Marriage is ordinarily a public practice, supported by, as well as supportive of, society. But it need not fall within the purview of the state. Public Practice, Private Law articulates a conception of marriage as a morally rich and important institution that ought to be subject to private rather than legislative or judicial ordering. It elaborates a robust understanding of marriage that captures what both different-sex and same-sex couples might see as valuable about their relationships. It explains why sexual ethics (...) won't yield a normative model of marriage, and why the kind of marital love worth wanting, can. It goes on to show how an understanding of marriage as rooted in demanding commitments can allow for divorce before arguing that the state should cease to sponsor marriages. It concludes by suggesting that both state and non-state institutions should acknowledge the marriages of same-sex couples. (shrink)

This chapter shows that feminist bioethics begins with critical engagement. Feminist bioethics as perspective centers the experiences of women – women's health, challenges that women primarily face within health care contexts, gaps in research that are only understood as gaps when one takes women seriously as women. The chapter highlights a few significant breakthroughs in feminist theory broadly that have informed feminist bioethics as perspective and as methodology – standpoint theory, relational autonomy, and intersectionality – in order to show how (...) an intentionally feminist lens can improve bioethics for everyone. Feminists understood that healthcare generally, and bioethics, in particular, were important sites for feminist thought. The traditional view of autonomy in bioethics is centered on the individual. The chapter also highlights an example of public practice, The Black Mamas Matter Alliance, that shows the important work of Black women's community advocacy as a blueprint for a public feminist bioethics. (shrink)

Kant argues that the “discipline” of reason holds us to public argument and reflective thought. When we speak the language of reasoned judgment, Kant maintains, we “speak with a universal voice,” expecting and claiming the assent of all other rational beings. This language carries with it a discipline requiring us to submit our judgments to the forum of our rational peers. Remarkably, Kant does not restrict this thought to the realm of politics, but rather treats politics as the model for (...) reason's authority in all the provinces that rational beings inhabit. (shrink)

Kant argues that the “discipline” of reason holds us topublicargument and reflective thought. When we speak the language of reasoned judgment, Kant maintains, we “speak with a universal voice,” expecting and claiming the assent of all other rational beings. This language carries with it a discipline requiring us to submit our judgments to the forum of our rational peers. Remarkably, Kant does not restrict this thought to the realm of politics, but rather treats politics as the model for reason's authority (...) in all the provinces that rational beings inhabit. (shrink)

The years 2015 and 2016 were marked by violent protests at South African universities. While the focus of many of the protests was on access to university education, an equally major theme was the decolonisation of universities. University statues, such as that of Cecil John Rhodes at the University of Cape Town and many others, were pulled down or defaced. Within the discourse on decolonisation of curriculum, statues were viewed as symbols of maintaining and preserving the colonial hegemony that is (...) being sustained by a Western or Eurocentric curriculum taught at universities. These developments led to a national discourse, which, among others, highlighted universities as spaces of exclusion because of residual colonial features. These protests became represented by hashtags such as #RhodesMustFall. These protests indicated a conflict and contest to eradicate the remnants of colonialism, as represented by statues, which some protesters argued should be replaced by symbols of black liberation and anti-apartheid iconic symbols. For an integrated South Africa, with its constitutional ideals of a rainbow nation, a discourse of coexistence is required. In this situation, a contextually engaged reformatory public practical theology is required to contribute to a constructive discourse and coexistence. (shrink)

Youth ministry as a sub-discipline of practical theology has traditionally always had an ecclesial focus. The focus was often based on the practices of proselytisation and discipleship, a sort of ‘reach and teach’ model whereby Christian believers would do the ‘reaching and teaching’ of the ‘lost’ youth. This is most true in an evangelical context and is further undergirded by a Western concept of personal salvation nearly devoid of any communal responsibilities and context. The traditional model, therefore, in evangelical (...) churches was reaching the ‘lost’ with the Gospel of Jesus Christ, with the aim of personal salvation for the individual who would eventually become a member of the faith community through a discipleship programme. Thus, the beginning and end of the entire process were the focus on personal salvation devoid of any contextual consideration. Youth ministry as practical theology must move into the area of public theology to engage the practices inherited from the western model by engaging with the public (youths) as public theologians (those who influence the theologies of the youth), and the public faiths and spiritualities (the expression of the youth’s theologies) to be relevant to the majority and developing world.Contribution: In this study, the author suggests that this ‘reach and teach’ paradigm with an ecclesial focus in the context of the majority and developing world is no longer suitable to meet the needs of youth. In addition, the author recommends a more appropriate framework with youth ministry as public practical theology for consideration. (shrink)

