bluuebunny/crossref_metadata_2025 huggingface dataset:
家庭成員共同決定——儒家家庭本位思想在臨床決定中的體現
Authors: XU Hanhui
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract also in English.儒家家庭本位思想對於中國傳統社會有著極其深刻的影響，而這種影響直到今天仍然發揮著巨大的作用，並由此形成了中國特有的社會結構和家庭觀念。在中國家庭中，家庭成員之間的關係更加密切，遇到重大事情，往往會由家庭成員共同做出決定。由於這種特殊的文化氛圍，在臨床決定的時候，應該用家庭共同決定代替個人自主決定，這種模式既能保障個人權利，維護個人利益，同時也是尊重家庭決定，營造和諧的家庭關係。Family involvement in medical decision making is a common practice in China due to the influence of Confucianism, which emphasizes the family as an organic unit. Instead of speaking of the individual’s right to choose and make a decision, the Confucian model for “informed consent” calls for “family co-decision making” or “co-determination.” The essay argues that China has long-standing moral traditions such as Confucianism, with its inherent ethical views toward family values that are still pertinent to a person’s daily life in general and bio-medical issues in particular.The author points out that those who acknowledge the role of the family in medical decision making feel much more satisfied. Sometimes both medical and non-medical burdens related to family roles and relationships are taken into consideration, but a patient who has good family relationships would rather family members be actively involved in the decision making. In addition, as young people are becoming increasingly individualistic under the influence of Western culture, family medical co-decision making can promote the Confucian values of family, family responsibility, and the well-being of individuals.DOWNLOAD HISTORY | This article has been downloaded 1791 times in Digital Commons before migrating into this platform.
前言: 家破——人亡
Authors: FAN Ruiping
Published: March 2021

LANGUAGE NOTE | Document text in Chinese儒家文化重視家族、家庭，舉世皆知。近代以來，經歷“幾千年未有之大變局”，西風東漸，社會動盪，家族破碎，人生扶搖。文革時代，人們高唱“天大地大不如黨的恩情大，爹親娘親不如毛主席親”的荒唐歌謠，上演夫妻互相揭發、孩子痛毆父母的慘烈景象。往事不堪回首！好在大災大難之後，中國人的家庭倫理還是大致保留了下來。不管一家還能生幾個孩子，親子關係依舊緊密；經濟上不分彼此，決策上總是為家人著想（用梁漱溟先生的觀點來說，“眼裡只見家人，不見自己”）；為了孩子的前途而樂於犧牲自己的享樂，相互忍讓，心繫後代，離婚率較低，單身、單親家庭很少；成年子女總是牽掛著年老父母的孤獨生活，“常回家看看”成為心底的強烈呼喚。凡此種種，千千萬萬的中國人還是一如既往地攜帶著“齊家”的個人身份：家人之間的緊密關係、天倫之樂，依然塑照著個人的生活意義和人生價值。不誇張地說，就我們這個文化的主要徵象(prime symbols)而言，如果大部分人的“家”不存在了，我們這種意義上的人也就不存在了。把一個成語的意思稍微調整一下，那就是：家破——人亡！DOWNLOAD HISTORY | This article has been downloaded 37 times in Digital Commons before migrating into this platform.
家庭作為弱勢人群的首重保障: 儒家倫理與醫療倫理
Authors: LO Ping Cheung
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract also in English.晚近國際生命倫理學的個人主義色彩仍然甚濃，本文以如何保護醫療弱勢人群（病人）為例，指出國際生命倫理委員會2009年報告書這方面的弊病。文中一方面解釋了儒家倫理學的“家庭共決” 模式，為何應當作為保護醫療弱勢人群的首重保障，另方面也梳理出其它價值體系的相關觀點，發現某些西方學者也有類似看法，只是未為重視。筆者最後以香港公立醫院對終止維持生命治療及預設醫療指示的道德指引為例，說明儒家的家庭共決模式實際如何運作。Individualism is still very much alive in “international” bioethics. Using two documents from the International Bioethics Committee as examples (Proposed Outline for a Report on Respect for Human Vulnerability and Personal Integrity, 2009; Report of the IBC on the Principle of Respect for Human Vulnerability and Personal Integrity, 2011), and focusing on hospital patients as a vulnerable group, this essay points out the pitfalls of individualistic bioethics. Confucianism advocates family co-determination rather than individual self-determination, and this model of decision making can serve as the first bulwark in protecting vulnerable patients. This model of medical decision making is not unique to Chinese culture, but is actually advocated by a small number of Western scholars. This essay also illustrates how family co-determination in medical decisions works using the example of two recent policies introduced in Hong Kong public hospitals, viz., forgoing life-sustaining treatment for the terminally ill and the use of advance directives.DOWNLOAD HISTORY | This article has been downloaded 342 times in Digital Commons before migrating into this platform.
“家庭共決”保障脆弱人群的倫理限度及困境
Authors: LIU Junrong
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract in English only.The role of the family as “the first guarantee” of vulnerable groups is extremely limited and not always effective. When disagreements arise between patients and their family members, family co-determination can do nothing to help. Respecting patients’ autonomy should be taken as the premise of family co-determination; the government and society undertake more important responsibilities in the protection of vulnerable groups.DOWNLOAD HISTORY | This article has been downloaded 52 times in Digital Commons before migrating into this platform.
