This paper discusses the relation between deontic logic and the study of conversational interactions. Special attention is given to the notion of remedial interchange as analysed by sociologists and linguistic pragmaticians. This notion is close to the one of contrary-to-duty (reparational) obligation, which deontic logicians have been studying in its own right. The present article also investigates the question of whether some of the aspects of conversational interactions can fruitfully be described by using formal tools originally developed in the study (...) of iterated belief change. I here adapt the latter tools to deontic logic, and attempt an account of remedial interchange (and, more generally, contrary-to-duty reasoning) in terms of commutation. This account brings the dynamics of obligations to the fore. (shrink)

The aim of this paper is to strengthen the point made by Horty about the relationship between reason holism and moral particularism. In the literature prima facie obligations have been considered as the only source of reason holism. I strengthen Horty’s point in two ways. First, I show that contrary-to-duties provide another independent support for reason holism. Next I outline a formal theory that is able to capture these two sources of holism. While in simple settings the proposed account (...) coincides with Horty’s one, this is not true in more complicated or “realistic” settings in which more than two norms collide. My chosen formalism is so-called input/output logic. A bottom-line example is introduced. It raises the issue of whether the conventional wisdom is right in assuming that normative reasons run parallel to epistemic ones. (shrink)

This paper offers a two dimensional variation of Standard Deontic Logic SDL, which we call 2SDL. Using 2SDL we can show that we can overcome many of the difficulties that SDL has in representing linguistic sets of Contrary-to-Duties (known as paradoxes) including the Chisholm, Ross, Good Samaritan and Forrester paradoxes. We note that many dimensional logics have been around since 1947, and so 2SDL could have been presented already in the 1970s. Better late than never! As a detailed case (...) study illustrating the power of 2SDL, we examine the system DL of Deontic Logic of Andrew Jones and Ingmar Pörn offered in 1985 to solve the Chisholm paradox of Contrary to Duties. The critical examination is done using logics and methods available in 1985 and solutions are proposed using what was available in 1985. (shrink)

This paper offers a two dimensional variation of Standard Deontic Logic SDL, which we call 2SDL. Using 2SDL we can show that we can overcome many of the difficulties that SDL has in representing linguistic sets of Contrary-to-Duties (known as paradoxes) including the Chisholm, Ross, Good Samaritan and Forrester paradoxes. We note that many dimensional logics have been around since 1947, and so 2SDL could have been presented already in the 1970s. Better late than never! As a detailed case (...) study illustrating the power of 2SDL, we examine the system DL of Deontic Logic of Andrew Jones and Ingmar Pörn offered in 1985 to solve the Chisholm paradox of Contrary to Duties. The critical examination is done using logics and methods available in 1985 and solutions are proposed using what was available in 1985. (shrink)

This paper offers a two dimensional variation of Standard Deontic Logic SDL, which we call 2SDL. Using 2SDL we can show that we can overcome many of the difficulties that SDL has in representing linguistic sets of Contrary-to-Duties (known as paradoxes) including the Chisholm, Ross, Good Samaritan and Forrester paradoxes. We note that many dimensional logics have been around since 1947, and so 2SDL could have been presented already in the 1970s. Better late than never! As a detailed case (...) study illustrating the power of 2SDL, we examine the system DL of Deontic Logic of Andrew Jones and Ingmar Pörn offered in 1985 to solve the Chisholm paradox of Contrary to Duties. The critical examination is done using logics and methods available in 1985 and solutions are proposed using what was available in 1985. (shrink)

This paper considers parental duties of beneficence and non-maleficence to use prenatal genetic testing for non-treatable conditions. It is proposed that this can be a duty only if the testing is essential to protect the interests of the child ie only if there is a risk of the child being born to a life worse than non-existence. It is argued here that non-existence can be rationally preferred to a severely impaired life. Uncontrollable pain and a lack of any (...) opportunity to develop a continuous self are considered to be sufficient criteria for such preference. When parents are at risk of having a child whose life would be worse than non-existence, the parents have a duty to use prenatal testing and a duty to terminate an affected pregnancy. Further, such duty does not apply to any conditions where the resulting life can be considered better than non-existence. (shrink)