I once heard John Arras, who was one of bioethics’ bright lights and, toward the end of his life, a member of the Presidential Commission for the Study of Bioethical Issues, remark that it is hard for an ethics commission not to “do paint‐by‐numbers ethics.” What I think Arras had in mind is an approach that, in the set of essays that make up this special report, Rebecca Dresser describes as a listing of “general, often relatively uncontroversial” moral positions to (...) support largely procedural recommendations. Arras was calling attention to one of the challenges and sometimes frustrations of commission thinking. It is a recurring topic in this special report, Goals and Practices of Public Bioethics, which features a series of reflections about how national bioethics commissions around the world have contributed to public understanding and public policy about bioethical issues. Both the topic and the authors are drawn from the final two public meetings of the PCSBI, which was the most recent U.S. example of a national bioethics commission and whose winding down created an occasion for pondering the different forms and functions of bioethics commissions. (shrink)

Examination of a limited number of publisher’s Instructions for Authors, guidelines from two scientific societies, and the widely accepted policy document of the International Committee of Medical Journal Editors (ICMJE) provided useful information on authorship practices. Three of five journals examined (Nature, Science, and the Proceedings of the National Academy of Sciences) publish papers across a variety of disciplines. One is broadly focused on topics in medical research (New England Journal of Medicine) and one publishes research reports in a (...) single discipline (Journal of Bacteriology). Similar elements of publication policy and accepted practices were found across the policies of these journals articulated in their Instructions for Authors. A number of these same elements were found in the professional society guidelines of the Society for Neuroscience and the American Chemical Society, as well as the ICMJE Uniform Requirements for Manuscripts Submitted to Biomedical Journals. Taken together, these sources provide the basis for articulating best practices in authorship in scientific research. Emerging from this material is a definition of authorship, as well as policy statements on duplicative publication, conflict of interest disclosure, electronic access, data sharing, digital image integrity, and research requiring subjects’ protection, including prior registration of clinical trials. These common elements provide a foundation for teaching about scientific authorship and publication practices across biomedical and life sciences disciplines. (shrink)

An historical review of authorship definitions and publication practices that are embedded in directions to authors and in the codes of ethics in the fields of psychology, sociology, and education illuminates reasonable agreement and consistency across the fields with regard to (a) originality of the work submitted, (b) data sharing, (c) human participants’ protection, and (d) conflict of interest disclosure. However, the role of the professional association in addressing violations of research or publication practices varies among (...) these fields. Psychology and sociology provide active oversight with sanction authority. In education, the association assumes a more limited role: to develop and communicate standards to evoke voluntary compliance. With respect to authorship credit, each association’s standards focus on criteria for inclusion as an author, other than on the author’s ability to defend and willingness to take responsibility for the entire work. Discussions across a broad range of research disciplines beyond the social sciences would likely be beneficial. Whether improved standards will reduce either misattribution or perceptions of inappropriate attribution of credit within social science disciplines will likely depend on how well authorship issues are addressed in responsible conduct of research education (RCR), in research practice, and in each association’s ongoing efforts to influence normative practice by specifying and clarifying best practices. (shrink)

A woman is listening to Sinatra before work. As she later describes it, ‘suddenly from nowhere I could hear my mother singing along to it … I was there again home again, hearing my mother … God knows why I should choose to remember that … then, to actually hear her and I had this image in my head … of being at home … with her singing away … like being transported back you know I got one of those (...) … like shivery feelings really suddenly’ (Anderson 2004, 9-10). An older couple, discussing their honeymoon forty years ago, each say that they can’t remember the show they saw, until through iterative, puzzled cross-cuing they finally get there – ‘Desert Song, that’s it’ (Harris et al 2011, 292). An elderly English veteran of a prisoner of war camp in Japan, finishing up morning tea with a young Japanese social scientist interested in reconciliation, suddenly calls out loudly - in Japanese - ‘stand to attention’. He stands to attention in front of her: like many of the men she interviews, he physically re-enacts fragments of that long-past world of the camp, bringing that absent past into this new present context with a visceral shock (Murakami 2001, 2012; Middleton & Brown 2005, 133-136). (shrink)

The documented low levels of reliability of the peer review process present a serious challenge to editors who must often base their publication decisions on conflicting referee recommendations. The purpose of this article is to discuss this process and examine ways to produce a more reliable and useful peer review system.