Engelhardt on the Family
Authors: LI Hon Lam
Published: March 2021

LANGUAGE NOTE | Document text in EnglishTristram Engelhardt, Jr. offers erudite and compelling arguments for the view that all families should try to realize the traditional family. Although I tend to agree with him from a personal standpoint, I doubt that this view can be justified to those with whom we are in reasonable disagreement about the family. I make three critical points. First, although Engelhardt stops short of saying that the state should encourage people to form traditional families, or discourage those who do not, some state perfectionists might do so. From the perspective of public reason, it is unjust for the state to favor some conceptions of what is good over others, if these conceptions are all reasonable. Moreover, those whose conceptions of the good are not favored will feel that they are disrespected. Second, insofar as Engelhardt thinks that all families should try to realize traditional families, the traditional family would not be perceived as good by those who do not like children. Moreover, it would be difficult to persuade those who have decided not to have children for reasons of career, burden, or more altruistic concerns. Third, against Engelhardt’s stance against the “egalitarian aspirations” of liberalism, I argue that women too often sacrifice their possible careers for the sake of the family, even when they hold advanced degrees from prestigious universities, or professional qualifications. This kind of injustice is too uncomfortable to ignore.DOWNLOAD HISTORY | This article has been downloaded 29 times in Digital Commons before migrating into this platform.
儒家家庭價值的應用與生物科技倫理
Authors: IP King Tak
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract also in English.隨着科技的發展，當代社會出現了好些新的道德議題。學者嘗試從不同的宗教、哲學及文化傳統，如儒家角度，回應這些議題。部分學者在詮釋儒家傳統時，卻往往只選取某些儒家的重要概念，或引用某些儒家重要的經典，然後論證儒家在回應某議題的適切性。但是，儒家並非僅僅是一套哲學的系統。儒家在過往千多年，一直為中國社會提供生活的指導原則。所以，我們關注的，應是如果將儒家這些原則應用到今天相關議題時，將出現怎樣的狀况；以及這些原則在歷史上的應用又能否為當代建構儒家倫理提供在概念與經典外的資源。本文探索的，正是建構儒家倫理的方法問題。筆者嘗試從儒家的婚姻家庭價值及其在歷史上的具體應用，看它對當代中國在生物科技方面的抉擇帶來什麼影響。如果儒家是一個活傳統，其價值觀在過往的應用亦應可為今日的處境帶來洞見，同時亦展現出儒家倫理歷久不變的價值。In response to the challenges presented by ever-emerging moral issues in contemporary society, ethicists try to obtain input from different religious, philosophical and cultural traditions, and Confucianism is a popular choice. In following Confucian ethics, people grasp important Confucian concepts, quote important passages from the Classics and engage in exegesis to argue for the contemporary relevancy of Confucianism and Confucian ethics. However, because Confucianism is a living tradition that has guided Chinese life for years, other questions must be addressed when considering Confucian ethics. How have Confucian principles been applied historically to handle similar issues? Can these past applications serve as a source for addressing contemporary Confucian ethics? This paper considers how people adhere to Confucian ethics. The author determines how select Confucian family values have been applied in the past to help the Chinese to achieve major objectives related to marriage and family, and shows how they apply to the use of biotechnology in contemporary China. The paper contends that if Confucianism remains a living Chinese tradition, its past applications should give insights, however heuristic, into how people currently adhere to Confucian ethics.DOWNLOAD HISTORY | This article has been downloaded 538 times in Digital Commons before migrating into this platform.
“儒醫”概念的文化與政治意蘊
Authors: CHENG Guobin
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract also in English.雖然中國歷史上儒者行醫是比較普遍的現象，但“儒醫”作為專有名詞出現是北宋時期。後世學者多在其文化意義上闡發這概念的社會學和倫理學意義，強調儒醫在知識結構和價值取向方面的特徵。本文對《宋會要輯稿》所輯錄北宋官方文件中“儒醫”一詞的前後語境及相關政策設計思路進行了考查，認為北宋官方提出“儒醫”概念，是在醫學社會發展需要和醫學社會地位低的雙重壓力下而採取的政策選擇，其目的是通過制度設計和文化正名的方式吸引儒生加入以加強醫學行業，同時也借此整合醫學，將醫學更好地統一於儒家的王政體系之中。The earliest definition of ruyi (Confucian physicians or literati-physicians) referred to the literati the imperial court intended to recruit for its Taiyiju, the Imperial Medical Services. The concept of ruyi emerged and gained popularity during the Song period, after which the Confucian physician occupied a unique position between the literatus and physician in the social hierarchy. From an institutional perspective, the official Hanlin Medical Institute functioned as a special medical service department whose major responsibility was to take care of the imperial family. The Imperial Medical Services, which had initially been under the jurisdiction of the Hanlin Artisans Institute, became part of the Guozijian, the Directorate of Education in the Song period, due to imperial sponsorship. This essay contends that the process of the “Confucianization of medical doctors” initiated by the court elevated the social position of physicians, making them members of the Confucian political system.Based on the Chinese historical work the Song Huiyao Jigao (Song Dynasty Manuscript Compendium), this essay discusses the cultural and political implications of literati-physicians during the Song Dynasty. It argues that although Confucian literati-physicians viewed themselves as the elite group in the realm of medical skills, the social dilemma of their “middle” social position was evident in the medical histories written during the period. The term ruyi is understood in three ways: (1) practical/medical skills; (2) the Confucian methodologies adopted in studying medicine; and (3) the Confucian ethical codes. Literati-physicians were expected to go beyond their professional boundaries and attain a social status parallel to the Confucian literati who passed through the thorny gate of the civil service examinations.DOWNLOAD HISTORY | This article has been downloaded 576 times in Digital Commons before migrating into this platform.