In his applied moral philosophy, Kant formulates the parents’ duty to make their child happy. I argue that, for Kant, this duty is an ad hoc attempt at compensating for the parental guilt of having brought a person into the condition of existence – and hence also having created her need for happiness – on their own initiative. I argue that Kant’s considerations regarding parental duties and human reproduction in general imply arguments for an ethically justified anti-natalism, (...) but that this position is abolished in his teleology for meta-ethical reasons. (shrink)

This article explores the possibility that there is a parental duty to use preimplantation genetic diagnosis (PGD) for the medical benefit of future children. Using one genetic disorder as a paradigmatic example, we find that such a duty can be supported in some situations on both ethical and legal grounds. Our analysis shows that an ethical case in favor of this position can be made when potential parents are aware that a possible future child is at substantial risk of (...) inheriting a serious genetic condition. We further argue that a legal case for a duty to use PGD for medical benefit can be made in situations in which potential parents have chosen to conceive through in vitro fertilization and know that any children conceived are at substantial risk of having a serious genetic condition. (shrink)

The American Journal of Bioethics, Volume 12, Issue 4, Page 14-15, April 2012.

The introduction of in vitro fertilization (IVF) results in a separation of sex and reproduction which has generated enormous ethical debate (Lauritzen 1993). Surrogacy makes this situation more complicated by bringing a surrogate mother into reproduction. A surrogacy case may involve five individuals (in addition to the surrogate child). These are the commissioning couple, the gamete donors, and the surrogate mother. Hence, a surrogate child may have up to five parents, including biological parents, commissioning parents, and a gestational parent. The (...) question is which of these people should undertake parental duty? In terms of the acquisition of parental duty, there are three accounts. They are the biological connection account, the causal account, and the consent account. In this article, I try to argue that only the commissioning parents should undertake the parental duty for the surrogate child based on the latter two accounts. I do not apply the biological connection account because the biological connection account fails to explain one’s parental duty, which I will show in the following sections. (shrink)

This article argues that parents have a special, shared duty to organize for collective action on climate change mitigation and adaptation, but not for the reason one might assume. The apparently obvious reason is that climate change threatens life, health and community for the next generation, and parents have a special duty to their children to protect their basic human interests. This argument fails because many parents could protect their children from these central harms without taking more general action to (...) combat climate change, let alone to mitigate it. Instead, subtler reasons are advanced, drawing on children’s relational interests or on their interests as moral agents. It is argued that parents owe it to their children to combat climate change because of the indirect impact on current children of serious threats to their children and grandchildren, and of being required to live in a radically unjust world. It is further argued that parents may owe it directly to their more distant descendants to mitigate climate change because of the role current parents played in bringing them into the world. (shrink)

I argue that the best available parent view, in its present formulation, struggles to accommodate for our very weighty duty not to perpetuate historical injustices. I offer an alternative view that reconciles this tension.

Several states in the United States of America and countries in Europe punish parents when their minor child commits a crime. When parents are being punished for the crimes committed by their children, it should be presumed that parents might be held responsible for the deeds of their children. This article addresses the question whether or not this presumption can be sustained. We argue that parents can be blamed for the crimes of their children, not because they have the duty (...) to control their children as is often maintained, but because they have the duty to assist their child to develop in such a way that s/he becomes a morally competent agent. (shrink)

Several states in the United States of America and countries in Europe punish parents when their minor child commits a crime. When parents are being punished for the crimes committed by their children, it should be presumed that parents might be held responsible for the deeds of their children. This article addresses the question whether or not this presumption can be sustained. We argue that parents can be blamed for the crimes of their children, not because they have the duty (...) to control their children as is often maintained, but because they have the duty to assist their child to develop in such a way that s/he becomes a morally competent agent. (shrink)

This book examines the question of what parental obligations procreators incur by bringing children into being. Prusak argues that parents, as procreators, have obligations regarding future children that constrain the liberty of would-be parents to do as they wish. Moreover, these obligations go beyond simply respecting a child’s rights. He addresses in turn the ethics of adoption, child support, gamete donation, surrogacy, prenatal genetic enhancement, and public responsibility for children.

