Abstract
The second revision of the Hospice Palliative Care Act added a new criterion that allows for a patient’s family to petition for the withdrawal of life sustaining treatment if a terminal, incompetent patient’s wishes are unknown and the patient satisfies DNR criteria. In the third and most recent revision, the requirement of consulting an ethics committee has been removed. These changes reflect the long established practice of family consent in medical decision-making in Taiwan as well as in Confucian cultural contexts. This paper presents some of the key features of this practice and the attendant rationale for family decision-making in hospice care. It argues how and why family decision making is beneficial for both the patient and the family as well as for medical professionals. Some short-comings and difficulties are discussed and solutions proposed. This paper also examines how family consent and the mediation of medical professionals can enforce and protect the best interest of the patient.
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Notes
- 1.
The contemporary Neo-Confucianism referred to in this paper is the so-called third generation of Confucianism, that is, the successor of the pre-Chin Confucianism of Confucius, Mencius and Xunzi, and the Song-Ming Neo-Confucianism. The main figures include the late Professors Tang Chun-i, Mou Tsung-san and Hsu Fu-kuan, who have written influential classics on Chinese and Confucian philosophies.
- 2.
- 3.
Christine Korsgaard would call such an identity “practical identity” or “moral identity,” with the implication that it defines our obligations and values. See: Korsgaard 1996, pp. 90–130.
- 4.
The Book of Rites mentions Confucius’ story of Tsengzi who sustains slight, but not life threatening, punishment from his father.
- 5.
I have elaborated a Confucian model of clinical consultation in Lee 2008.
- 6.
In Mencius, 1A:7. “Ren-shu” is a political term first coined by Mencius. It was then extended by Chinese physicians in the Ming Dynasty to mean the art of medicine.
References
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Lee, S. C. 2008. A theory and model of ethical consultation. In Bedside consultation: Theory and practice, ed. S.C. Lee and D.J. Tsai, 1–11. Taipei: Hu-nan Book Company.
MacKenzie, C., and N. Stoljar, eds. 2002. Relational autonomy: Feminist perspectives on autonomy, agency, and the social self. Oxford: Oxford University Press.
Mencius. 1984. Mencius. In The four books, annotated & ed. by Zhu Xi. Taipei: Legein Publisher.
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Lee, S. (2015). Family Consent in Medical Decision-Making in Taiwan: The Implications of the New Revisions of the Hospice Palliative Care Act. In: Fan, R. (eds) Family-Oriented Informed Consent. Philosophy and Medicine(), vol 121. Springer, Cham. https://doi.org/10.1007/978-3-319-12120-8_8
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DOI: https://doi.org/10.1007/978-3-319-12120-8_8
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