從儒家傳統論中醫職業精神的形成機制
Authors: LIU Yunzhang
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract also in English.中國傳統醫師職業精神是中國優秀職業精神的有機組成部分，影響其形成與發展有着多方面因素，尤其是儒家思想。儒家的人本文化特質為醫學、醫療實踐與醫師職業精神營造出濃郁的文化背景；儒家的“不為良相，當為良醫”的價值觀逐步提升了醫學與醫師職業精神的社會地位與價值；儒家的核心價值思想——“仁”深刻揭示了醫師職業精神的內在本質與要求；儒家的責任倫理使醫師在行醫實踐中始終按照社會對醫師職業的整體責任要求、按照為病家謀幸福的個體責任要求規範自己的言行；儒家的“修身”促進了醫師職業精神的養成。所有這些都從不同側面促進了中國傳統醫師職業精神的形成。儒家思想對中國傳統醫師職業精神的形成為當下中國醫師職業精神建設提供了有益的啟示與借鑒。The “Regulations on Medical Ethics for Medical Professionals in the PRC” promulgated by the Chinese Ministry of Health function as contemporary moral rules for medical professionalism. The principles underlying these ethical rules are not that different from those underlying bio-medical ethics in the West, which provides a broad platform for medical ethics and moral codes. However, this paper explores Confucian moral teachings to supplement the current discourse related to professional ethics. The issue up for discussion is how medical professionalism can be reconstructed based on Confucianism. This paper outlines the Confucian ethics that formed the cultural context in which traditional Chinese medical practice is perceived and conducted.According to Confucianism and especially the tradition of ruyi (or literati-physicians), “humanness (ren) is the art of medicine and healing.” Medical practice is considered part of the process of moral self-cultivation. Accordingly, the principles of Confucian ethics in medicine are not confined to regulating the external conduct of the professional agent, but are extended to cultivate the internal disposition of the moral agent, allowing a physician to fully understand the appropriate relationship between the physician and patient. Moral codes and regulations are necessary and essential for sustaining any sound medical practice. However, according to Confucian teachings, it is more important for medical professionalism to involve a mechanism that can transform medical practice from a technical craft into a spiritual pathway.DOWNLOAD HISTORY | This article has been downloaded 591 times in Digital Commons before migrating into this platform.
德性倫理與醫療專業精神
Authors: CHAN Jonathan
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract also in English.中國的醫療制度存在着很多問題。很多人歸究於中國政府錯誤地將醫療推向缺乏足夠監管的市場。本文認為，中國的醫療制度存在着很多問題固然是由於缺乏足夠的市場監管。但是，亦涉及到醫療行業人員的專業失德的問題。本文即旨在探討醫療行業人員的“醫德”問題。本文對比兩種不同的“醫德”觀，它們分別為規則式的醫德觀和以德性為本的醫德觀。本文認為規則式的醫德觀會遇到很多困難，而以德性為本的醫德觀卻較能克服有關困難。China faces many healthcare problems. Many people, such as experts Prof. William Hsiao and Li Ling, attribute these problems to the unregulated marketization of the country’s healthcare system. This paper argues that although the unregulated marketization of its healthcare system contributes to many of China’s healthcare problems, a lack of professionalism is also an important factor. Furthermore, it argues that the Chinese medical profession requires both regulation and professionalism. It focuses on the moral aspect of medical professionalism (i.e., medical professional ethics) by discussing the rule- and virtue-based approaches to ethics. Alasdair MacIntyre initially observed the differences between these two approaches in his book, After Virtue. This paper discusses how the two approaches can be used to flesh out rule- and virtue-based medical professional ethics. It argues that rule-based medical professional ethics encounter severe difficulties from which virtue-based medical professional ethics are immune, and that there is therefore an urgent need to research virtue-based medical professional ethics.DOWNLOAD HISTORY | This article has been downloaded 358 times in Digital Commons before migrating into this platform.
順其自然
Authors: ZHANG Daqing
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract in English only.The author agrees that way of life is an important social determinant of health and longevity. However, an individual’s choice of way of life depends more on her/his own understanding of nature and life than on the differences between Eastern and Western culture, because rationalist and empirical traditions co-exist in both the East and the West. Rationalists assume that people are capable of understanding and controlling both nature and the human body, and empiricists argue that people should follow nature. In general, people who attempt to follow nature and lead moderate lives have a high life expectancy and are more likely to be healthy.DOWNLOAD HISTORY | This article has been downloaded 51 times in Digital Commons before migrating into this platform.
對生命倫理學相關問題的思考
Authors: CHEN Xiaoyang , WANG Wenfei , JI Haoyi
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract in English only.The cultural authority of bioethics has recently been subject to fierce debate. Although there appear to be no specific reasons for this deep divergence, it is necessary to clarify the problems and attempt to resolve the crisis. In this article, we discuss some ofthe points made by Professor Solomon in his recent paper. Bioethics has been culturally and socially rooted throughout its development since the 1960s. It can even be regarded as a kind of cultural product, shaped by diverse national cultures, religions, political systems and so on. However, it is impossible to deny that bioethics today faces challenges arising from multiculturalism and universality. It is important to respect cultural differences while at the same time helping to make global cognition possible. Bioethics scholars must work together to develop the discipline further. We strongly recommend that a balance is kept during this process to ensure a harmonious academic atmosphere.DOWNLOAD HISTORY | This article has been downloaded 50 times in Digital Commons before migrating into this platform.
儒家生命倫理對基因改造的倫理辯護與批判
Authors: LIU Tao
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract also in English.本文在考察西方學者對基因改造倫理爭議的基礎上，發掘儒家生命倫理對基因改造倫理所具有的辯護與批判功能。筆者認為，孔子提出的仁愛思想和孟子提出的不傷害原則，可以為基因治療進行倫理辯護。《周易》、《中庸》、《荀子》等儒家經典提出的天道觀及其對天人關係的闡釋，可以為體細胞基因增強提供倫理辯護。儘管如此，儒家生命倫理卻難以對生殖細胞基因增強進行倫理辯護，基因改造在現實推行過程中會產生一系列複雜的新問題。基因改造的問題需要運用儒家倫理對其進行反思和批判，在此基礎上找出合乎儒家倫理精神訴求的解決之道。Many people feel that genetic engineering, particularly genetic enhancement, has disrupted the traditional understanding of the distinction between choice and chance and its ethical implications. Scholars in the West have strongly objected to scientists’ “playing God” on the grounds that genetic engineering devalues human beings and contravenes intrinsic ethical principles. What is the traditional Confucian view of genetic engineering? The author contends that certain aspects of Confucian thought support the idea of genetic engineering. For instance, Confucian scholars do not define human nature (renxing) as fixed, let alone biologically fixed. The Confucian understanding of human nature as processual offers an ethical foundation for arguments in favor of genetic enhancement: specifically, there is no reason to believe that we as humans cannot or should not exceed the limitations imposed by our biological nature.Among the possible applications of genetic enhancement are the radical extension of the human health-span, the eradication of disease, the elimination of unnecessary suffering, and the augmentation of humans’ intellectual, physical, and emotional capacities. The author shows that although classical Confucianism does not directly address these modern scientific and technological issues, relevant arguments can be found within the Confucian tradition. For example, Xunzi’s account of humans’ “active relationship” (wei) with non-human nature suggests that conscious effort is required for human beings to build a moral relationship with the world. The author points out that the emphasis placed on “active participation” by Xunzi and other subsequent Confucians marks a departure from the Daoist commitment to passivity, as explicated by Zhuangzi. For Confucians, renxing is expressed through the human wei. It can thus be inferred that Confucianism does not reject the notion of genetic choice. However, the author also explains why Confucians may be cautious about or even critical of certain enhancement practices.DOWNLOAD HISTORY | This article has been downloaded 737 times in Digital Commons before migrating into this platform.