Shared views regarding the moral respect which is owed to children in family life are used as a guide in determining the moral permissibility of nontherapeutic clinical research procedures involving children. The comparison suggests that it is not appropriate to seek assent from the preadolescent child. The analogy with interventions used in family life is similarly employed to specify the permissible limit of risk to which children may be exposed in nontherapeutic research procedures. The analysis indicates that recent writers misconceive (...) how certain moral principles, such as respect for personal autonomy, require us to act toward children. The results are also used to assess proposed federal regulations on research with children. (shrink)

"What do grown children owe their parents?" Over two decades ago philosopher Jane English asked this question and came up with the startling answer: nothing (English 1979). English joins many contemporary philosophers in rejecting the once-traditional view that grown children owe their parents some kind of fitting repayment for past services rendered. The problem with the traditional view, as argued by many, is, first, that parents have duties to provide fairly significant services to their growing children, and persons do (...) not owe repayment for others' mere performance of duty; second, even where parents go above and beyond duty in their loving and generous rearing of their children, the benefits are bestowed, at least on young children, without their voluntary acceptance and consent, and so, again, fail to generate any obligation of subsequent repayment on their part (see Blustein 1982: 182-3). Moreover, the entire idiom of obligation and repayment, in English's 1 words, "tends to obscure, or even to undermine, the love that is the correct ground of filial obligation" (352). English's alternative, however -- that children strictly "owe" their parents nothing except what flows naturally from whatever love and affection exist between them -- also strikes many as problematic. Christina Hoff Sommers offers examples of what seem to be clearly delinquent adult children, who simply don't "feel" like sharing their lives with their aging parents, or providing any emotional or financial support to them, and so don't (Sommers 1986: 440-41). Sommers points out that we need some talk of obligations in order to fill in the cracks in human relationships where love and affection fail: "The ideal relationship cannot be 'duty-free,' if only because sentimental ties may come unraveled, often leaving one of the parties at a material disadvantage'" (450-51). Sommers proposes as her alternative to English that legitimate duties arise out of special relationships defined by social roles: being a father or mother, a son or a daughter, "is socially as well as biologically prescriptive; it not only defines what one is; it also defines who one is and what one owes" (447).. (shrink)

Displaying her intellectual and literary abilities from a young age, 'Mrs Taylor of Ongar' enjoyed writing all her life. She had eleven children, of whom six survived to adulthood. Her published works began with advice books for her own daughters, produced when increasing deafness made ordinary conversation difficult for her. This book, published in 1818, follows her earlier works for young women with a guide to conduct and 'reciprocal duties' within the family. Stern warnings and cautionary tales are given (...) to show the importance of duty to and respect for parents by children, but the parental duties of care in rearing and especially in education are emphasised. Early discipline, lovingly applied, is seen as the key to successful parenting, and its absence is deemed disastrous. Like Ann Taylor's Practical Hints to Young Females, the book offers fascinating insights into the middle-class ideal of domestic happiness. (shrink)

A central feature of Confucianism is the doctrine that an adult child has, for want of a better word, the ‘duty’ to care for his elderly parents1. Whether this doctrine should be framed in terms of an ethic of duties as opposed to an ethic of virtues is a vexed question. It might be argued that the doctrine is best framed in terms of the behaviour and dispositions appropriate to an agent who is, within the Confucian moral vision, good. (...) Nonetheless, in both popular discourse and in much the secondary literature, the doctrine is characterized in terms of a moral ‘ought’. We will adopt this perspective, and talk of the ‘filial duty of care’. We investigate the empirical question of whether Chinese communities still have a strong sense of this duty. We conclude that although there is a widespread perception among Chinese communities that their sense of filial duty of care has been eroded, in fact the adherence to it remains robust. (shrink)

Several philosophers argue that individuals have an interest-protecting right to parent; specifically, the interest is in rearing children whom one can parent adequately. If such a right exists it can provide a solution to scepticism about duties of justice concerning distant future generations and bypass the challenge provided by the non-identity problem. Current children - whose identity is independent from environment-affecting decisions of current adults - will have, in due course, a right to parent. Adequate parenting requires resources. We (...) owe duties of justice to current children, including the satisfaction of their interest-protecting rights; therefore we owe them the conditions for rearing children adequately in the future. But to engage in permissible parenting they, too, will need sufficient resources to ensure their own children's future ability to bring up children under adequate conditions. Because this reasoning goes on ad infinitum it entails that each generation of adults owes its contemporary generation of children at least those resources that are necessary for sustaining human life indefinitely at an adequate level of wellbeing. (shrink)

