold are expressly identifiable in Confucius’ teachings. However, Confucius’ emphasis on the filial piety, family values, the “love of gradation”, altruism of people, and the “role specified relation oriented ethics” will (...) inevitably influence the “specification” and application of these bioethical principles and hence tend to grant “beneficence” a favourable position that diminishes the respect for individual rights and autonomy. In contrast, the centrality of respect for autonomy and its stance of “first among equals” are more and more stressed in Western liberal viewpoints. Nevertheless, if the Confucian “doctrine of Mean” and a balanced “two dimensional personhood” approach are properly employed, this will require both theorists and clinicians, who are facing medical ethical dilemmas, of searching to attain due mean out of competing moral principles thus preventing “giving beneficence a priority” or “asserting autonomy must triumph”. (shrink)

Fan (2010) did a good job in applying his interpretation of Confucian ethics of giftedness to genetic enhancement. To him, it is God-like Heaven that gives lives to us and our ancestors as gifts th...

The main contentions of this paper are twofold. First, there is a more than century‐old Japanese tradition of human rights based on a fusion of Western concepts of natural rights and a radical reinterpretation of Confucianism, the major proponent of which was the Japanese thinker Nakae Chomin. Secondly, this tradition, although a minority view, is crucial for remedying the serious defects in the present Japanese medical system. In the latter half of the nineteenth century, Nakae Chomin sought to reinterpret Chinese (...) tradition, especially Confucianism, by injecting the concepts of popular sovereignty and democratic equality, drawn from Western sources. The resulting view maintained the Confucian commitment to a moral nexus for society, but replaced hierarchy with egalitarianism. The pressing need for such an approach to patients' rights in present‐day Japan is illustrated by two recent cases: the photographing and commercial exploitation of patients' genitals without serious response by authorities, and the attempt by physicians to manipulate the time of death and, possibly, to improperly pressure family members in order to transplant organs from the brain‐dead victim of a criminal assault. Such problems stem from hierarchy and paternalism, which seem to be a legacy of the rapid, state‐sponsored introduction of Western medicine in the mid‐nineteenth century, and in particular from the government's adoption of and support for German military medicine as a model for Japan. (shrink)

Since COVID-19 is a global-scale pandemic, it can only be solved on the global level. In this context, intercultural dialogues are of utmost importance. Indeed, different models of traditional ethics might be of assistance in constructing a new, global ethics that could help us confront the present predicament and prepare for other possible global crises that might await us in the future. The explosive, pandemic spread of COVID-19 in 2020 clearly demonstrated that in general, one of the most effective tools (...) for containment of the epidemics is precisely human and interpersonal solidarity, which must also be accompanied by a certain degree of autonomous self-discipline. The present paper follows the presumption that these types of personal and interpersonal attitudes are—inter alia— culturally conditioned and hence influenced by different traditional models of social ethics. In light of the fact that East-Asian or Sinic societies were more successful and effective in the process of containing and eliminating the virus compared to the strategies of the Euro-American regions, I will first question the widespread assumption that this effectiveness is linked to the authoritarian political traditions of the Sinic East and Southeast Asian areas. Then, I will critically introduce the Confucian ethics of relations, which in various ways has influenced the social structures of these regions, and clarify the question of whether and in which way the relics of this ethics had an actual effect on the crisis resolution measurements. The crucial aim of this paper is to contribute to the construction of theoretical groundworks for a new, transculturally grounded global ethics, which is more needed today than ever before. (shrink)

Across the world, socio-economic forces are shifting the locus of long-term care from the family to institutional settings, producing significant moral, not just financial costs. This essay explores these costs and the distortions in the role of the family they involve. These reflections offer grounds for critically questioning the extent to which moral concerns regarding long-term care in Hong Kong and in mainland China are the same as those voiced in the United States, although family resemblances surely exist. Chinese moral (...) values such as virtue and filial piety embedded in a Confucian moral and social context cannot be recast without distortion in terms of modern Western European notions. The essay concludes that the Confucian resources must be taken seriously in order to develop an authentic Chinese bioethics of long-term care and a defensible approach to long-term care policy for contemporary society in general and Chinese society in particular. (shrink)

