ABSTRACT 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‐centred, 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. (shrink)

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. (shrink)

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. (shrink)

This chapter gives an outline of the development of the human organ transplant system in Hong Kong, whose key features are a soft opt-in system and strict prohibitions on commercial dealings in human organs for transplant. It is argued that under such a system, there is a lack of incentives for either cadaveric or living organ donations and for family members to endorse deceased donation. This argument is followed by an investigation of the shortage of organ donations in Hong Kong, (...) the limited success of the government promotion to improve the number of donations, and a discussion of new alternatives for improvement that have been initiated or proposed. It is argued that the feasibility and effectiveness of these alternatives are limited and uncertain. More radical reform of the existing system in terms of honorary, compensationalist, and familist incentives is needed and they all need to be taken into consideration. (shrink)

This chapter discusses some legal implications of Hong Kong’s three types of organ donation incentive and presents further thoughts about their ethical and policy implications. It aims to transform the useful findings presented in previous chapters into legal solutions and policy innovations in practice. We argue that the Hong Kong law is able to incorporate mixed incentive measures and further suggest detailed legal rules regarding organ incentives for the government to consider. In terms of ethical and policy implications in a (...) wider context, we suggest a paradigm shift in incentive structure and the adoption of mixed incentive measures for the promotion of organ donation and procurement. However, we agree that the exact choice or combination of organ incentive measures ultimately depends on how each country or jurisdiction will assess their practical effectiveness, political legitimacy, and ethical justification. (shrink)

This work examines the importance of distinguishing different levels of psychological explanation and the primacy of the computational level over implementational levels. The framework of levels allows us to recognize the role of formal theories as tools for specifying reasoning tasks at the computational level. It is shown that formal specifications of reasoning tasks allow us to analyze the complexity of the specified tasks and also serve to define reasoning competence and performance errors. Complexity analysis helps us identify tractable, practically (...) significant, subclasses of inference. The identification of these subclasses provides useful ante hoc and post hoc specifications for AI programming projects and psychological modeling. Formalization and complexity analysis also enable us to examine tradeoffs between tractability and range of applicability of implementations of a reasoning task. It is undesirable to obtain tractability at the expense of limiting the applicability of a cognitive mechanism to an unreal situation or a toy domain. It is argued that this undesirable result can be avoided if we examine the structure of the environment in which a mechanism is supposed to work and the environmental assumptions that make the computation tractable. Finally, it is demonstrated that many problems the human mind needs to solve in normal environments are indeed tractable and that the mind is equipped with adaptive mechanisms to solve them efficiently. This demonstration undermines a skeptical challenge to human rationality based on claims that many problems are intractable and that the capacity of the human mind is limited. (shrink)

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. (shrink)

This chapter contains sections titled: A Naturalistic Account of Human Rationality Geography of Thought: A Tale of Two Versions Nisbett on Logic and Contradiction How Radical are East‐West Differences in Thinking Style? Some Implications for the Education of Critical Thinking Acknowledgements Notes References.