A record of the words and teachings of Confucius, _The Analects_ is considered the most reliable expression of Confucian thought. However, the original meaning of Confucius's teachings have been filtered and interpreted by the commentaries of Confucianists of later ages, particularly the Neo-Confucianists of the Song dynasty, not altogether without distortion.In this monumental translation by Professor D. C. Lau, an attempt has been made to interpret the sayings as they stand. The corpus of the sayings is taken as an organic (...) whole and the final test of the interpretation rests on the internal consistency it exhibits. In other words, _The Analects_ is read in the light of _The Analects._This results in a truer understanding of Confucius' thought than the traditional interpretation and paves the way for a re-assessment of its importance in the history of Chinese thought and its relevance to the present day world.This volume also contains an introduction to the life and teachings of Confucius, and three appendices on the events in the life of Confucius, on his disciples, and on the composition of _The Analects._. (shrink)

Priority setting (also known as resource allocation or rationing) occurs at every level of every health system and is one of the most significant health care policy questions of the 21st century. Because it is so prevalent and context specific, improving priority setting in a health system entails improving it in the institutions that constitute the system. But, how should this be done? Normative approaches are necessary because they help identify key values that clarify policy choices, but insufficient because different (...) approaches lead to different conclusions and there is no consensus about which ones are correct, and they are too abstract to be directly used in actual decision making. Empirical approaches are necessary because they help to identify what is being done and what can be done, but are insufficient because they cannot identify what should be done. Moreover, to be really helpful, an improvement strategy must utilize rigorous research methods that are able to analyze and capture experience so that past problems are corrected and lessons can be shared with others. Therefore, a constructive, practical and accessible improvement strategy must be research-based and combine both normative and empirical methods. In this paper we propose a research-based improvement strategy that involves combining three linked methods: case study research to describe priority setting; interdisciplinary research to evaluate the description using an ethical framework; and action research to improve priority setting. This describe-evaluate-improve strategy is a generalizable method that can be used in different health care institutions to improve priority setting in that context. (shrink)

A model for ethical problem solving -- Values in health and illness -- What is the source of moral judgments? -- Benefiting the patient and others : duty to do good and avoid harm -- Justice : allocation of health resources -- Autonomy -- Veracity : honesty with patients -- Fidelity : promise-keeping, loyalty to patients, and impaired professionals -- Avoidance of killing -- Abortion, sterilization, and contraception -- Genetics, birth, and the biological revolution -- Mental health and behavior control (...) -- Confidentiality : ethical disclosure of medical information -- Organ transplants -- Health insurance, health system planning, and rationing -- Experimentation on human subjects -- Consent and the right to refuse treatment -- Death and dying. (shrink)

Over the course of its first seven editions, Principles of Biomedical Ethics has proved to be, globally, the most widely used, authored work in biomedical ethics. It is unique in being a book in bioethics used in numerous disciplines for purposes of instruction in bioethics. Its framework of moral principles is authoritative for many professional associations and biomedical institutions-for instruction in both clinical ethics and research ethics. It has been widely used in several disciplines for purposes of teaching in the (...) classroom, during conferences, etc. (shrink)

Integrating theory with case studies, this book examines the practical application of moral theory in clinical decision-making through 40 composite cases based on actual clinical experience. Complex, realistic, and challenging, these examples contain the multiplicity of factors faced in clinical crises, making this a superb exploration of the ways in which theory relates to actual life-or-death situations.

Under the clear and thoughtful editorship of Ruiping Fan, The Renaissance of Confucianism in Contemporary China provides new and highly substantive insights into the emergence of a renewed, relevant, and perceptively engaged Confucianism in 21st century China. Through the vibrantly diverse essays contained in this volume, and in cogent overview through Fan’s introduction, one learns that Confucianism is thoroughly misunderstood, if it is seen only through Western lenses. It cannot be absorbed into that rights-based “global” discourse that has been the (...) West’s troubled inheritance from the Enlightenment. Extraordinarily thoughtful Chinese voices are found in this volume that converse with each other in serious and revealing ways. Should genuine exchange continue to develop between Western thinkers and Chinese Confucians, The Renaissance of Confucianism in Contemporary China will surely be an indispensable pathway into those core issues, moral and social, that will unavoidably be encountered as China and the West advance further into the 21st century. -/- -/- Stephen A. Erickson, Professor of Philosophy and the E. Wilson Lyon Professor of the Humanities, Pomona College, USA -/- -/- The Renaissance of Confucianism in Contemporary China features an important school of Confucianism in Mainland China today, “Political Confucianism,” powerfully articulated by Jiang Qing, author of the leading article in this volume. “Political Confucianism” is unique: on the “Political” side, it rejects many core values of liberalism, the dominant political ideology in the West; and on the “Confucianism” side, it rejects the one-sided emphasis on the inner sageliness of “New Confucianism” developed in Hong Kong and Taiwan in the last century. In this volume, the programmatic essay by Jiang Qing is followed by penetrating essays, either further expanding on or critically examining various themes of Jiang’s original essay, by eminent scholars, many of whom are committed Confucians themselves. The volume concludes with an informative biography of Jiang Qing. It is a must-read for anyone who is interested in learning about the situation of Confucianism in contemporary China in particular and about Confucianism or contemporary China in general. -/- -/- Yong HUANG, Chief Editor, Dao: A Journal of Comparative Philosophy -/- This is the most important recent study of Chinese culture and political theory. It offers a rich insight into the renaissance of authentic Confucian commitments in contemporary China and the foundationally different moral and political direction that it proposes for China’s future. The essays Fan brings together tie the power of China’s rich past to the prospect of a China quite different from what the West envisages. It is a “must-read” for anyone seeking to understand China in the 21st century. -/- -/- David Solomon, W.P. and H.B. White Director of the Center for Ethics and Culture, University of Notre Dame. (shrink)

