The Confucian bioethics of surrogate decision making: Its communitarian roots
The Confucian bioethics of surrogate decision making: Its communitarian roots
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DOI：
10.1007/s11017-011-9191-z
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发表时间：
2011-10-01
影响因子：
1.4
通讯作者：
Fan, Ruiping
中科院分区：
文献类型：
--
作者：
Fan, Ruiping
家庭是中国社会的典范社区。本文探讨了中国社群主义规范，表达了对家庭权威和自主权的强烈承诺，是当代中国生命伦理学的核心。特别是，它集中在代理决策的问题，以说明儒家家庭为基础的社群主义生命伦理。本文首先描述了在中国生命伦理学中，当患者失去决策能力时，家庭作为一个整体为重要的医疗和手术干预提供同意的方式。有人认为，没有一个既定的秩序，为代理决策者的做法（e。例如，在一个实施例中，配偶、子女，然后是父母），这反映了人们承认，家庭作为一种社会现实，不能被简化为默认决策者的适当顺序的刻板印象。这种描述的家庭是在权力，使代理决定为一个不称职的家庭成员是丰富的阐述之间的差异的概念，病人自主权，家庭自主权，道德自主权。中国模式，以及儒家的家庭社群主义生活，涉及家庭自治，这是由儒家对道德自治的理解所支持的，而不是个人自治。最后，根据医生的角色，讨论了中国模式中患者和家庭利益与患者过去愿望之间可能发生冲突的问题。
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.