Preimplantation genetic diagnosis (PGD) is available where there is a 'significant risk of a serious genetic condition being present in the embryo', the criteria established by the Human Fertilisation and Embryology Authority (HFEA) and Human Genetics Commission (HGC). There are a number of controversies about this practice, notably to what extent people can agree on the term 'serious' and whether 'serious' should only mean 'serious for the possible child' or whether it might also, or sometimes instead, mean 'serious for the (...) prospective parents'. This paper moves into different controversial territory by considering the scope of reproductive autonomy beyond selection against serious genetic conditions. Here I consider the argument that parents might actually be morally required to select children with what are sometimes called 'enhanced' features or traits to select 'the best' as this has been described. Reflection on the realities and costs of an attempt to use in vitro fertilization (IVF) and PGD to select 'the best' possible child rebuts the argument in favour of any such 'maximizing' duty on behalf of prospective parents. (shrink)

Several states in the United States of America and countries in Europe punish parents when their minor child commits a crime. When parents are being punished for the crimes committed by their children, it should be presumed that parents might be held responsible for the deeds of their children. This article addresses the question whether or not this presumption can be sustained. We argue that parents can be blamed for the crimes of their children, not because they have the duty (...) to control their children as is often maintained, but because they have the duty to assist their child to develop in such a way that s/he becomes a morally competent agent. (shrink)

Even though co‐parenthood is one of the most significant close personal relationships that people can have, there is relatively little philosophical work on the moral duties that co‐parents owe each other. This may be due to the increasingly questionable assumption, still common in our societies, that co‐parenthood arises naturally from marriage or romantic coupledom and thus that commitment to a co‐parent evolves from a commitment to a marital or romantic partner. In this article, we argue that co‐parenthood should be (...) seen as a relationship in its own right, which generates specific moral duties. Co‐parents should come to explicit agreements with each other regarding the most important areas of potential conflict between them. Such agreements may have to be renegotiated over time. We explore some possible non‐negotiable co‐parental duties such as the duties not to alienate the child from the other parent(s) and not to trap a co‐parent in a particularly vulnerable situation. We consider some legal and societal implications of our argument and, finally, suggest some pragmatic benefits of our proposal. (shrink)

How should we understand the duties between those who share in parenting a child? Those who engage in shared parenting have duties to each other derived from the child's interests, but they also have additional duties to each other as sharers in parenting. The intentional account of duties between parents appears unable to explain the stringency of duties of shared parenting, as it seems to permit a parent to relinquish unilaterally their duties of shared (...) parenting. Drawing on the work of Bratman, Alonso, and Scanlon, I develop a shared intention account of duties of shared parenting. Duties of shared parenting are constituted by the distinctive combination of the value of reliance in shared intentions, the importance of assurance in agreements, the significance of autonomy is deciding one's goals, and the entitlement to choose with whom one shares the intimacy of parenting. On this view, duties of shared parenting are shown to be stringent, but not duties of strict performance. Thus, I argue that the intentional account of parental duties is able to explain the stringency of duties of shared parenting. (shrink)

Parental Obligations and Bioethics: The Duties of a Creator collects and supplements Bernard G. Prusak’s work on the ethics of procreation and parenthood, and applies his unique theoretical approach to related issues in bioethics and social philosophy. In this review, I’ll first summarize what I take to be the argumentative core of the book, and then offer a brief critical assessment.

A continuing need for care for elderly, combined with looser family structures prompt the question what filial obligations are. Do adult children of elderly have a duty to care? Several theories of filial obligation are reviewed. The reciprocity argument is not sensitive to the parent–child relationship after childhood. A theory of friendship does not offer a correct parallel for the relationship between adult child and elderly parent. Arguments based on need or vulnerability run the risk of being unjust to those (...) on whom a needs-based claim is laid. To compare filial obligations with promises makes too much of parents’ expectations, however reasonable they may be. The good of being in an unchosen relationship seems the best basis for filial obligations, with an according duty to maintain the relationship when possible. We suggest this relationship should be maintained even if one of the parties is no longer capable of consciously contributing to it. We argue that this entails a duty to care about one’s parents, not for one’s parents. This implies that care for the elderly is not in the first place a task for adult children. (shrink)

