Abstract
This volume poses fundamental challenges to the Western bioethical decision-making framework. It can be viewed as a sally in the culture wars. Authors in the volume argue, inter alia, that the fundamental ethical unit to which questions and decisions in medicine ought to be directed is the family, not the atomic individual. This is a message requiring our attention, because it highlights a truth about the beliefs of many people—even those, like me, who ultimately still side in favor of individualism—that the family is a—or the—fundamental unit of concern.
In the process of practicing a traditional way of life, our understanding of the world is translated into a deeper conviction and belief about how the world really is.
(Zhao, this volume, p. 9)
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- 1.
The terms “West” and “East” are problematic for a number of reasons, not least because they imply homogeneity of belief where it does not exist. However, the authors in this volume adopt these terms as heuristics for describing general cultural norms, so I likewise make use of them.
- 2.
I do not mean to suggest that authors in this volume are arguing that the West should change its model—rather, most of them are arguing against the exported Western individualist model being applied to—or imposed on—East Asian contexts.
- 3.
For example, Ilhak Lee quotes the seminal Confucian text and explains: “In The Analects…, filial duty is mentioned as the foundation of all human relationships: ‘filial piety and fraternal submission! Are they not the root of all benevolent actions?’” (p. 4).
- 4.
Wong points out that in a survey done in Taiwan, “the results showed that patients strongly claimed their own right to be informed about their disease to be superior over their family’s wishes to keep them uninformed” (p. 4). Yang cites a survey in China showing that “Ninety percent of patients indicated that they wanted family members and physicians to understand and respect their end of life wishes” (Yang, p. 11). In the Chinese context, this may mean that they want their families to consider their wishes, not that their wishes must be followed.
- 5.
For example, as Yang points out, “In the United States, studies have indicated that patients’ family members are involved with end-of-life decisions 60–80 % of the time and patients often prefer to make end-of-life decisions within the family context (Haley et al. 2002)” (Yang, p. 45).
- 6.
Of course, in a Western context we might not decide to require this, but we could design a form that strongly encourages and enables it. In both Eastern and Western contexts, though, the legal status of such a consent form would need further delineation. For example, could only donors with family signatures successfully donate? What happens in the case of disagreement among family members? Which signatures need to be on the form?
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Rasmussen, L. (2015). Families and Individuals in Medical Decision Making. 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_18
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DOI: https://doi.org/10.1007/978-3-319-12120-8_18
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