How do we know that particular answers in bioethical controversies are true, or are at least getting closer to the truth? We gain insight into this question by applying Alasdair MacIntyre’s work on the nature of rationality, rational justification, and tradition. Using MacIntyre’s work and the papers in this issue of The Journal of Medicine and Philosophy, I propose a framework for members of particular traditions to judge whether they themselves or other traditions are getting closer to or further away (...) from the truth in particular bioethical questions. Members of different traditions—be it Confucian, Aristotelian, politically liberal, utilitarian, or something else—should look at how they and their theoretical rivals look at empirical data to address bioethical questions, the moral judgments they make, and the laws and regulations they support. Some level of agreement on these issues need not require individual traditions to eschew their foundational premises or values; recognizing the reality of moral pluralism and disagreement should not prevent us from seeing this. Neither, as MacIntyre argues, should pluralism and disagreement obscure that a necessary condition for successful rational exchange and adjudication between competing traditions is granting authority to certain norms and virtues. (shrink)

This article discusses the application of artificially intelligent robots within eldercare and explores a series of ethical considerations, including the challenges that AI (Artificial Intelligence) technology poses to traditional Chinese Confucian filial piety. From the perspective of Confucian ethics, the paper argues that robots cannot adequately fulfill duties of care. Due to their detachment from personal relationships and interactions, the “emotions” of AI robots are merely performative reactions in different situations, rather than actual emotional abilities. No matter how (...) “humanized” robots become, it is difficult to establish genuine empathy and a meaningful relationship with them for this reason. Even so, we acknowledge that AI robots are a significant tool in managing the demands of elder care and the growth of care poverty, and as such, we attempt to outline some parameters within which care robotics could be acceptable within a Confucian ethical system. Finally, the paper discusses the social impact and ethical considerations brought on by the interaction between humans and machines. It is observed that the relationship between humans and technology has always had both utopian and dystopian aspects, and robotic elder care is no exception. AI caregiver robots will likely become a part of elder care, and the transformation of these robots from “service providers” to “companions” seems inevitable. In light of this, the application of AI-augmented robotic elder care will also eventually change our understanding of interpersonal relationships and traditional requirements of filial piety. (shrink)

The paper attempts to set a guideline to contemporary common morality debate. The author points out what he sees as two common problems that occur in the field of comparative cultural studies related to a common morality debate. The first problem is that the advocates and opponents of common morality, consciously or unconsciously, define the moral terms in question in a way that their respective meanings would naturally lead to the outcomes that each party desires. The second problem is that (...) the examples each party chooses as the empirical evidences may not be as simple and clear-cut as the researchers think they are, mainly because the situational contexts where the examples are located between two different cultures vastly differ. To prevent these mistakes, the author emphasizes that we should pay attention to a subtle distinction between "thick" and "thin" construed from the levels of "theoretical status" and of "material content". With the conceptual distinctions in mind, the author shows how different cultures (i.e., Western individualist society and East Asian neo-Confucian society) see the moral principles like autonomy and beneficence in different lexical orders. (shrink)

