This paper critically examines the liberal model of decision making for the terminally ill and contrasts it with the familial model that can be found in some Asian cultures. The contrast between the two models shows that the liberal model is excessively patient-centered, and misconceives and marginalises the role of the family in the decision making process. The paper argues that the familial model is correct in conceiving the last journey of one's life as a sharing process rather than a process of exercising one's prior or counterfactual choice, and concludes by suggesting a policy framework for the practice of familialism that can answer the liberal challenge that familialism cannot safeguard the patient from abuse and neglect.
This article reveals the outcome of a study on the perceptions of elders, family members, and healthcare professionals and administration providing care in a range of different long-term care facilities in Hong Kong with primary focus on the concepts of autonomy and dignity of elders, quality and location of care, decision making, and financing of long term care. It was found that aging in place and family care were considered the best approaches to long term care insofar as procuring and balancing the values of dignity, autonomy, family integrity and social sustainability were concerned. An elder having the final say was generally accepted. The results also initiated the importance of sharing of financial responsibility among elders, children and government albeit the emphasis was placed on individuals. Furthermore, dignity of elders was not considered purely a synonym of autonomy, but it had also to do with respect, family and social connections.
This paper examines the practice of informed consent in Hong Kong by drawing on structured interviews conducted with eleven physicians, three patients, and four family members primarily at a well-established public hospital in Hong Kong. The findings of this study show that the Hong Kong approach to medical decision-making lies somewhere between that of America on the one hand, and mainland China on the other. It is argued that the practice of medical decision-making in Hong Kong can be modeled by a moderate familism that is directed towards achieving the best interests of the patient (1) as understood by the physician, (2) in consultation with the family, (3) under the prima facie presumption that consent is not required for disclosure of information to the family, (4) while aiming at an eventual albeit frequently partial and vague disclosure to the patient.
Richard Nisbett's The Geography of Thought is one of several recent works that have highlighted purported differences in thinking patterns between East Asians and Westerners on the basis of empirical research. This has implications for teaching and for other issues such as cultural integration. Based on a framework consisting of three distinct notions of rationality, this paper argues that some of the differences alleged by Nisbett are either not real or exaggerated, and that his geography of thought fails to provide an adequate account of thinking styles across cultures. The paper concludes with a discussion of the implications for teaching and learning critical thinking that can be drawn from the framework developed. (2003) is one of several recent works that have highlighted purported differences in thinking patterns between East Asians and Westerners on the basis of empirical findings; it has implications for teaching and other issues such as cultural integration. This paper offers a critical examination from a philosophical perspective of Nisbett's view on these apparent differences in ways of thinking, with particular attention given to the alleged differences in relation to critical thinking. In the following section we outline a naturalistic approach to the study of human rationality. Based on this approach, the notions of ideal rationality, adaptive rationality and critical rationality are developed. In the third section a geography of thinking styles that is different from Nisbett's is constructed by applying the three notions of rationality. In the fourth section we reject Nisbett's claim that East Asians have a stronger tendency to think 'illogically' than do Westerners. In the fifth section, we argue that Nisbett's geography of thought is inaccurate because the alleged differences between Eastern and Western styles of thinking are not real or overstated, and suggest that our geography of thought can provide a more adequate account of thinking styles across cultures. In the final section, implications for the teaching and learning of critical thinking are drawn from the geography we develop in this paper.
Nisbett's The Geography of Thought
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