導言: 醫學模式與宗教關懷
Authors: WANG Jue , FAN Ruiping
Published: March 2021

LANGUAGE NOTE | Document text in Chinese本期《中外醫學哲學》特別推出“醫學模式”專題，聚焦現代生物醫學的深層危機，試圖在醫學與文化、科學與宗教之間為醫學教育與醫學實踐的前途探路。DOWNLOAD HISTORY | This article has been downloaded 106 times in Digital Commons before migrating into this platform.
身體倫理視域下現代醫學模式的哲學反思與重構——對孫慕義先生〈身體〉一文的呼應與商榷
Authors: LIU Junrong
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract in English only.Sun Muyi’s article provides illuminating views and arguments regarding the proper model of medicine. From Sun’s perspective, the bio-psycho-social model of medicine retains traces of body-mind dualism. It differs from Michel Foucault’s view of the body, which is one of phenomenological holism. That view, as Sun sees it, constitutes a comprehensive philosophical reflection on the modern bio-psycho-social medical model, providing an objective understanding of the unity of body and mind. Sun argues that a religious dimension is inevitably embedded in this objective understanding when establishing a body ethics model of contemporary medicine. This commentary agrees that Sun’s view provides useful reflections on the construction of a proper model of medicine. It is right that we should go beyond the bio-psycho-social medical model to pay more attention to the sick individual him or herself and to strengthen doctor-patient communication regarding the body and human dignity. However, it is also contended that the body ethics model of medicine should constitute a criticism of religious medical models and resist any religious zeal being applied to the study of medical ethics.DOWNLOAD HISTORY | This article has been downloaded 77 times in Digital Commons before migrating into this platform.
等著被說出的軀體與病患意義
Authors: QIU Hongzhong
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract in English only.Sun’s article is a useful exploration of the body ethics model of medicine. However, a body is not the equivalent of a person—the body is waiting to utter its meaning. This commentary, which adopts a phenomenological perspective, discusses different ways of treating the body and of interrogating the senses of the body understood by patients and doctors. Divergent such senses influence the doctor-patient relationship in quite distinct ways. To establish a new clinical model, this commentary holds that we need to pay greater attention to the epistemology and methodology of somatic phenomenology, which can inspire us to understand the comprehensive significance of the body for medicine.DOWNLOAD HISTORY | This article has been downloaded 35 times in Digital Commons before migrating into this platform.
正本清源: 李瑞全人論與醫學本質思想之回復
Authors: TSAI Duujian
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract in English only.Professor Lee Shui Chuen regards medicine as a historical product of human civilization, with medical traditions differing in accordance with the historical and cultural contexts in which they developed. “Medicine as the art of humanness” is a Confucian notion that reflects the value placed on the relations between body and mind, mind and environment, and medicine and the humanities. Although contemporary Western medicine has made significant progress through reductionism, Descartes’ dichotomy between mind and body has led to contemporary calls for spiritual and mental engagement. The efforts of Western medicine to free itself from alienated instrumental rationality through a shift toward a more holistic and ecological worldview highlight the values common to both Chinese and Western medicine.DOWNLOAD HISTORY | This article has been downloaded 53 times in Digital Commons before migrating into this platform.
中國傳統的整體觀的思維模式對意義與神聖價值的拯救
Authors: CAI Yu
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract in English only.The failure to reform the modern Western model of medicine stems from the reductionist mode of thinking, as demonstrated by Prof. Jeffrey Bishop. Since the Enlightenment, the popular mode of thinking in Western medicine has been a kind of mechanical materialist reductionism, which is characteristic of instrumental rationality. It is also a spatial pattern of thinking—the body becomes separable from the mind. The thinking underlying Chinese medicine and Confucian bioethics based on Chinese philosophy, in contrast, is holistic in nature. Meaning and sacred values appears only in the mindset of the whole. From the Confucian bioethical perspective, a reasonable medical model is one based on the patient’s overall biological, social, psychological, and spiritual existence, rather than on any one of these as a discrete factor. Confucian bioethics is a mix of uncompromising realism and reasonable belief in the Dao of Heaven and the virtue of ren (humanity). It is rooted in traditional Chinese culture, and remains what the Chinese need today.DOWNLOAD HISTORY | This article has been downloaded 33 times in Digital Commons before migrating into this platform.