Purpose Much prior literature has discussed bioethics from a Confucian perspective in biomedical research, but little has applied Confucianism in examining ethics in social and behavioral research involving human subjects. This paper aims to reexamine the Belmont principles in social and behavioral research from a Confucian perspective to discuss their applicability and limitations and propose implications for revising or extending them potentially in the future. Design/methodology/approach A comparison is conducted on bioethics and social and behavioral research (...) ethics. Afterward, a critical analysis is conducted on the Belmont principles of respect for persons, beneficence and justice from a Confucian perspective regarding their application in social and behavioral research. Findings From a Confucian perspective, the Belmont principles are necessary but may not be sufficient to cover the width and depth of ethical issues in social and behavioral research, such as those in crowd work-based research. This paper proposes that ethical guidelines for social and behavioral research may need to be updated from the Belmont principles adopting or incorporating certain Confucian ethics. Originality/value Social and behavioral research ethics have been relatively marginal compared to the bioethics deliberation in the existing literature. Unlike Beauchamp and Childress’s continued efforts in refining ethical guidelines for biomedical research specifically, little similar work has been done in this area since the Belmont report’s publication in 1979. This paper sheds light on building more refined and specific ethical guidelines to navigate the ever-growing numbers and diversities of nonmedical research topics, methodologies and contexts. (shrink)

This article examines the cross-cultural bioethical concerns stemming from the potential use of CRISPR-Cas9 for genetic enhancement projects. It emphasizes the need to differentiate between basic and non-basic human rights when considering genetic enhancement, as recent international declarations lack this distinction. Basic rights possess a universal nature and are applicable across cultures, while non-basic rights are culturally specific and should be determined within respective regions. To illustrate this, the study explores the acceptance or rejection of non-basic rights related to genetic (...) enhancement in two distinct cultural categories: Type-A and Type-B cultures. Type-A cultures predominantly adhere to a liberal moral framework, while Type-B cultures are rooted in Confucian morality. Additionally, the article argues for two basic rights in genetic enhancement: the right to be free from bodily harm and the right to be free from deception. These rights differ from non-basic rights and should be universally upheld in all cultures. By analyzing a hypothetical case and drawing parallels with the He Jiankui incident, the article investigates the violation of these two basic rights in each scenario, regardless of cultural context. Consequently, both cases should be unequivocally rejected in both Type-A and Type-B cultures. (shrink)

LANGUAGE NOTE | Document text in Chinese; abstract also in English. 2022年底，中國內地政府發佈了一系列政策，完成了新冠疫情防控從以＂政府”為主體的舊做法，到充分發揮＂家庭＋個人”主體作用的新做法的轉變。本文基於“仁愛”、＂公義”、＂誠信”及“和諧”等儒家生命倫理的 四項基本原則，立足於防疫做法轉變過程中的行為主體，探討了防疫主體變化背景下的民派生活和健康保障問題、資源與財富分配公正問題、真實可靠資訊獲取問題、費用共擔與資源共用問題。本文認為，＂家庭＋個人＋政府” 多主體協作防疫的實現是必然的；相較於防疫舊做法，新的防疫做法更加可持續。當下中國內地亟需加快恢復正常生產生活，緩解防疫主體變化對全社會帶來的＂陣痛”，與此同時總結經驗，為之後可能出現的疫情反復進行提前 準備。 In late 2022, the central government of China introduced a series of policies for the mainland as part of a comprehensive transformation of COVID-19 Pandemic Prevention and Control (PPC) from the traditional, government-centered approach to a novel approach that prioritizes individuals and families. Drawing upon the four fundamental principles of Confucian bioethics, namely “benevolence,” “justice,” “integrity,” and “harmony,” this paper examines the ethical challenges of safeguarding lives (...) and health, ensuring a fair distribution of resources and wealth, obtaining accurate and reliable information, and openly sharing the costs and resources throughout this transformation in the PPC approach. By focusing on the key actors involved in the process, we propose that the shift from a government-centric to a collaborative “family + individual + government” approach is both necessary and sustainable. Accordingly, we advocate for accelerating the return to normal production and daily life to mitigate the societal “pain” associated with the transformation. Additionally, we urge the government to reflect on its previous experience and prepare for a possible pandemic recurrence. (shrink)