This book takes stock of the wide range of practices of deliberative mini-publics. More concretely, it takes an informed look at preconditions, processes, and outcomes. Furthermore, it provides a critical assessment of the experience with mini-publics, in particular policy-impact. The book brings together leading scholars in the field, most notably James S. Fishkin and Mark E. Warren. It speaks to students and scholars with an interest in democracy and democratic innovations. This is the first comprehensive account of the booming (...) practice of deliberative mini-publics. Not only does it provide the reader with a systematic review of the variety of mini-publics, it also discusses their weaknesses and makes recommendations on how to make mini-publics a viable component of democracy. (shrink)

This article looks at the ethical quandaries, and their social and political context, which emerge as a result of international nuclear waste substitution. In particular it addresses the dilemmas inherent within the proposed return of nuclear waste owned by Japanese nuclear companies and currently stored in the United Kingdom. The UK company responsible for this waste, British Nuclear Fuels Limited (BNFL), wish to substitute this high volume intermediate-level Japanese-owned radioactive waste for a much lower volume of much more highly radioactive (...) waste. Special focus is given to ethical problems that they, and the UK government, have not wished to address as they move forward with waste substitution. The conclusion is that waste substitution can only be considered an ethical practice if a set of moderating conditions are observed by all parties. These conditions are listed and, as of yet, they are not being observed. (shrink)

In 2006, the Chief Medical Officer for England published the report Good Doctors, Safer Patients in a call for strengthened regulation of the medical profession. The changing relationship between patients and doctors in the United Kingdom arises from the interplay between societal expectation and clinical governance, personal formation and professional practice, private being and public doing. The wisdom of professional practice is in the habits of professionals, a practical wisdom that is the reflex of professional identity. Socialization into a profession (...) is the formation of such identity through the legitimate peripheral participation of the apprentice, oriented towards the contingent granting of admission to the community of practice. The conditional nature of continued insider status, permitting members to interact with clients across the professional boundary, is essential to the contract through which the profession enjoys the privileges conferred by society. The governance of the profession is therefore also necessarily circumscribed, a political reality that is currently evidenced in the regulation of medical practice in the United Kingdom. (shrink)

This chapter explores the relationship between public philosophy and deliberative democracy, both at a broad philosophical level and more granularly at the forms of deliberative practice that political theorists and philosophers have embraced and tried to foster. Deliberative democracy theory promises to create a culture of robust public inquiry, scrutiny, and judgment to which the more formal sectors of the public sphere, namely legislatures, must respond. Deliberators consider various points of view, work through costs and consequences, work through what must (...) be given up, and develop a public will on which public policies can rest. Beyond the classroom, some philosophers and social theorists have applied the cognitivist aspect of critical thinking to assess the value of more public deliberations, arguing that the outcomes of deliberation are valuable to the extent that they track the truth. (shrink)

Postema's article discusses, lucidly and probingly, a central jurisprudential idea, which he calls the autonomy thesis. In its general form it is shared by many writers who otherwise support divergent accounts of the nature of law. It is, according to Postema, a thesis that is meant to account for a core idea, that the law's “defining aim is to … unify public political judgment and coordinate social interaction.” In some form or another this core idea is probably supported by Postema (...) himself. However, in this article his concern is to criticize what he takes to be the widespread belief that it is explained by the autonomy thesis. The autonomy thesis is flawed and must be rejected. In arguing to that conclusion he succumbs to one of the unattractive tendencies of contemporary legal and political philosophy, namely he does not discuss anyone's view, but a family of views. This allows one to construct one's target by selecting features from a variety of authors so that the combined picture is in fact no one's view, and all those cited as adhering to it would disagree with it. (shrink)

Numerous recommendations and guidelines aim to improve the quality, timeliness and transparency of medical publications. However, these guidelines use ambiguous language that can be challenging to interpret, particularly for speakers of English as a second language. Cultural expectations within the Asia-Pacific region raise additional challenges and several studies have suggested that awareness and application of ethical publication practices in the Asia-Pacific region is relatively low compared with other regions. However, guidance on applying ethical publication practice guidelines in (...) the Asia-Pacific region is lacking. This commentary aims to improve publication practices in the Asia-Pacific region by providing guidance on applying the 10 principles of the Good Publication Practice 3 (GPP3) guidelines and the International Committee of Medical Journal Editors (ICMJE) criteria for authorship. Recommendations are provided for encore presentations, applying the ICMJE authorship criteria in the context of regional cultural expectations, and the role of study sponsors and professional medical writers. Ongoing barriers to compliance with guidelines are also highlighted, and additional guidance is provided to support authors submitting manuscripts for publication. The roles of regional journals, regulatory authorities and professional bodies in improving practices are also discussed. (shrink)

