East Asian medicine, biomedical research, and health care policy are framed by their own set of moral and cultural commitments. Chief among these is the influence of Confucian ideas. A rich portrayal is offered of the implications of Confucian moral and ontological understandings for medical decision-making, human embryonic stem cell research, and health care financing. What is offered is a multifaceted insight into what distinguishes East Asian bioethical reflections. This volume opens with an exploration of the Confucian recognition of the family as an entity existing in its own right and which is not reducible to its members or their interests. As the essays in this volume show, this recognition of the family supports a notion of family autonomy that contrasts with Western individualistic accounts of proper medical decision-making. There are analyses of basic concepts as well as explorations of their implications for actual medical practice. The conflicts in East Asian countries between traditional Confucian and Western bioethics are explored as well as the tension between the new reproductive technologies and traditional understandings of the family. The studies of East Asian reflections concerning the moral status of human embryos and the morality of human embryo stem cell research disclose a set of concerns quite different from those anchored in Christian and Muslim cultural perspectives. The volume closes with an exploration of how Confucian cultural resources can be drawn upon to meet the contemporary challenges of health care financing.
Preface Shui Chuen Lee I. A View from Asia: An Introduction Shui Chuen Lee, Justin Ho Medicine and the Biomedical Technologies in the Context of Asian Perspectives II. The Family and its Impact on Bioethics and Personhood Ruiping Fan Confucian Familism and its Implications for Bioethics H. Tristram Engelhardt, Jr. The Family in Transition and in Authority: The Impact of Biotechnology Stephen Erickson Family Life, Bioethics, and Confucianism III. Medical Decision-Making and Traditional Conception of the Family Shuh-Jen Sheu A Truth-Telling Guideline: The Choice Between Patient Family Autonomy Stephen Wear Truth-Telling to the Sick and Dying in Traditional Chinese Culture: A Reappraisal Shui Chuen Lee On Relational Autonomy: From Feminist Critique to a Confucian Model for Clinical Practice Leonardo D. de Castro Reproductive Technology and Post-traditional Family IV. Human Embryonic Stem Cell Research: Confucian, Islamic, and Western Perspectives Ruiping Fan The Ethics of Experimenting with Human Pluripotent Stem Cells and the Interests of the Family Shui Chuen Lee A Confucian Evaluation of Embryonic Stem Cell Experimentation: An Analysis of the Moral Status of Human Embryos Wen-May Rei Reproductive Choices in a Patriarchal, Legal, and Social Institution: Sex Selection in Taiwan Wong Hon Chung Regulations for Human Embryonic Stem Research in East Asian Countries: A Confucian Critique Sahin Aksoy, Anwar Nasim An Islamic Approach to Stem Cell Experimentation H. Tristram Engelhardt, Jr. Why Western Culture, Unlike Confucian Culture, is so Concerned about Embryonic Stem Cell Research: The Christian Roots of the Difference V. Taking the Family Seriously: Confucian Approaches to Health Care Financing Kris Teo Confucian Health Care System in Singapore: A Family-oriented Approach to Financial Sustainability Erika Yu Respect for the Elderly and Family Responsibility: A Confucian Response to the Old Age Allowance Policy in Hong Kong Jeremy Garrett and Justin Ho The Family and Medical Savings Accounts: Reflections on Confucian Approaches to Health Care Financing VI. A Concluding, Quasi-Confucian Postscript Ruiping Fan Reflecting on the Family, Confucius, H. T. Engelhardt, Jr. and the Health Care Challenges of the 21st Century