Medical Beneficence: Understanding the Chinese Medical Ethical Tradition
Keywords:醫療行善, 儒家, 道教, 佛教
LANGUAGE NOTE | Document text in Chinese; abstract also in English.
China has a long standing of a dominant medical ethical tradition. This tradition can be characterized a medial beneficence. The physician, within this tradition, is morally required to pursue the best interest of the patient rather than the best interest of himself. The practice of this tradition is characteristic of the Chinese culture of family determination on medical issues and is also closely related to the basic virtues approved in the Chinese community.
This tradition is rooted in three primary Chinese religions. First, Confucianism sets the basis of Chinese medical beneficence. Confucianism emphasizes humanity (ren) as the fundamental principle of human life. Humanity represents a specific human heart-mind that has been invested to every human by Heaven, the ultimate reality. The human heart-mind includes the potential of loving, respecting others, and distinguishing right and wrong. Accordingly, humanity, in its very basic sense, requires loving humans. Medicine provides a good means in practicing humanity. Thus in Chinese culture medicine is termed "the art of humanity." In addition, the Confucian virtue of filial piety has often been the impetus to push the Chinese physician to study and practice medicine effectively.
Daoism cherishes human life and seeks to gain longevity in terms of Daoist techniques, such as doing physical exercise and making chemical drugs. It includes a strong idea of retribution. Heaven, earth, and man co-exist in a vast field of qi (flowing energy), where qi of each part influences others through the influence of the qi field. Good moral behavior, according to Daoism, becomes a necessary condition for one to be able to gain longevity or even immortality. Thus, Daoism joins Confucianism in stressing that the physician ought to do his best to help the patient improve health, both bodily and mentally.
Chinese Buddhism is similar in this regard. A crucial idea involved here is the Buddhist concept of karma. Karma is literally "action," "doing," or "deed." It says that one reaps what one sowed. Until one is entirely enlightened, everyone goes through an infinite process of rebirth and the result of one's rebirth depend s upon one's accumulated karma. Hence one must do as much good as possible in order to obtain a better next life. Practicing medicine is an effective tool to achieve this goal. Besides, the Buddhist precepts such as "no killing" also plays an important role in Chinese medical practice.
In short, Confucian, Daoist, and Buddhist teachings have shaped the Chinese tradition of medical beneficence. This tradition requires the physician to place the patient's benefit first and the physician's interest second. For Confucianism, this is the requirement of human appropriate ness, fairness, or justice. This tradition also shows a closely-knit team work between the physician and the family to seek the best interest for the patient. The consideration of truth- telling to the patient and the patient's right to medical decision has never been emphasized.
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Copyright (c) 1999 International Journal of Chinese & Comparative Philosophy of Medicine
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