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2_28_05_216j_rev - 21A.216J Dilemmas in Bio-Medical...

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21A.216J Dilemmas in Bio-Medical Ethics 2005/2/28 (M), Week 5, Class 8 Reading C.Y. Tse, A Chong, and S.Y. Fok, “Breaking Bad News: A Chinese Perspective.” Palliative Medicine , Vol 17, No 4 (Jun 2003): 339-343 L.J. Blackhall, G. Frank, S. Murphy and V. Michel, “Bioethics in a Different Tongue: the case of Truth-Telling.” Journal of Urban Health, Vol 78, No 1 (Mar 2001): 59-71. Kuhse and Singer, Bioethics: An Anthology , pp 485-512 Class Business Paper 1 was OK but needs to involve more readings; a few were spectacular. Next paper will examine the Goods’ chapters. Issues of Autonomy and Disclosure When should a doctor disclose to patient? One of the arguments for confidentiality with special relationship with patient-doctor is issue of trust, which we take for granted and expect that our best interests are at heart, the ideal of beneficence and that the MD is working for our good. Whether MD discloses depends on the culture of the patient but also relates to questions of TRUST. Student Presentation Impression: Disclosure, diagnosis, prognosis. Cultural perspectives, research articles— easier to read “Breaking Bad News: a Chinese perspective” —a Western Chinese perspective Background: Tse—palliative care director; Chong—total quality management and social gerontology Keep in mind that the article that they are educated in the Western sense and trying to achieve the Western model Disclosure is viewed as a harmful act, violates maleficence principle. Very big generalization of CHINA. o Depends on the person and individual, whether they would want to place themselves in that situation. How valid are these articles? Questions asked depend on the moment in that person’s life and that opinions are subject to immediate change. Interesting point—the methodology of understanding people’s experience of Marshall and Koenig for on-the-ground study to really explore their experiences. Paper uses survey—use of quantitative. Anthropology is more qualitative, less structured and © 2005 OCW 1
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more observation-based and situational/in the moment and the other conditional factors (economics, family, etc.) that play into decisions. Why Chinese families tend to take over a person’s choice? o Western society—focus on the individual. Chinese—family interdependence and decision-making. Paper argues that shouldn’t be how it works, even though autonomy is not a traditional concept, but veracity is. What do you think about the notions of “this is a principle of Cheng ”? How are they using the concepts of culture, the concepts of science that are being appropriated to use its authority to construct a culture in a certain way? o Is this true? As you get older, you expect your kids to take care of you, just like you take care of your parents. As you get older, you lose power.
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