The current global ecological crises have, inter alia, led to an upsurge in massive migrations, food crises, diseases, pandemics, increased conflict and war especially in African societies. Most of those affected are the small farmers in rural communities who depend on agriculture. This crisis has not only raised concerns about the extent of the damage humans and human activities are causing to the natural environment but has also ignited discussions about the urgent necessity for a change in human behavior and (...) our obligations towards a new agrarian philosophy. In this chapter, I argue that Henry Odera Oruka’s Parental Earth Ethics could be adopted as a new principle of global justice and for grounding global environmental ethics. This principle invites us towards rethinking ecological fairness and global justice. Specifically, I opine that Oruka’s Parental Earth Ethics could be a veritable resource in our search for: (i) promoting global justice in the use and equal distribution of wealth and world resources for the common good and security of all, and (ii) global environmental ethics. It is basically driven by the ethical principle of the human minimum, which ought to inspire us humans to be more ethically and politically responsible in their use and distribution of world resources for the good and security of all. (shrink)

A continuing need for care for elderly, combined with looser family structures prompt the question what filial obligations are. Do adult children of elderly have a duty to care? Several theories of filial obligation are reviewed. The reciprocity argument is not sensitive to the parent–child relationship after childhood. A theory of friendship does not offer a correct parallel for the relationship between adult child and elderly parent. Arguments based on need or vulnerability run the risk of being unjust to those (...) on whom a needs-based claim is laid. To compare filial obligations with promises makes too much of parents’ expectations, however reasonable they may be. The good of being in an unchosen relationship seems the best basis for filial obligations, with an according duty to maintain the relationship when possible. We suggest this relationship should be maintained even if one of the parties is no longer capable of consciously contributing to it. We argue that this entails a duty to care about one’s parents, not for one’s parents. This implies that care for the elderly is not in the first place a task for adult children. (shrink)

I examine how co-parents should handle differing commitments about how to raise their child. Via thought experiment and the examination of our practices and affective reactions, I argue for a thesis about the locus of parental authority: that parental authority is invested in full in each individual parent, meaning that that the command of one parent is sufficient to bind the child to act in obedience. If this full-authority thesis is true, then for co-parents to command different things (...) would be for them to contest one another’s authority. The only course that respects the authority of both parents is for co-parents to agree to command the same thing. Further, what is commanded must not result from a ‘capitulation’ by one co-parent, rather, it should result from a compromise. Parental authority involves a duty to deliberate about which commands it is best to give the child. If a command results from a capitulation, one parent will rightly think of themselves as not having fulfilled their parental duty. Parental compromises are not best understood as bargains or conflicts, but by the metaphor of gifts given by each parent out of respect for the other’s authority. (shrink)

It is commonly assumed that many, if not most, adult children have moral duties to visit their parents when they can do so at reasonable cost. However, whether such duties persist when the parents lose the ability to recognise their children, usually due to dementia, is more controversial. Over 40% of respondents in a public survey from the British Alzheimer’s Society said that it was “pointless” to keep up contact at this stage. Insofar as one cannot be morally (...) required to do pointless things, this would suggest that children are relieved of any duties to visit their parents. In what appears to be the only scholarly treatment of this issue, Claudia Mills has defended this view, arguing that our duties to visit our parents require a type of relationship that is lost when parents no longer remember who their children are. This article challenges Mills’ argument. Not only can children be duty-bound to visit parents who have lost the ability to recognise them, I argue that many children do in fact have such duties. As I show, these duties are grounded in any special interests that their parents have in their company; the fact that visiting their parents might allow them to comply with generic duties of sociability; and/or the fact that such visits allow them to express any gratitude that they owe their parents. (shrink)

Some people oppose abortion on the grounds that fetuses have full moral status and thus a right to not be killed. We argue that special obligations that hold between mother and fetus also hold between parents and their children. We argue that if these special obligations necessitate the sacrifice of bodily autonomy in the case of abortion, then they also necessitate the sacrifice of bodily autonomy in the case of organ donation. If we accept the argument that it is obligatory (...) to override a woman’s bodily autonomy for the sake of an unborn child’s survival, we must continue to override the bodily autonomy of parents to ensure the survival of their living children, until the parent no longer has a special obligation to their child to the same degree as their special obligation to the fetus. And if the life of a child is truly more important than the bodily autonomy of its parents, as must be the case to force women to carry unwanted pregnancies to term, this should remain true until such a time that their children are no longer considered their responsibility. Thus, parity of reasoning suggests that policies compelling the gestation of a fetus should be accompanied by policies compelling organ donation. (shrink)