瘟疫中的道德敘事
Authors: CHENG Guobin
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract also in English.無論是過去還是現在，重大傳染性疾病（瘟疫）對社會和醫學都構成巨大的挑戰。當代研究已經揭示了醫師的職業倫理責任話語並不足以應對這一挑戰，因而需要美德的補充。本文通過對清代江南瘟疫中的醫學道德敘事的研究，指出美德倫理的確能發動社會醫療資源以應對瘟疫，但其本身依賴於特定的醫學認知、社會組織、倫理關係以及共用價值觀。在當代重建傳統醫學道德需要充分重視這一前提，注重於傳統倫理生活世界的重構，而非僅僅進行理論的建構。The emergence of deadly infectious diseases usually poses a critical challenge to medicine and medical practice. Many contemporary ethicists maintain that medical ethics today should be supplemented by the language of virtues because what is called “professional ethics” is not sufficient to respond to the challenge of medical crises in a time of epidemic diseases. By examining the moral narrative in the historical context of the deadly plague that occurred during the Qing Dynasty, the author argues that the traditional Chinese virtue ethics played an important role in mobilizing social resources and implementing control strategies to deal with the public health crisis. Nevertheless, the author also shows that virtue ethics are very often conditioned by a particular kind of medical knowledge, a given social organization, and the shared values of a particular community. That is to say, virtue ethics are closely related to the real-world life and its tradition. This must be taken into consideration when we attempt to reconstruct medical ethics today.Meanwhile, professional ethics are also needed to address the outbreak of infectious and communicable disease to deal with issues such as access to treatment, informed consent, mandatory or involuntary screening, and so forth.DOWNLOAD HISTORY | This article has been downloaded 653 times in Digital Commons before migrating into this platform.
《莊子》生死觀對臨終者的生命關懷
Authors: CHEN Cuiting
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract also in English.臨終關懷的兩大議題是疼痛和死亡，對於臨終患者來說，死亡的話題有為凸顯，患者在死亡面前普遍表現出濃重的焦慮和恐懼。本文試圖通過追溯《莊子》的生命哲學，從中汲取面對死亡的智慧，揭開死亡的神秘面紗，消解臨終患者對死亡的恐懼。將死亡從繁複的人倫關係中抽離出來，以期還原死亡的本真狀態。本文闡述了莊子自然主義思想對人們面對生死問題的啟發，並進一步論述從“觀化”的角度，消融狹隘的個體本位，才能實現形上生命的自我超越。而明瞭生死一條的道理，將死亡視作一種可能性經驗，則是對生的最為深刻的覺醒。Two major issues in hospice care are pain and death. For those who are facing death and dying, the issues are intensified. This paper discusses the issues relating to death and hospice care in a framework of the Daoist philosophy on life and death, as outlined in the Zhuangzi. The author attempts to show that the wisdom of Daoism can help us to deal with the finitude and vulnerability of human life when facing death. According to the Zhuangzi, the world of experience is constantly transforming and death is part of that transformation. Therefore, it is possible for the adaptive qualities of the perfectly well-adjusted person to remain balanced in the midst of this unavoidable stage of change and transformation (hua). This realization of the impermanence of life and the transient nature of worldly things, even human relations, leads to the Daoist attitude of non-attachment that enables one to realize the true nature of life and death. The paper concludes that a positive attitude toward life and death, as represented in the Zhuangzi, can help patients and their family members to deal with the pain of illness and death. The author also points out that embracing natural transformation is a way for the Daoist to attain the self-transcendence that ultimately dismantles the dichotomy between life and death.DOWNLOAD HISTORY | This article has been downloaded 1379 times in Digital Commons before migrating into this platform.
臨床護士護理倫理認知、踐行現狀調查及對策分析
Authors: GE Xian , LEI Hongyan , LIU Dongmei
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract also in English.本文研究目前臨床護士護理倫理認知踐行現狀，分析相關影響因素，探討新形勢下增強臨床護士護理倫理認知實踐的對策。研究採用“臨床護士護理倫理認知及踐行現狀調查問卷”和“患者對護士護理倫理服務滿意度調查問卷”對成都市3所三甲醫院的500 名護士以及相應的三所醫院的209 名患者進行隨機問卷調查，並對調查結果進行統計分析。文章建議通過國家政策改善醫院管理、完善教育體制、改善社會環境、加強護士自身學習等方法提高護士護理倫理的認知踐行能力。The purpose of this study is to investigate and analyze the ethical awareness and practice of clinical nurses in nursing care. By using specially designed questionnaires to interview 500 clinical nurses and 209 patients at three hospitals in Chengdu, Sichuan Province, the authors examine the current relationship in medical practice between medical professionals and patients.The study shows that the total score for the ethical knowledge of nurses is 16.38±3.91; for ethical practice it is 63.43±15.99; and the average score is 2.49±0.64. The score for patients’ satisfaction is 37.56±7. The study also shows that there are significant differences in ethical awareness among nurses with different educational levels and professional titles.Ethical practice is acknowledged as an essential part of good nursing, yet defining what comprises such practice is complex. The paper suggests that more ethical education that targets the situation in China should be provided that offers a holistic understanding of professional ethics for the nursing profession. Such ethical education is badly needed given the ethical tensions between medical professionals and patients in China today.DOWNLOAD HISTORY | This article has been downloaded 947 times in Digital Commons before migrating into this platform.
靈魂存在嗎？——瀕死經驗的啟示
Authors: KWAN Kai Man
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract also in English.人有靈魂嗎？唯物論與二元論的哲學爭論很複雜，任何一方要徹底駁倒另一方都不容易。隨著醫學進步，近年不少關於瀕死經驗(NDE)的研究為這問題提供不少新的資料。若有一些NDE 被證明是可靠和真實的話，的確會對唯物論構成挑戰。本文會指出對NDE 的認識與醫療照顧（特別是垂危的病人）息息相關，然後探討種種對瀕死經驗的自然主義解釋。生理學理論包括：NDE 純粹是藥物的作用；是缺氧所致等。而心理學理論則包括建構論，人格解體的效應，幻想和想像，或出生時的記憶等。我認為現時還沒有醫學科學或心理學的理論能充分和全面解釋NDE 的現象。我接著探討一些可靠知覺的案例和研究，並指出這對瀕死經驗的可靠性提供相當支持。我的結論是：NDE 的存在是不能抹殺的，而且NDE 對靈魂的存在似乎提供了某程度的支持。Do human beings have a soul? The philosophical debate between materialism and dualism is highly complex, and it is difficult for one side to convince the other. Due to advances in modern medicine, we now have much more research on the phenomena of near-death experiences (NDEs), and these new data provide more information to settle this debate. If some NDEs were shown to be veridical, it would pose a challenge to materialism.This paper is the first to argue that the understanding of NDEs is in fact very relevant to medical care, especially the care of terminally ill patients. I explore various naturalistic explanations of NDEs. Physiological theories appeal to the effects of drugs or oxygen deficiency. Psychological theories include constructivism, the defense mechanism of depersonalization, and the appeal to fantasy. I argue that these theories cannot provide an adequate explanation of the phenomena of NDE. I then examine cases of veridical perception in NDE and review the related research. I argue that these cases provide considerable support for the veridicality of at least some NDEs. I finally conclude that we should not dismiss the significance of NDEs and that they seem to provide some support for the existence of the soul.DOWNLOAD HISTORY | This article has been downloaded 3681 times in Digital Commons before migrating into this platform.