American health care reformers face a number of ethical issues, including familiar debates over the merits of a single-payer system and publicly provided universal health insurance. No matter how these debates are resolved, a further ethical question must be addressed. Both universal coverage and a single-payer system are compatible with permitting some patients to pay more for faster, better, or more health care choices. Should the United States continue to have a two-tier health care system in which wealth grants some (...) patients access to medical services that others with the same needs cannot obtain? Critical evaluation of both principled objections to inequalities and practical objections to anticipated social and medical consequences of a two-tier health care system are needed. (shrink)

: The focus of questions of justice in health policy has shifted during the last 20 years, beginning with questions about rights to health care, and then, by the late 1980s, turning to issues of rationing. More recently, attention has focused on alternatives to cost-effectiveness analysis. In addition, health inequalities, and not just inequalities in access to health care, have become the subject of moral analysis. This article examines how such trends have transformed the philosophical landscape and encouraged some in (...) bioethics to seek guidance on normative questions from outside of the contours of traditional philosophical arguments about justice. (shrink)

The use of the Quality Adjusted Life-Year (QALY) as a measure of the benefit obtained from health care expenditure has been attacked on the ground that it gives a lower value to preserving the lives of people with a permanent disability or illness than to preserving the lives of those who are healthy and not disabled. The reason for this is that the quality of life of those with illness or disability is ranked, on the QALY scale, below that of (...) someone without a disability or illness. Hence we can, other things being equal, gain more QALYs by saving the lives of those without a permanent disability or illness than by saving the lives of those who are disadvantaged in these ways. But to do so puts these disadvantaged people under a kind of double jeopardy. Not only do they suffer from the disability or illness, but because of it, a low priority is given to forms of health care that can preserve their lives. This, so the objection runs, is unjust or unfair. This article assesses this objection to the use of QALYs as a basis for allocating health care resources. It seeks to determine what is sound in the double jeopardy objection, and then to show that the defender of QALYs has an adequate response to it. (shrink)

We all have beliefs, even strong convictions, about what is just and fair in our social arrangements. How should these beliefs and the theories of justice that incorporate them guide our thinking about practical matters of justice? This wide-ranging collection of essays by one of the foremost medical ethicists in the USA explores the claim that justification in ethics, whether of matters of theory or practice, involves achieving coherence between our moral and non-moral beliefs. Amongst the practical issues addressed in (...) the volume are the design of health-care institutions, the distribution of goods between the old and the young, and fairness in hiring and firing. In combining ethical theory and practical ethics this volume will prove especially valuable to philosophers concerned with ethics and applied ethics, political theorists, bioethicists, and others involved in the study of public policy. (shrink)

Libertarian views on rights tend to rule out coercive redistribution for purposes of public health care guarantees, whereas liberal conceptions support coercive funding of potentially unlimited access to medical services in the name of medical needs. Taking the “priority of liberty” seriously as supreme political value, a plausible prudential argument can avoid these extremes by providing systematic reasons for both delivering and limiting publicly financed guarantees. Given impending demographic change and rapid technical progress in medicine, only a two-tier system with (...) explicitly limited public guarantees and optional privately financed health services seems acceptable. (shrink)

This paper is aimed at a critical assessment of the moral framework of the current Chinese health system from a Confucian perspective, by focusing on the debate between the individual directed approach and the family-oriented approach to a health care system. Concerned with the nature and status of the family in communal life, the paper deals with the following questions: to cope with the frailties of material life (including susceptibility to disease), what good is presupposed by human existence and flourishing; (...) why it is the family that serves as the primary locus of bearing and realizing this unique good; and what kind of society might possess the structures necessary to achieve the good thus conceived. All these questions lead to a revision of the theory of justice required in health care, in favor of family health saving accounts as an important institutional guarantee. (shrink)

In this article, I offer an abridged reconstruction of the foundational elements of Confucian moral commitments, which, I will argue, still provide the background moral substance for moral reflection in mainland China, Hong Kong, Taiwan, Singapore, and Korea. The essay presents implications of Confucianism for establishing an appropriate health care system and critically assesses the features of current health polices in mainland China, Hong Kong, and Singapore. The goal is to offer a family-oriented, non-individualist account of resource allocation that takes (...) family authority and responsibility seriously. (shrink)

Recently implemented Chinese health insurance schemes have failed to achieve a Chinese health care system that is family-oriented, family-based, family-friendly, or even financially sustainable. With this diagnosis in hand, the authors argue that a financially and morally sustainable Chinese health care system should have as its core family health savings accounts supplemented by appropriate health insurance plans. This essay’s arguments are set in the context of Confucian moral commitments that still shape the background culture of contemporary China.