Over the last century, there have been considerable variations in the frequency of use and types of diagrams used in mathematical publications. In order to track these changes, we developed a method enabling large-scale quantitative analysis of mathematical publications to investigate the number and types of diagrams published in three leading mathematical journals in the period from 1885 to 2015. The results show that diagrams were relatively common at the beginning of the period under investigation. However, beginning in 1910, they (...) were almost completely unused for about four decades before reappearing in the 1950s. The diagrams from the 1950s, however, were of a different type than those used earlier in the century. We see this change in publication practice as a clear indication that the formalist ideology has influenced mathematicians’ choice of representations. Although this could be seen as a minor stylistic aspect of mathematics, we argue that mathematicians’ representational practice is deeply connected to their cognitive practice and to the contentual development of the discipline. These changes in publication style therefore indicate more fundamental changes in the period under consideration. (shrink)

Anne-Marie Schultz explores Plato’s presentation of Socrates as a philosopher who tells narratives about himself in the Theaetetus, Symposium, Apology, and Phaedo. She argues that scholars should regard Socrates as a public philosopher, while examining Socratic self-disclosive practices in the works of bell hooks, Kathy Khang, and Ta-Neishi Coates.

Creating Public Value in Practice: Advancing the Common Good in a Multi-Sector, Shared-Power, No-One-Wholly-in-Charge World brings together a stellar cast of thinkers to explore issues of public and cross-sector decision-making within a framework of democratic civic engagement. It offers an integrative approach to understanding and applying the concepts of creating public value, public values, and the public sphere. It presents a framework and language for opening a constructive conversation on what governments, businesses, nonprofits, and citizens can achieve in a democracy (...) that honors a broad range of public values. Public officials, scholars, and citizens alike are engaged in an intense debate about the proper purpose, role, and size of government. In the midst of this debate is a growing concern that important public values are ignored by government reform efforts. This book explores the different definitions of public value and approaches to public value creation, discernment, measurement, and assessment. The text helps clarify the issues and demonstrates how the meaning of public value is intimately related to how it is theorized, operationalized, and measured. The book examines the many alternatives for recognizing, measuring, and assessing public value and addresses the pros and cons of each approach. The result is a contribution to the ongoing dialogue about the virtues and limitations of a focus on the public sphere, public values, and how to create public value in the context of developing and implementing policies, programs, projects, and plans that ideally boost confidence in public institutions. (shrink)

Poverty continues to present an enormous challenge to the well-being of humanity. Different frameworks on poverty tend to identify different persons as poor, impacting on efforts to fight poverty. The church as a role player in the public domain needs a framework that can assist it in its task of working for salvation and liberation in the face of overwhelming poverty. Acombined framework, from Amartya Sen’s entitlement approach and capability approach, is amalgamated and suggested as an integrated framework that could (...) act as a lens or a viewpoint from which the church could venture to conceptualise, quantify and respond to instances of poverty. Keywords: Poverty; Church; Well-being; Amartya Sen; Entitlement Approach; Capability Approach. (shrink)

The “public charge” rule is a long-standing immigration policy that seeks to determine the likelihood that a prospective immigrant will become dependent on the government for subsistence. When the Trump administration sought to expand the criteria that would count against an applicant for permanent residency to include public benefits historically excluded from the calculation, thousands of commenters wrote to oppose or support the proposed changes. This paper explores the moral and practical reasons commenters provided for their position on the public (...) charge rule and considers the value of the public comment process for immigration, health, and social policy. (shrink)

Articles by Lyn Horn and Alison Thompson highlight several points crucial to understanding how our theory figures in wider debates about social justice as well as the particular relevance of our theory for assessing the overall practice of public health (Horn, 2013; Thompson, 2013). We begin with these two articles, first to respond to and concur with many of their central points, and second to set the stage for dealing more efficiently with some points raised in the other articles.