大乘中觀哲學的生死觀
Authors: ZHANG Ellen Y.
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract also in English.生死是任何哲學和宗教都不能迴避的問題，佛教更是如此。相比中國傳統的儒家思想，佛教對死亡，甚至如何去死具有更詳盡的梳理和論證。而佛教的生死觀又源於佛教的核心的教義以及其背後的哲學思考。根據佛教的教義，覺悟、解脫或涅槃意味著從根本上去除人生的煩惱，而佛教認為，人生最大的煩惱便是生死輪迴之煩惱。但大乘佛教的反對將覺悟與紅塵、涅槃與輪迴看作絕對的二元對立，因此強調在生死煩惱中體驗超越的時空和宇宙的真理。本文以大乘中觀學派為主，從其「緣起性空」的哲學脈絡和「相即不二」的辦證思維，審視大乘佛教的生死觀以及它對中國儒道傳統的補充與融合。最後，文章論述中觀學的生死觀在當代臨終關懷中的啟示意義。Death is one of the major issues for all religious traditions; it is especially so for Buddhism, as Buddhist teaching is centered upon death and the impermanence of life. This essay discusses death and dying from the framework of the philosophy of life and death, as outlined in the Māhayānic Buddhism of China. The discussion centers on early Madhyāmika Buddhism and its non-dualist approach to samsara and nirvana, this world and the other world, and life and death. The essay shows that the notions of reincarnation and karmic action offer an alternative perspective on the finitude of human existence and reflection upon life’s uncertainty pertaining to the experience of death. The author contends that the theory of interdependent origination explicated by Madhyāmika Buddhism helps Buddhists to develop adaptive qualities that enable a person to remain balanced in the maelstrom of change and impermanence. This realization of the impermanence of life and the emptiness of interdependent origination leads to the Buddhist ethical positions of no self and non-attachment.The essay also addresses the question of hospice care from the perspective of Buddhism as a religious support system. Although Buddhists understand that suffering is a part of life, there is a general desire to avoid suffering whenever possible. Hospice care is important in Buddhism not only because Buddhists recognize the weakness and fragility of the body and mind in the process of death and dying, but also because Buddhists see the connection between the patient’s end-of-life needs, both physical and spiritual, and the well-being of other people associated with the patient. The essay argues that a positive attitude toward life and death, as presented in Madhyāmika Buddhism, can help patients and their families to deal with the pain and anxiety of terminal illness.DOWNLOAD HISTORY | This article has been downloaded 1527 times in Digital Commons before migrating into this platform.
中觀哲學與佛教的生死觀
Authors: YAO Zhihua
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract in English only.This essay highlights the tension between the Madhyāmika and mainstream Buddhist views on life and death. As an extreme position that aimed to refute the ideas of Abhidharma and Yogācāra, the Madhyāmika view cannot properly reflect the mainstream Buddhist view on the issue. To explain the possibility of reincarnation, Buddhists developed the concept of a mental continuum, which is in contrast to the Hindu idea of a soul (ātman) and the Jaina idea of subtle matter (pudgala). Many Buddhist philosophical schools have expounded various concepts along this line, for instance, the Theravāda concept of a life continuum (bhavāṅga), the Mahāsāṃghika concept of root consciousness (mūlavijñāna), the Mahīśāsaka concept of the aggregate that penetrates life and death (āsaṃsārika-skandha), the Vātsīputrīya concept of person (pudgala), and the Yogācāra concept of store consciousness (ālayavijñāna). With these concepts, the mainstream Buddhist schools assume life after death in the form of a mental continuum.In contrast, the Madhyāmikas developed their view on life and death based on their doctrine of non-duality. For them, life is no other than death and death is no other than life. It is not necessary that there is life after death. By comparing the various views on death among different world religions, we learn that the Madhyāmikas’ view is similar to the Daoist view that sees death as another form of union between heaven and earth, and hence is not substantially different from life itself. I conclude that there is a certain tension between the Madhyāmika view of life and death and the mainstream Buddhist view, and, to a certain extent, it is non-Buddhist.DOWNLOAD HISTORY | This article has been downloaded 743 times in Digital Commons before migrating into this platform.
