ArgumentIn this article I describe the establishment and early development of an institution that is unique to the history of Chinese medicine – the Imperial Pharmacy. Established in 1076 during the great reforms of the Song dynasty, the Imperial Pharmacy was a remarkable institution that played different political, social, economic, and medical roles over the years of its existence. Initially it was an economic institution designed to curb the power of plutocrats who were manipulating medicinal drug markets in their favor. (...) A few decades later, I claim, the Imperial Pharmacy became a public-health-oriented institution focusing on selling readymade prescriptions in addition to simples. Various records, including local gazetteers and local maps, indicate that the Imperial Pharmacy expanded about a century after it was established to include dozens of branches throughout the empire. The Pharmacy's impact on the practices of physicians during these years is somewhat vague. It seems, however, to have posed an unwelcome addition to the medical scene, since it enabled uninitiated practitioners who relied on the Pharmacy's formulary to fit patients' symptoms to their own prescriptions and dispense medications with relative ease. (shrink)

There is a prevailing conviction that if traditional medicine (TRM) or complementary and alternative medicine (CAM) are integrated into healthcare systems, modern scientific medicine (MSM) should retain its principal status. This paper contends that this position is misguided in medical contexts where TRM is established and remains vibrant. By reflecting on the Chinese policy on three entrenched forms of TRM (Tibetan, Mongolian and Uighur medicines) in western regions of China, the paper challenges the ideology of science that lies behind the (...) demand that all traditional forms of medicine be evaluated and reformed according to MSM standards. Tibetan medicine is used as a case study to indicate the falsity of a major premise of the scientific ideology. The conclusion is that the proper integrative system for TRM and MSM is a dual standard based system in which both TRM and MSM are free to operate according to their own medical standards. (shrink)

This study is a contribution to Chinese-Western dialogue of bioethics but perhaps the first one of its kind. From a Chinese-Western comparative ethical perspective, this work brings Chinese ethical theories, especially Confucian ethics, into a contemporary context of the epidemic of HIV/AIDS, and to see how the deeply-rooted thoughts of Confucius interact, compete, or integrate with concepts from Western ethical traditions. An underlying belief is that some ideas in Confucian ethics are important and insightful beyond their cultural and historical origins (...) in China and other Confucianism influenced societies.Methodologically, this thesis employs two approaches, conceptual normative analysis combined with critical interpretation. The ‘interpretive’ approach I employ, as an important methodology supplementing my normative analysis, not only deals with Chinese ancient texts, but also explains specific beliefs and practices in China.With a critical eye, this thesis carefully examines a number of key topics in the ethics of AIDS in China from a cross-cultural perspective. Topics including: views on personhood and the vulnerability of People Living with HIV/AIDS; prioritising and balancing the role of ‘harm reduction’ and the role of ‘eradication of deviant behaviour’ in AIDS policy in China; rights-based opt-out approach and duty-based family-centred approach in HIV testing and Biobanking; blood donation; moral responsibility and personal responsibility for health; and the popular rhetoric of ‘innocent infection’ versus ‘guilty infection’ in AIDS. My overall aim in this work is to present a cross-cultural bioethics study through the investigation of some ethical issues in AIDS in China from a Chinese-Western comparative perspective and also attempt to suggest a humane and effective policy for HIV/AIDS which I believe is appropriate to both traditions. I believe this work has contributed to our knowledge in three related but independent areas: the control of the epidemic of HIV/AIDS in China; medical ethics in China; and to both the methods and the utility of cross-cultural study of bioethics between China and the West. (shrink)

Traditional Chinese Medicine has been criticized for being unscientific because the theory on which it is based involves entities like qi and ’meridians’ that appear ambiguous and because the internal ‘organs’ like the kidney and the spleen are very different from those of modern anatomy and physiology. Even more so, TCM methods of therapy based on the yin-yang principle, the model of the five elements, and the classification of illnesses according to standard constellations of symptoms are largely unproven by the (...) protocols of modern evidence-based medicine. This dissertation attempts to reconstruct TCM theory by: providing explanations of TCM entities as abstractions and constructs that relate to observable body functions and illness symptoms and interpreting TCM theory as comprising heuristic models that were constructed from clinical experience to fit empirical observations of illnesses and their treatments with herbal medications and acupuncture. It suggests that scientists should be less concerned with the ontological status of TCM entities and the epistemic credentials of TCM models than with the ability of these concepts and models to guide physicians in therapy. More importantly, it makes the argument that these models are testable using the methods of evidence-based medicine. There are methodological difficulties associated with randomized controlled trials partly because TCM treatments tend to be individualized and syndromes are dynamic in nature; observational trials may be more appropriate in some situations. It is also possible that, for patients who are more culturally attuned to TCM, the placebo effect is strongly at play and may render the real effects of TCM treatments harder to tease out in clinical trials. The dissertation concludes that the main postulates of TCM should be put to rigorous test. The result may be a leaner but more robust theory, with parts that do not stand up to the test being rejected or modified, and a possible acceptance of its more modest therapeutic claims for a limited range of pathological conditions like pain and chronic illnesses. (shrink)