Machine generated contents note: Preface; Introduction Angus Dawson; Part I. Concepts: 1. Resetting the parameters: public health as the foundation for public health ethics Angus Dawson; 2. Health, disease and the goal of public health Bengt Brülde; 3. Selective reproduction, eugenics and public health Stephen Wilkinson; 4. Risk and precaution Stephen John; Part II. Issues: 5. Smoking, health and ethics Richard Ashcroft; 6. Infectious disease control Marcel Verweij; 7. Population screening Ainsley Newson; 8. Vaccination ethics Angus Dawson; 9. Environment, ethics (...) and public health: the climate change dilemma Anthony Kessel and Carolyn Stephens; 10. Public health research ethics: is non-exploitation the new principle for population-based research ethics? John McMillan; 11. Equity and population health: toward a broader bioethics agenda Norman Daniels; 12. Health inequities James Wilson; Index. (shrink)

BackgroundEthics is the science of moral and ethical rules recognised in human life and attempts to verify what is morally right and wrong. Healthcare ethics is seen as an integrated part of the daily activities of health facilities. Healthcare professionals’ standardisation and uniformity in healthcare ethics are urgent and basic requirements. Therefore, this study aimed to assess the practice of the code of ethics and associated factors among health professionals in Central Gondar Zone public hospitals, Northwest Ethiopia, 2021.MethodsA facility-based cross-sectional (...) study design with a mixed method was conducted on 631 health professionals from Central Gondar Zone public hospitals. For the quantitative part, pre-tested self-administered questionnaires were used, and for the qualitative part, key informant interviews with a semi-structured questionnaire were used. Variables with a p value of < 0.2 in binary logistic regression entered into a multivariable logistic regression, then p value < 0.05 and AOR were used to declare statistically significant variables in quantitative data. A thematic content analysis was used for qualitative data analysis.ResultsThis study revealed that only 286 health professionals had good practice of the code of ethics. Good ethical knowledge, favourable attitude, and satisfaction of health professionals with their jobs were significantly associated with the practice of health care ethics.ConclusionsHealth professionals' overall level of practice of health care ethics in the Central Gondar Zone public hospitals was poor. This necessitates practical training, ongoing follow-up, availing of necessary medical equipment, a smooth working environment, and modification of the recognition system for health professionals. (shrink)

The paper uses two historical examples, public health (1840-1880) and town planning (1945-1975) in Britain, to analyse the challenges faced by goal-driven research, an increasingly important trend in science policy, as exemplified by the prominence of calls for addressing Grand Challenges. Two key points are argued. (1) Given that the aim of research addressing social or global problems is to contribute to improving things, this research should include all the steps necessary to bring science and technology to fruition. This need (...) is captured by the idea of practical integration, which brings this type of research under the umbrella of collective practical reason rather than under the aegis of science. Achieving practical integration is difficult for many reasons: the complexity of social needs, the plurality of values at stake, the limitation of our knowledge, the elusive nature of the skills needed to deal with uncertainty, incomplete information and asymmetries of power. Nevertheless, drawing from the lessons of the case studies, it is argued that (2) practical integration needs a proper balance between values, institutions and knowledge: i.e. a combination of mutual support and mutual limitation. Pursuing such a balance provides a flexible strategy for approximating practical integration. (shrink)

Financing Public Schools moves beyond the basics of financing public elementary and secondary education to explore the historical, philosophical, and legal underpinnings of a viable public school system. Coverage includes the operational aspects of school finance, including issues regarding teacher salaries and pensions, budgeting for instructional programs, school transportation, and risk management. Diving deeper than other school finance books, the authors explore the political framework within which the schools must function, discuss the privatization of education and its effects on public (...) schools, offer perspectives regarding education as an investment in human capital, and expertly explain complex financial and economic issues. This comprehensive text provides the tools to apply the many and varied fiscal concepts and practices that are essential for aspiring public school administrators who aim to provide responsible stewardship for their students. (shrink)

Background: Publication of ethically uncertain research occurs despite well-published guidelines set forth in documents such as the Declaration of Helsinki. Such guidelines exist to aide editorial staff in making decisions regarding ethical acceptability of manuscripts submitted for publication, yet examples of ethically suspect and uncertain publication exist. Our objective was to survey journal editors regarding practices and attitudes surrounding such dilemmas. Methods: The Editor-in-chief of each of the 103 English-language journals from the 2005 Abridged Index Medicus (...) list publishing original research were asked to complete a survey sent to them by email between September-December 2007. Results: A response rate of 33% (n = 34) was obtained from the survey. 18% (n = 6) of respondents had published ethically uncertain or suspect research within the last 10 years. 85% (n = 29) of respondents stated they would always reject ethically uncertain articles submitted for publication on ethical grounds alone. 12% (n = 4) of respondents stated they would approach each submission on a case-by-case basis. 3% (n = 1) stated they would be likely to publish such research, but only with accompanying editorial. Only 38% (n = 13) give reviewers explicit instruction to reject submissions on ethical grounds if found wanting. Conclusions: Editorial compliance with the Declaration of Helsinki in rejecting research that is conducted unethically was difficult to ascertain because of a poor response rate despite multiple attempts using different modalities. Of those who did respond, the majority do reject ethically suspect research but few explicitly advise reviewers to do so. In this study editors did not take advantage of the opportunity to describe their support for the rejection of the publication of unethical research. (shrink)