Habermas and Zhuangzi against Liberal Eugenics
Authors: CHAI David
Published: March 2021

LANGUAGE NOTE | Document text in English; abstract also in Chinese.是否有一種道家的基因增強倫理學？考慮到時間差異，道家思想能容納這樣一種提問嗎？就生命科技的持續進展而言，我們所面臨的存在論威脅是無比真實的。圍繞著自然與人造的爭論曾經牢固地樹立在神學家與哲學家的頭腦之中；然而最近在自由優生學的喧囂中上述爭論已然消失殆盡。這一運動激起了幾位傑出人士的反對，包括哲學家尤爾根．哈貝馬斯。他們反對的立足點就是基因操控抹煞了人性本質與人造物之間的差別。道家原則上贊同這一反對，但卻是出於不同的理由。本文將表明道家可以提供一種存在－宇宙論辯護——如莊子在關於疾病與畸形的故事中所表明的——以加強哈貝馬斯從社會－政治視角出發的對自由優生學的批評。雖然沒有直接提到自由優生學本身，但與哈貝馬斯一樣，這些故事表明人類生命的開端根本說來是超出人類控制的，而改變這一根基就意味著重塑自我與自由的涵義。What would a Daoist ethics of human enhancement look like? Can Daoism even entertain such a question given the temporal disparity? In light of the ongoing advancement of biotechnology, the ontological threat awaiting us is all too real. Indeed, the debate surrounding natural versus artificial has long been entrenched in the minds of theologians and philosophers alike; in recent years, however, it has been swept up in the commotion over liberal eugenics. This movement has prompted several prominent figures, such as the philosopher Jurgen Habermas, to interject on the grounds that genetic manipulation erases the distinction between the human and the manufactured. Daoism, in principle, would agree, but for different reasons. This paper shows how Daoism can contribute to Habermas’s social-political opposition to liberal eugenics by offering an onto-cosmological line of defense, as seen in the stories on illness and malformation in the Zhuangzi. While not referring to liberal eugenics per se, these stories argue, as does Habermas, that humans have a beginning to life that is ultimately beyond their control, and to alter this origin is to recast the meaning of selfhood and freedom.DOWNLOAD HISTORY | This article has been downloaded 165 times in Digital Commons before migrating into this platform.
哈貝馬斯與莊子的共同陣線？
Authors: WANG Qin
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract in English only.Chai attempts to demonstrate how Zhuangzi can be used to supplement Habermas’s arguments against liberal eugenics. He argues that both Habermas and Zhuangzi would view liberal eugenics as falling on the wrong side of the natural/artificial divide. It is debatable whether his interpretation of Zhuangzi as both fatalist and epistemically modest suits this conclusion. In particular, it is doubtful that someone who is suspicious of whether humans can ever have knowledge of nature would be entitled to assert that liberal eugenics is unnatural. Even if this position is possible, it would be one that equally rejects Habermas. Habermas attempts to isolate genetic engineering from acceptable interventions in a person’s life. Daoism, to the extent that it rejects liberal eugenics, would equally view the latter kinds of interventions as misguided. Chai’s Daoist ethics of human enhancement, therefore, could hardly be used to supplement Habermas’s position.DOWNLOAD HISTORY | This article has been downloaded 54 times in Digital Commons before migrating into this platform.
前言: 健康的文化生命倫理探索
Authors: FAN Ruiping
Published: March 2021

LANGUAGE NOTE | Document text in Chinese本期論文探討健康與文化之間的關係問題，內容包括中國傳 統文化對於中國人的健康概念的塑造及意義，儒家生命倫理對於 當前中國醫療改革的啟示和指導、及其對於現代中國醫療保健制 度變遷的評價和總結，儒家的心身觀點對於“換頭術”的看法， 以及中國傳統文化與當代中國人的遺體捐獻行為的關係。DOWNLOAD HISTORY | This article has been downloaded 135 times in Digital Commons before migrating into this platform.
健康水平平等追求與中國綱常倫理——基於中國醫療衛生體制改革進程的思考
Authors: BIAN Lin
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract also in English.中國傳統綱常蘊含著深刻的生命道德原則，發掘、認識和理解這一傳統倫理文化的核心內容，對認識和審視當代中國以追求社會健康水準平等為目的的醫療衛生體制改革具有重要的道德價值。如果說綱常倫理是根基，而與綱常倫理一脈相承的儒家生命倫理思想，則能夠為認識和解決醫療衛生體制改革的具體問題提供理論支援和邏輯分析框架。用“差等之愛”的思想分析醫保籌資制度便是例證。中國醫改八年成就斐然，社會健康水準平等應當成為醫改的目標指向，中國傳統綱常中保障生命安全和提供生命基本供養的思想，能夠成為醫改的道德原則和倫理智慧，而儒家生命倫理學則能夠將綱常倫理思想轉化為實在的方法與路徑。Traditional Chinese ethics contain profound bioethical teachings and principles. For the purpose of understanding and reflecting on the ongoing health care system reform in mainland China in recent years, it is important to rediscover, recognize and understand the central teachings of traditional Chinese ethics, especially the cardinal Confucian virtues in Chinese traditions. It is implausible to pursue health equality for everyone, as individuals inevitably exhibit differences in their health conditions no matter what kind of health care system is maintained. However, it is plausible to accomplish health equality in the sense that everyone in society enjoys a similar public health care system. With the great achievements made during the eight-year process of health care system reform in China, health equality has rightly become the target of reform and been significantly improved. Following the cardinal Chinese ethical virtues and principles that advocate for both universal and differentiated/graded love, the Chinese reform should not only pursue health equality, but also allow individuals to pursue private insurance schemes for themselves and their family members to practice differentiated/graded love. The government should not only ensure equality of public insurance for everyone in Chinese society, but also leave sufficient room for individuals to purchase private insurance for better or quicker health care.DOWNLOAD HISTORY | This article has been downloaded 142 times in Digital Commons before migrating into this platform.
儒家觀念與現代同性婚姻的可能性——兼及我們對待傳統的態度
Authors: CHEN Zhiwei
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract in English only.Professor Zhang Xianglong responded to the issue of legalization of same-sex marriage from the perspective of Confucianism, and expounded the possible attitude of Confucianism towards this issue. His ideas are new and important, but he may have neglected the applicability of Confucianism in modern society. If Chinese traditional culture, especially some specific Confucian concepts, such as Yin and Yang, male and female, patriarchal law, etc., does not undergo the transformation of modernity and is weighed against Western concepts, its power to explain the problems in the process of modernization will be greatly reduced.DOWNLOAD HISTORY | This article has been downloaded 166 times in Digital Commons before migrating into this platform.
