Table Of ContentFamily-Oriented Informed Consent
Philosophy and Medicine
VOLUME 121
Founding Co-Editor
Stuart F. Spicker
Senior Editor
H. Tristram Engelhardt, Jr., Department of Philosophy, Rice University, 
and Baylor College of Medicine, Houston, Texas
Associate Editor
Lisa M. Rasmussen, Department of Philosophy, University of North Carolina 
at Charlotte, Charlotte, North Carolina
ASIAN STUDIES IN BIOETHICS AND THE PHILOSOPHY OF MEDICINE 7
Series Editor
Ruiping Fan, Department of Public Policy, City University of Hong Kong, 
Hong Kong
Editorial Board
Kazumasa Hoshino, Kyoto Women’s University, Kyoto, Japan
Shui Chuen Lee, National Central University, Chung-li, Taiwan
Ping-cheung Lo, Hong Kong Baptist University, Hong Kong
Ren-Zong Qiu, Chinese Academy of Social Sciences, Beijing, China
For other titles published in this series, go to  
http://www.springer.com/series/6414
Ruiping Fan
Editor
Family-Oriented Informed 
Consent
East Asian and American Perspectives
Editor
Ruiping Fan
Department of Public Policy
City University of Hong Kong
Hong Kong
Hong Kong SAR
 
ISSN 0376-7418                ISSN 2215-0080 (electronic)
ISBN 978-3-319-12119-2         ISBN 978-3-319-12120-8 (eBook)
DOI 10.1007/978-3-319-12120-8
Library of Congress Control Number: 2014958883
Springer Cham Heidelberg New York Dordrecht London
© Springer International Publishing Switzerland 2015
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part 
of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, 
recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or 
information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar 
methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication 
does not imply, even in the absence of a specific statement, that such names are exempt from the relevant 
protective laws and regulations and therefore free for general use.
The publisher, the authors and the editors are safe to assume that the advice and information in this book 
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the 
editors give a warranty, express or implied, with respect to the material contained herein or for any errors 
or omissions that may have been made.
Printed on acid-free paper
Springer is part of Springer Science+Business Media (www.springer.com)
Acknowledgments
Most chapters included in this volume were discussed at an international conference 
titled, “Family-Oriented Informed Consent: East Asian and American Perspectives 
on a Cardinal Moral Practice,” held in Hong Kong, December 13–14, 2012. The 
conference was sponsored by the Department of Public Policy of the City Univer-
sity of Hong Kong. I am also grateful for funding provided by the Center for the 
Study of Culture, Ethics, and the Environment in Alaska. I thank Professor Ray For-
rest, the Head of the Department of Public Policy at City University of Hong Kong, 
Professor Brian Partridge, the Director of Center for the Study of Culture, Ethics, 
and the Environment, and Professor H. Tristram Engelhardt, Jr. for their support of 
the conference. I am thankful to my research assistant, Ms. Cao Chengcheng, for 
her assistance in preparing for the conference.
I would like to thank the authors for contributing their essays and for their efforts 
revising and improving their essays in response to critical feedback after the confer-
ence. I appreciate the work of Jennifer Bulcock and Victor Saenz in polishing the 
English of those chapters contributed by East Asian authors whose mother tongue 
is not English. I am particularly grateful to Lisa Rasmussen, Associate Editor of the 
Philosophy and Medicine series, for her arduous efforts made for the publication of 
this volume.