This paper is concerned with the ambiguities and confusions that arise when studies of the ‘surveillance state’ are contrasted with studies of the ‘service state’. Surveillance studies take a largely negative view of the information capture and handling of personal data by Government agencies. Studies that examine Government service providing take a largely positive view of such data capture as Government is seen to be attempting to enhance service provision to individual citizens. This paper examines these opposing perspectives through a (...) series of case studies and concludes that a new understanding and methodology should be brought forward so as to create a reconciliation of these two points of departure for research. The call is for an holistic appreciation of data capture activities by Government so that researchers and public policy makers alike can appreciate and reconcile these competing perspectives. (shrink)

_New Public Management and the Reform of Education_ addresses complex and dynamic changes to public services by focusing on new public management as a major shaper and influencer of educational reforms within, between and across European nation states and policy actors. The contributions to the book are diverse and illustrate the impact of NPM locally but also the interplay between local and European policy spheres. The book offers: A critical overview of NPM through an analysis of debates, projects and policy (...) actors A detailed examination of NPM within 10 nation states in Europe A robust engagement with the national and European features of NPM as a policy strategy The book actively contributes to debates and analysis within critical policy studies about the impact and resilience of NPM, and how through a study of educational reforms in a range of political systems with different traditions and purposes a more nuanced and complex picture of NPM can be built. As such the book not only speaks to educational researchers and professionals within Europe but also to policymakers, and can inform wider education and policy communities internationally. (shrink)

Rethinking the relationship between eighteenth-century Pietist traditions and Enlightenment thought and practice, _The Practices of Enlightenment_ unravels the complex and often neglected religious origins of modern secular discourse. Mapping surprising routes of exchange between the religious and aesthetic writings of the period and recentering concerns of authorship and audience, this book revitalizes scholarship on the Enlightenment. By engaging with three critical categories--aesthetics, authorship, and the public sphere--_The Practices of Enlightenment_ illuminates the relationship between religious and aesthetic modes of (...) reflective contemplation, autobiography and the hermeneutics of the self, and the discursive creation of the public sphere. Focusing largely on German intellectual life, this critical engagement also extends to France through Rousseau and to England through Shaftesbury. Rereading canonical works and lesser-known texts by Goethe, Lessing, and Herder, the book challenges common narratives recounting the rise of empiricist philosophy, the idea of the "sensible" individual, and the notion of the modern author as celebrity, bringing new perspective to the Enlightenment concepts of instinct, drive, genius, and the public sphere. (shrink)

These essays, by widely respected scholars in fields ranging from social and political theory to historical sociology and cultural studies, illuminate the significance of the public/private distinction for an increasingly wide range of ...

: This paper argues that three salient corrupt practices that mark contemporary Chinese health care, namely the over-prescription of indicated drugs, the prescription of more expensive forms of medication and more expensive diagnostic work-ups than needed, and illegal cash payments to physicians—i.e., red packages—result not from the introduction of the market to China, but from two clusters of circumstances. First, there has been a loss of the Confucian appreciation of the proper role of financial reward for good health care. (...) Second, misguided governmental policies have distorted the behavior of physicians and hospitals. The distorting policies include (1) setting very low salaries for physicians, (2) providing bonuses to physicians and profits to hospitals from the excessive prescription of drugs and the use of more expensive drugs and unnecessary expensive diagnostic procedures, and (3) prohibiting payments by patients to physicians for higher quality care. The latter problem is complicated by policies that do not allow the use of governmental insurance and funds from medical savings accounts in private hospitals as well as other policies that fail to create a level playing field for both private and government hospitals. The corrupt practices currently characterizing Chinese health care will require not only abolishing the distorting governmental policies but also drawing on Confucian moral resources to establish a rightly directed appreciation of the proper place of financial reward in the practice of medicine. (shrink)