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J Med Ethics 2005;31:159-163 doi:10.1136/jme.2002.002113
  • Global medical ethics

The bioethical principles and Confucius’ moral philosophy

  1. D F-C Tsai
  1. Correspondence to:
 Assistant Professor D F-C Tsai
 Department of Social Medicine and Department of Family Medicine, National Taiwan University College of Medicine, Department of Medical Research, National Taiwan University Hospital, No 1, Section 1, Jen-Ai Road, Taipei, 100, Taiwan; fctsaiha.mc.ntu.edu.tw
  • Received 10 October 2002
  • Accepted 1 October 2003
  • Revised 26 November 2003

Abstract

This paper examines whether the modern bioethical principles of respect for autonomy, beneficence, non-maleficence, and justice proposed by Beauchamp and Childress are existent in, compatible with, or acceptable to the leading Chinese moral philosophy—the ethics of Confucius. The author concludes that the moral values which the four prima facie principles uphold are expressly identifiable in Confucius’ teachings. However, Confucius’ emphasis on the filial piety, family values, the “love of gradation”, altruism of people, and the “role specified relation oriented ethics” will inevitably influence the “specification” and application of these bioethical principles and hence tend to grant “beneficence” a favourable position that diminishes the respect for individual rights and autonomy. In contrast, the centrality of respect for autonomy and its stance of “first among equals” are more and more stressed in Western liberal viewpoints. Nevertheless, if the Confucian “doctrine of Mean” (chung-yung) and a balanced “two dimensional personhood” approach are properly employed, this will require both theorists and clinicians, who are facing medical ethical dilemmas, of searching to attain due mean out of competing moral principles thus preventing “giving beneficence a priority” or “asserting autonomy must triumph”.

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