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The ethics of betel nut consumption in Taiwan
  1. Joseph Tham1,
  2. Geoffrey Sem2,
  3. Eugene Sit3,
  4. Michael Cheng-tek Tai4
  1. 1 School of Bioethics, Pontificio Ateneo Regina Apostolorum, Rome, Italy
  2. 2 Faculty of Health, School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
  3. 3 Faculty of Medicine, University of Hong Kong, Hong Kong, SAR China
  4. 4 Department of Bioethics and Medical Humanities, Chung Shan Medical University, Taichung, Taiwan
  1. Correspondence to Dr Joseph Tham, School of Bioethics, Pontificio Ateneo Regina Apostolorum, Via degli Aldobrandeschi 190, Rome 00163, Italy; jtham{at}


The ethics of betel nut use in Taiwan are examined in this article. It first presents scientific facts about the betel quid, its consumption and negative health consequences and then analyses the cultural background and economic factors contributing to its popularity in Asia. Governmental and institutional attempts to curb betel nut cultivation, distribution and sales are also described. Finally, the bioethical implications of this often ignored subject are considered.

  • History of Health Ethics/Bioethics
  • Informed Consent
  • Substance Abusers/Users of Controlled Substances
  • Social Aspects

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  • Contributors GS was responsible for the empirical and medical aspects of betel nut. ES researched the socioeconomic and governmental response. MC-tT reviewed the situation in Taiwan and advised on the ethical analysis. JT is the main author who conceived the idea for the paper, coordinated all the efforts and submitted the paper in its present form.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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