權利與善——論同性婚姻
Authors: FANG Xudong
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract also in English.本文由兩個部分構成，第一部分闡述了不反對同性婚姻合法化的理由，逐一討論了對同性婚姻合法化的五種反對意見，認為它們都不成立。第二部分論述了儒家推崇異性婚姻的原因，其主要考慮是同性婚姻不能像異性婚姻那樣可以提供倫理的完整性。作者強調，作為公民權利，同性婚姻可以被自由追求，但作為儒家則以異性婚姻為婚姻的理想模式。前者事關權利，後者事關“善”，有各自的界限，不得逾越。This paper consists of two parts. In the first part, the author refutes, one by one, five objections to the legalization of same-sex marriage, including arguments grounded in naturalness, origin, reductio ad absurdum, compromising traditional marriage, and Jiang Qing’s doctrine of particular human rights. The strongest reason for advocating the legalization of same-sex marriage is the doctrine of equal rights. As contemporary people, we have no reason to deny that all individuals have equal rights. The second part discusses why Confucianism prefers heterosexual marriage. The main consideration is that same-sex marriages cannot provide ethical integrity, as heterosexual marriages do. The author emphasizes that, as a civil right, same-sex marriage can be pursued freely, but for a Confucian, heterosexual marriage is the ideal mode of marriage. The former concerns what is “right,” whereas the latter relates to what is “good.” There is an insurmountable boundary between right and good.DOWNLOAD HISTORY | This article has been downloaded 423 times in Digital Commons before migrating into this platform.
儒學、還是儒學自由主義？
Authors: FAN Ruiping
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract in English only.In providing his reasons for not objecting to the legalization of same-sex marriage, Professor Fang Xudong fully accepts a robust liberal dichotomy between the right and the good as well as the liberal principle of neutrality. This renders his Confucian reflection essentially liberal rather than authentically Confucian. It is ethically incoherent for him to claim that he does not object to the legalization of same-sex marriage although he believes same-sex couples cannot embody ethical integrity as heterosexual marriages do.DOWNLOAD HISTORY | This article has been downloaded 79 times in Digital Commons before migrating into this platform.
也談人工智能診斷技術的倫理問題
Authors: LIU Tao
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract in English only.There are two main theoretical frameworks for discussion of the ethical problems of AI diagnostic technology: consequential theory and deontology. From the perspective of consequential theory, it is impossible for AI diagnostic technology to qualitatively surpass a doctor’s diagnosis, due to the former’s inferior intelligence. However, if AI can achieve rapid and efficient diagnoses while ensuring patient subjectivity, there is no reason why it should not replace physician diagnosis. The deontological perspective offers four options in response to strong AI. In any case, our bottom line should be to guard the subjectivity of patients and healthy people. AI may take the place of traditional diagnosis and treatment, and even of doctors, but it should not do so at the expense of the subjectivity of patients and healthy people.DOWNLOAD HISTORY | This article has been downloaded 87 times in Digital Commons before migrating into this platform.
危言聳聽還是未雨綢繆？——談ＡＩ醫生與患者關係
Authors: MA Yonghui
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract in English only.The last few years have witnessed huge growth in the capabilities and applications of AI. The applications of AI in medical and clinical settings are also expanding at an unprecedented rate. AI is expected to help solve many medical and diagnostic problems and support well-being and health; however, concerns are also growing about the potential for AI doctors to undermine the traditional doctor–patient relationship. The article by Guobin Chen et al. provides a systematic analysis of this issue, to which the current paper is a response. The target article has two main parts. First, it seeks to determine whether the "significance" and "meaning" of the doctor–patient relationship will be eroded, or even eliminated, by AI technologies. Second, it discusses the difference between the Western emphasis on autonomous agents and the Chinese "Dao of completing and perfecting oneself" (cheng-ren zhi dao), and points out that it is very important to recognize this distinction when providing an alternative Chinese approach to the relationship between the AI doctor and patient.DOWNLOAD HISTORY | This article has been downloaded 21 times in Digital Commons before migrating into this platform.
人工智能批判的話語悖論
Authors: LIN Fen
Published: March 2021

LANGUAGE NOTE | Document text in Chinese; abstract in English only.In the dominant discourse of the "human–machine relationship," people and machines are the subjects, with a mutually shaping influence. However, this framework neglects the crux of the current critical analysis of AI. It reduces the problems with new technology to the relationship between people and machines, ignoring the re-shaping of the relationship between "people and people" in the era of new technology. This simplification may mislead policy and legal regulations for new technologies. Why would a robot killing cause more panic than a murder committed by a human? Why is a robot's misdiagnosis more troubling than a doctor's? Why do patients assume that machines make more accurate diagnoses than doctors? When a medical accident occurs, who is responsible for the mistakes of an intelligent medical system? In the framework of traditional professionalism, the relationship between doctors and patients, whether trusted or not, is based on the premise that doctors have specialized knowledge that patients do not possess. Therefore, the authority of a doctor is the authority of knowledge. In the age of intelligence, do machines provide information or knowledge? Can this strengthen or weaken the authority of doctors? It is likely that in the age of intelligence, the professionalism, authority and trustworthiness of doctors require a new knowledge base. Therefore, the de-skilling of doctors is not an issue of individual doctors, but demands an update of the knowledge of the entire industry. Recognizing this, policy makers must not focus solely on the use of machines, but take a wider perspective, considering how to promote the development of doctors and coordinate the relationship between doctors with different levels of knowledge development. We often ask, "In the era of intelligence, what defines a human?" This philosophical thinking should be directed toward not only the difference between machines and people as individuals, but also how the relationship between human beings, i.e., the social nature of humans, evolves in different technological environments. In short, this commentary stresses that a "good" machine or an "evil" machine—beyond the sci-fi romance of such discourse—reflects the evolution of the relationships between people. In today's smart age, the critical issue is not the relationship between people and machines. It is how people adjust their relationships with other people as machines become necessary tools in life. In the era of intelligence, therefore, our legislation, policy and ethical discussion should resume their focus on evolutionary relationships between people.DOWNLOAD HISTORY | This article has been downloaded 41 times in Digital Commons before migrating into this platform.