The development of biotechnologies has broadly interfered with a number of life processes, including human birth. An important moral question arises from the application of such medical technologies to birth: do biotechnological advancements violate human dignity? Many valid arguments have been raised. Yet bioethicists are still far from reaching a consensus on how best to protect the dignity of human birth. Confucianism is an influential ethical theory in China and presents a distinctive understanding of human dignity. In this paper, we (...) reconstruct the two Confucian concepts of dignity—namely, universal dignity and personal dignity. We then apply these concepts to human birth in the context of biotechnologies involving embryos and genetic enhancement. We conclude that the dual Confucian understanding of dignity contributes a valuable perspective to the question of whether biotechnologies related to human birth violate human dignity. (shrink)

With the emergence of clustered, regularly interspaced, short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) as one of the most promising new gene-editing techniques, scientists are now endeavoring to apply it to various domains. Among all the possible applications, gene editing in human embryos has received the most attention. Against this background, this article carries out a philosophical study on the ethical problems of human embryo gene editing or designing. Arguments against human embryo gene designing include that parents should be prohibited (...) from deciding their children’s future; commodifying children should be prohibited; the natural reproductive process should not be disturbed; and human embryo gene designing might foster discrimination. Arguments for human embryo gene designing include that parents should have the freedom to design their own babies and this freedom should not be limited; designing babies can promote the happy life of the baby; and totally forbidding embryo gene editing would drive the practice underground, where it would be performed illegally. This article analyzes all of these arguments and points out that all of them have some flaws. In order to draw a thoughtful conclusion, we turn to Confucianism and find a new perspective to determine whether designing babies with CRISPR technology is ethically permissible. (shrink)

LANGUAGE NOTE | Document text in Chinese; abstract also in English. 承認涉及自我與他者之間的相互認可，因而可以將承認理論理解為一項關於人倫構成的哲學理論。本文首先分析黑格爾、霍耐特的現代承認理論的得失，特別對霍耐特所提出的“生存模式的承認”與黑格爾的“主奴辯證法”進行 反思性分析，揭示出現代承認理論的人類學前提是將人理解為一個口只關注人的必死性的欲望的主體；之後回到奥古斯丁，通過重構奥古斯丁關於人從記憶中尋求上帝的描述，提出一種基於創造論(proctology)的承 認理論，指出這種承認理論的人類學前提是將人理解為一個關注人的降生性的感應的主體；最後通過分析儒教經典中的相關論述，指出天人之倫乃是父子之倫、朋友之倫、君臣之倫的基礎，從而為一種宗教性的生命倫理學奠定理 論基礎。 Recognition involves mutual recognition between the self and others. As such, the theory of recognition can be understood as a philosophical theory about the constitution of human relations. This article first analyzes Hegel's and Honneth's modern theories of recognition. It critically assesses Honneth's “recognition of the mode of existence” and Hegel's “master-slave dialectics,” revealing that these modern recognition theories embrace an anthropological premise: man is understood as a subject (...) who only pays attention to the desire of man's mortality. The article then turns to Augustine's doctrine. By reconstructing Augustine's description of man seeking God from memory, the article proposes a protology-based theory of recognition, laying out an alternate anthropological premise in which man is understood as a sympathetic subject concerned with human incarnation. Finally, in analyzing relevant discussions in Confucian classics, the article indicates that the relationship between Heaven and man is the foundation for the relationship between father and son, the relationship between friend and friend, and the relationship between monarch and minister, laying a theoretical foundation for Confucian religious bioethics. (shrink)

This paper is aimed at a critical assessment of the moral framework of the current Chinese health system from a Confucian perspective, by focusing on the debate between the individual directed approach and the family-oriented approach to a health care system. Concerned with the nature and status of the family in communal life, the paper deals with the following questions: to cope with the frailties of material life (including susceptibility to disease), what good is presupposed by human existence and (...) flourishing; why it is the family that serves as the primary locus of bearing and realizing this unique good; and what kind of society might possess the structures necessary to achieve the good thus conceived. All these questions lead to a revision of the theory of justice required in health care, in favor of family health saving accounts as an important institutional guarantee. (shrink)