Ruiping Fan  
v
Contents
Part I  Introduction
1   Informed Consent: Why Family-Oriented? ������������������������������������������    3
Ruiping Fan
Part II  Dependency, Autonomy, and the Role of the Family
2   Dependency, Decisions, and a Family of Care ���������������������������������������   27
Jeffery P� Bishop
3   Individually Directed Informed Consent and the Decline of 
the Family in the West �����������������������������������������������������������������������������   43
Mark J� Cherry
4   Family and Autonomy: Towards Shared Medical  
Decision-Making in Light of Confucianism �������������������������������������������   63
Jue Wang
Part III  Informed Consent: Individual-Oriented vs. Family-Oriented
5   The Ideal of Autonomy and Its Misuse ��������������������������������������������������   83
Kyungsuk Choi
6   The Confucian Alternative to the Individual-Oriented Model 
of Informed Consent: Family and Beyond ��������������������������������������������   93
Kam-Por Yu
7   The East Asian Family-Oriented Principle and the Concept 
of Autonomy ���������������������������������������������������������������������������������������������  107
Lawrence Y� Y� Yung
vii
viii Contents
Part IV  Family Consent in End-of-Life Decision Making
8   Family Consent in Medical Decision-Making in Taiwan: 
The Implications of the New Revisions of the Hospice 
Palliative Care Act �����������������������������������������������������������������������������������  125
Shui Chuen Lee
9   Filial Duty as the Moral Foundation of Caring for the 
Elderly: Its Possibility and Limitations �������������������������������������������������  137
Ilhak Lee (李日學)
10  End-of-Life Decision Making in Hong Kong: The Appeal of 
the Shared Decision Making Model �������������������������������������������������������  149
Ho Mun Chan, M� W� Tse Doris, Kam Hung Wong, 
Julian Chuk-Ling Lai and Chun Kit Chui
Part V  Risk Assuming, Organ Donation, Medical Research and the Family
11 F  amilies and Medical Decisions to Assume Risks for the 
Benefit of Others ��������������������������������������������������������������������������������������  171
Ana S� Iltis
12  On Family Informed Consent in the Legislation of Organ 
Donation in China ������������������������������������������������������������������������������������  187
Yu Cai
13 T  he Informed Consent of Human Medical Research in 
Mainland China: A Family-Based Binary Decision Model ������������������  201
Rui Deng
Part VI   Family Shared Decision Making, Truth Telling, 
and Advance Directives
14 T  oward a Shared Decision: Against the Fiction of the 
Autonomous Individual ���������������������������������������������������������������������������  219
Ryan R� Nash
15  A Confucian Worldview and Family-Based Informed 
Consent: A Case of Concealing Illness from the Patient in China �������  231
Wenqing Zhao
16  Towards a Good Practice of Family-Oriented Consent: 
Reflections on Medical Practice in Taiwan ��������������������������������������������  245
Hon Chung Wong
Contents  ix
17 A   Family-Oriented Confucian Approach to Advance 
Directives in End-of-Life Decision Making for Incompetent 
Elderly Patients ����������������������������������������������������������������������������������������  257
Yaning Yang
Part VII  Epilogue
18  Families and Individuals in Medical Decision Making ������������������������  273
Lisa M� Rasmussen
Index ����������������������������������������������������������������������������������������������������������������  287
Contributors
Jeffery P. Bishop  Tenet Endowed Chair in Health Care Ethics, Albert Gnaegi 
Center for Health Care Ethics, Saint Louis University, St. Louis, MO, USA
Yu Cai  Law School, Yunnan University of Finance and Economics, Kunming, 
Yunnan Province, China
Ho Mun Chan  Department of Public Policy, City University of Hong Kong, 
Kowloon, Hong Kong, China
Mark J. Cherry  Department of Philosophy, St. Edward’s University, Austin, TX, 
USA
Kyungsuk Choi  School of Law, Ewha Womans University, Seoul, Korea
Chun Kit Chui  Department of Public Policy, City University of Hong Kong, 
Kowloon, Hong Kong, China
Julian Chuk-Ling Lai  Department of Applied Social Studies, City University of 
Hong Kong, Kowloon, Hong Kong, China
Rui Deng  College of Humanities and Social Sciences, Shanxi Medical University, 
Taiyuan, Shanxi, China
M. W. Tse Doris  Department of Medicine and Geriatrics/Intensive Care Unit, 
Caritas Medical Centre, Hospital Authority, Kowloon, Hong Kong, China
Ruiping Fan  Department of Public Policy, City University of Hong Kong, Hong 
Kong, China
Ana S. Iltis  Center for Bioethics, Health and Society; Department of Philosophy, 
Wake Forest University, Winston-Salem, NC, USA
Ilhak  Lee  (李日學)  Department  of  Medical  Law  and  Ethics,  College  of 
Medicine, Asian Institute for Bioethics and Health Law, Yonsei University, Seoul, 
Seadamun-gu, Korea
Shui Chuen Lee  Graduate Institute of Philosophy, National Central University, 
Chungli, Taiwan
xi