This paper argues against the continued practice of Confucian familism, even in its moderate form, in East Asian hospitals. According to moderate familism, a physician acting in concert with the patient's family may withhold diagnostic information from the patient, and may give it to the patient's family members without her prior approval. There are two main approaches to defend moderate familism: one argues that it can uphold patient's autonomy and protect her best interests; the other appeals to cultural relativism by (...) construing the principle of ‘family autonomy’ to be incommensurable with that of individual autonomy. We respond to the first approach by explaining how the familist arguments either depend on some unreasonable assumptions or simply fail to articulate. The critique of the second approach is based on our recent survey showing that there is no dichotomy of relevant values between the East and the West: we believe that the result can effectively block the familist's reliance on certain traditional or cultural values to explain their resistance to the incorporation of pluralist values. Despite our disagreement with familism, we consider the Eastern emphasis on the family to be conducive to the communication between patient, family members and medical personnel, which is indispensible to the patient's well being and autonomy. We conclude that respect for patient autonomy is perfectly consistent with the involvement of the family in making medical decision as long as the family plays a merely consultant role. (shrink)

This paper argues against the continued practice of Confucian familism, even in its moderate form, in East Asian hospitals. According to moderate familism, a physician acting in concert with the patient's family may withhold diagnostic information from the patient, and may give it to the patient's family members without her prior approval. There are two main approaches to defend moderate familism: one argues that it can uphold patient's autonomy and protect her best interests; the other appeals to cultural relativism by (...) construing the principle of ‘family autonomy’ to be incommensurable with that of individual autonomy. We respond to the first approach by explaining how the familist arguments either depend on some unreasonable assumptions or simply fail to articulate. The critique of the second approach is based on our recent survey showing that there is no dichotomy of relevant values between the East and the West: we believe that the result can effectively block the familist's reliance on certain traditional or cultural values to explain their resistance to the incorporation of pluralist values. Despite our disagreement with familism, we consider the Eastern emphasis on the family to be conducive to the communication between patient, family members and medical personnel, which is indispensible to the patient's well being and autonomy. We conclude that respect for patient autonomy is perfectly consistent with the involvement of the family in making medical decision as long as the family plays a merely consultant role. (shrink)

Personal autonomy presupposes the notion of rationality. What is not so clear is whether, and how, a compromise of rationality to various degrees will diminish a person's autonomy. In bioethical literature, three major types of threat to the rationality of a patient's medical decision are identified: insufficient information, irrational beliefs/desires, and influence of different framing effects. To overcome the first problem, it is suggested that patients be provided with information about their diseases and treatment choices according to the objective standard. (...) I shall explain how this should be finessed. Regarding the negative impact of irrational beliefs/desires, some philosophers have argued that holding irrational beliefs can still be an expression of autonomy. I reject this argument because the degree of autonomy of a decision depends on the degree of rationality of the beliefs or desires on which the decision is based. Hence, to promote patient autonomy, we need to eliminate irrational beliefs by the provision of evidence and good arguments. Finally, I argue that the way to smooth out the framing effects is to present the same information in different perspectives: it is too often assumed that medical information can always be given in a complete and unadorned manner. This article concludes with a cautionary note that the protection of patient autonomy requires much more time and effort than the current practice usually allows. (shrink)

My dissertation concerns the question of how our desires and beliefs explain our bodily movements. This study aims to show that the solutions given to this question by both token physicalists, including Donald Davidson, Jerry Fodor, and Fred Dretske, and a proponent of a commonsense approach, Lynne Rudder Baker, are unsatisfactory. Finally, I discuss Daniel Dennett and argue that his theory is the only choice we have. ;All of the five philosophers claim that reasons cause actions. Davidson's theory fails to (...) answer the question at issue because, on his account, the intentional properties of reasons are causally inefficacious in producing bodily behavior. Although Dretske's and Fodor's theories do not have this problem, their accounts receive the challenge from externalists, who argue that our intentional properties are determined not only by intrinsic physicial properties, but also by our relation to the environment. Since our intrinsic physical properties determines our bodily behavior, intentional properties seem irrelevant to the production of bodily movements. In response to externalism, both Dretske and Fodor attempt to provide an account of intentionality. However, I argue that their accounts are unsatisfactory. A fortiori, they fail to show content has any explanatory role. ;Then I switch to Baker's commonsense approach. She rejects the Standard View of the physicalists, i.e., that to have a propositional attitude is to have a brain state that has propositional content, and endorses her 'Practical Realism.' I, however, contend that her rejection of the Standard View is not successful and that Practical Realism, being compatible with the Standard View, fails to provide any new insight into intentional explanation. So the question at issue is still unanswered. ;At the end, I discuss Dennett's theory, which also rejects the Standard View. According to Dennett, there is no ontological difference between our beliefs and the beliefs of a machine, a nation, and evolution, provided that their behavior can be interpreted from the intentional stance. Therefore, instead of providing an account of the intentional , Dennett attempts to dissolve our urge for such an account by "demystifying" our intentionality. (shrink)

Fodor’s Informational Semantics states that the content of a representation depends on the counterfactual relation between the representation and the represented. However, his theory suffers from the psychological explanation problem and the indeterminacy problem raised by twin cases. In response to these problems, Fodor has introduced narrow content and a mixed theory of content that combines a historical account with the counterfactual account. In The Elm and the Expert, he drops both of them for the reason that twin cases are (...) nomologically impossible. I argue that Fodor underestimates the persistence of the problems raised by twin cases. Consequently, I contend that Fodor has to keep both the narrow content and the historical account. (shrink)

Fodor’s Informational Semantics states that the content of a representation depends on the counterfactual relation between the representation and the represented. However, his theory suffers from the psychological explanation problem and the indeterminacy problem raised by twin cases. In response to these problems, Fodor has introduced narrow content and a mixed theory of content that combines a historical account with the counterfactual account. In The Elm and the Expert, he drops both of them for the reason that twin cases are (...) nomologically impossible. I argue that Fodor underestimates the persistence of the problems raised by twin cases. Consequently, I contend that Fodor has to keep both the narrow content and the historical account. (shrink)

Fodor’s Informational Semantics states that the content of a representation depends on the counterfactual relation between the representation and the represented. However, his theory suffers from the psychological explanation problem and the indeterminacy problem raised by twin cases. In response to these problems, Fodor has introduced narrow content and a mixed theory of content that combines a historical account with the counterfactual account. In The Elm and the Expert, he drops both of them for the reason that twin cases are (...) nomologically impossible. I argue that Fodor underestimates the persistence of the problems raised by twin cases. Consequently, I contend that Fodor has to keep both the narrow content and the historical account. (shrink)