Ruiping Fan

The family and harmonious medical decision making: cherishing an appropriate Confucian moral balance.

This essay illustrates what the Chinese family-based and harmony-oriented model of medical decision making is like as well as how it differs from the modern Western individual-based and autonomy-oriented model in health care practice. The essay discloses the roots of the Chinese model in the Confucian account of the family and the Confucian view of harmony. By responding to a series of questions posed to the Chinese model by modern Western scholars in terms of the basic individualist concerns and values embedded in the modern Western model, we conclude that the Chinese people have justifiable reasons to continue to apply the Chinese model to their contemporary health care and medical practice.

Which Care? Whose Responsibility? And Why Family? A Confucian Account of Long-Term Care for the Elderly

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.

A Confucian Reflection on Genetic Enhancement

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.

Which medicine? Whose standard? Critical reflections on medical integration in China

There is a prevailing conviction that if traditional medicine (TRM) or complementary and alternative medicine (CAM) are integrated into healthcare systems, modern scientific medicine (MSM) should retain its principal status. This paper contends that this position is misguided in medical contexts where TRM is established and remains vibrant. By reflecting on the Chinese policy on three entrenched forms of TRM (Tibetan, Mongolian and Uighur medicines) in western regions of China, the paper challenges the ideology of science that lies behind the demand that all traditional forms of medicine be evaluated and reformed according to MSM standards. Tibetan medicine is used as a case study to indicate the falsity of a major premise of the scientific ideology. The conclusion is that the proper integrative system for TRM and MSM is a dual standard based system in which both TRM and MSM are free to operate according to their own medical standards.

Toward a Confucian Family-Oriented Health Care System for the Future of China

Recently implemented Chinese health insurance schemes have failed to achieve a Chinese health care system that is family-oriented, family-based, family-friendly, or even financially sustainable. With this diagnosis in hand, the authors argue that a financially and morally sustainable Chinese health care system should have as its core family health savings accounts supplemented by appropriate health insurance plans. This essays arguments are set in the context of Confucian moral commitments that still shape the background culture of contemporary China.

A Reconstructionist Confucian Approach to Chinese Health Care

The world is witnessing a rapid development of current China ‐ its booming economy, promising markets, advancing sciences and technologies, and improving education, etc. However, China also faces enormous cultural, social and economic problems and difficulties. This paper focuses on issues in Chinese health care ethics, markets, and policies. Let me begin by summarizing a series of severe challenges that China is confronting in the demand and supply of health care as follows. 1. How should China adequately establish and stabilize a sustainable health care system for a huge population with an ever increasing portion of the retired elderly (demanding high-intensity health care interventions) and an ever decreasing portion of the working people (providing funds to support health care)? This is a crucially important issue for the long-term development of Chinese health care system, 1 being all the more urgent with the “four-two-one” structure of the current Chinese family under the government’s “one child per couple” populationcontrol policy. 2. What should be done to set up a basic health care delivery accessible to the Chinese peasants in the countryside? Indeed, between the urban and rural areas of current China, there exists an unfair “one country, two systems” in health care delivery: compared to their fellow citizens in cities, Chinese peasants receive much fewer health care funds, investments and facilities (some rural areas even do not have very basic health care elements, such as clean water and preventive vaccines), and most of them do not have any type of health insurance so that they have to pay out of pocket for every medical visit (Chen, 2005). This challenge is both ethically and economically formidable, because the countryside covers about eight hundred million Chinese people, composing about seventy-five percent of the country’s entire population.

Taking the Role of the Family Seriously in Treating Chinese Psychiatric Patients: A Confucian Familist Review of China’s First Mental Health Act

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 patients interests by refusing the familys 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 patients 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.

Introduction: The Rise of Authentic Confucianism

Many in the West are so fully embedded in their moral and political understandings that they take for granted that their moral intuitions reflect a global moral and political theoretical common ground. This conceit lies at the basis of the moral and political reflections of such contemporary Western thinkers as Ronald Dworkin, Jurgen Habermas, John Rawls, and even Richard Rorty. In different ways such presuppositions sustain the ideologies of such diverse parties as social democrats and neo-conservatives. The universality of these assumptions is radically falsified by China, which constitutes a moral, social and political counter-example. Although Western thinkers attempt to portray China as a country on its way to developing the moral and political commitments of the occident, China is in fact a country on its way to recapturing and rearticulating the Confucian moral and political commitments that lie at the foundations of Chinese culture and have a history reaching back even before Confucius (551–479 BCE) himself.

Building a Chinese Medicine Sector in Hong Kong

In the past 10–15 years, policy makers in Hong Kong have started to turn their attention to Chinese medicine. This article reviews their progress to date, and examines the different regional policy models they might learn from in framing health care policies to cover both Chinese and modern scientific medicine. It argues that the best way forward for Hong Kong is to position itself on a spectrum of nondiscriminatory state practice that offers equal respect to both traditional and modern medicines. In East Asia, China stands towards one end of this spectrum, and South Korea and Taiwan towards the other. The article holds that Hong Kong should place itself somewhere between the two.

Ritual as a Cardinal Category of Moral Reality: An Introduction

Ritual cements human life. It is not necessarily fully discursively apprehensible, as is traditional natural law or natural theology. Ritual engages prior to any conceptual thematization of its object and usually also transcends discursive statement. Ritual involves the synthesis of habit, image, symbol, movement, and emotion. It is therefore heuristic for a range of moral and religious insights. To be sure, as a central category of human existence, ritual is secondarily available for discursive appropriation. Yet, ritual is largely ignored in Western philosophical reflection. Hence, the importance of this volume: this book offers a philosophical assessment of the significance of ritual. First, this volume recognizes ritual’s pre- or non-discursive character, which nests virtue and directs moral action, so that ritual can be powerfully formative of both moral and immoral action. Second, this volume seeks to assess the roles ritual can play in the pursuit of virtue by those who recognize that the collective insight and wisdom of moral traditions can serve as a positive moral resource.