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Can familism be justified?

Kam-Yuen Cheng1, Thomas Ming, Aaron Lai

  • 1HKU SPACE Community College Community College - Philosophy, 13/F, 28 Wang Hoi Road Kowloon Bay, Kowloon Hong Kong. kycheng@hkuspace.hku.hk

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Confucian familism in East Asian hospitals is challenged, as it can undermine patient autonomy. While family involvement is valuable, it should be consultative, not directive, respecting individual autonomy in medical decisions.

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Area of Science:

  • Bioethics
  • Medical Ethics
  • Cultural Studies

Background:

  • Confucian familism, particularly its moderate form, influences medical decision-making in East Asian hospitals.
  • Moderate familism permits withholding patient information from patients and sharing it with families without explicit consent.
  • Defenses of familism include upholding patient autonomy and appealing to cultural relativism regarding family autonomy.

Purpose of the Study:

  • To critically evaluate the ethical justifications for Confucian familism in healthcare settings.
  • To challenge the notion that familism upholds patient autonomy or is culturally unique.
  • To propose an alternative model for family involvement in medical decisions.

Main Methods:

  • Philosophical argumentation against familist justifications.
  • Empirical survey data comparing Eastern and Western values.
  • Analysis of the relationship between family involvement, patient well-being, and autonomy.

Main Results:

  • Familist arguments for patient autonomy rely on flawed assumptions or are inadequately articulated.
  • Survey results indicate no fundamental dichotomy in values between East and West, countering cultural relativism claims.
  • Eastern emphasis on family can enhance communication but does not necessitate overriding individual autonomy.

Conclusions:

  • Moderate Confucian familism is ethically problematic and should be abandoned in East Asian hospitals.
  • Respect for patient autonomy is compatible with family consultation, not information control.
  • The ideal model involves family as consultants, ensuring patient well-being and autonomy are paramount.