As people grow old, many risk becoming chronically lonely which is associated with e.g. depression, dementia, and increased mortality. Whoever else should help to protect them from this risk, various philosophers have argued that any children that they might have will often be among them. Proceeding on this assumption, this article considers what filial duties to protect ageing parents from loneliness consist of, or might consist of. I develop my answer by showing that a view that may be intuitively (...) plausible, namely that they simply require children to visit their ageing parents regularly when they can do so at reasonable cost and call, text, and/or email them from time to time, is defective in three respects. First, it ignores children’s potential responsibilities to encourage and/or facilitate social interaction between their parents and third parties. Second, it ignores their potential responsibilities to help provide their parents with non-human companionship. Third, it elides over their duties to coordinate their efforts to offer loneliness protection with others. What I end up proposing instead, then, is an approach for protecting ageing parents from loneliness that is multi-faceted. (shrink)

This book examines the negative power that child maltreatment has on individuals and society ethically and politically, while analyzing the positive power that parental love and healthy families have. To address how best to confront the problem of child maltreatment, it examines several policy options, ultimately defending a policy of licensing parents, while carefully examining the tension between child and adult rights and duties.

The moral limits on how, and how much, parents may attempt to shape their children depend on what the moral project of parenthood is all about. A great deal has been written in the past forty years on the moral functions of parents and families and the acquisition and character of parental duties and rights. There has also been a great deal of philosophical writing on the use of technologies to create, select, and modify children, with such seminal (...) works as Warnock et al., and Robertson. The two literatures have overlapped... (shrink)

Parents resemble trustees, conservators, and other fiduciaries; they exercise broad discretion while making choices for vulnerable people. Like other fiduciaries, parents can be tempted to neglect their duties or pursue self-interest at the expense of those they should protect. This article argues against treating parents as fiduciaries for three reasons. First, the scope of parental fiduciary duties cannot be narrowed enough to make them tolerable. Arguments limiting fiduciary duties to cases where parents exercise delegated powers or (...) act within parenting roles fail. Most parental decisions involve dual powers or roles. Efforts to address these dual-role cases produce principles that are unduly demanding, complex, arbitrary, and morally unappealing. Second, we could limit parental fiduciary duties by designing parental roles to benefit children. Since children need devoted, happy, well-rounded parents, the principle of designing parental roles to benefit children would produce rules that leave room for parents to flourish. However, this principle does not justify specific legal or moral fiduciary norms. Third, we could redefine fiduciary duties so parents can balance their interests against children’s interests, making fiduciary duties less burdensome. However, expanding the definition of fiduciary threatens to encompass many duties within the fiduciary category, rendering the description almost meaningless. (shrink)

It may soon be possible to develop pills that allow parents to induce in themselves more loving behaviour, attitudes and emotions towards their children. In this paper, I consider whether pharmacologically induced parental love can satisfy reasonable conditions of authenticity; why anyone would be interested in taking such parental love pills at all, and whether inducing parental love pharmacologically promotes narcissism or results in self-instrumentalization. I also examine how the availability of such pills may affect the duty (...) to love a child. (shrink)

In this chapter, I argue that children who were selected for particular traits or genetically enhanced might feel, for this reason, less securely, spontaneously and fairly loved by their parents, which would constitute significant harm. ‘Parents’ refers, throughout this chapter, to the people who perform the social function of rearing children, rather than to procreators. I rely on an understanding of adequate parental love which includes several characteristics: parents should not make children feel they are loved conditionally, for features (...) such as intelligence, looks or temperament; they should not burden children with parental expectations concerning particular achievements of the child; and parental love is often expressed in spontaneous enjoyment and discovery of children’s features. This understanding of parental love provides a reason to question the legitimacy of parental use of selection and enhancement and to explain why parents should not engage on a quest for the ‘best child’. (shrink)

All over the world millions of children are without parental care. As a consequence they are liable to suffer serious harm. I argue the general duty to assist those in need extends to children without parental care and that some people are under a moral duty to adopt rather than have biological children. I defend this claim against the following objections: (1) intimate decisions are excluded from the duty to assist, (2) adopting children is too costly to be (...) required by morality, (3) the duty to assist is a collective duty, (4) the duty to assist is an imperfect duty, and (5) there are, in fact, very few adoptable children. (shrink)

This paper reports two cases in Hong Kong involving two native Chinese adolescent cancer patients (APs) who were denied their rights to consent to necessary treatments refused by their parents, resulting in serious harm. We argue that the dynamics of the ‘AP‐physician‐family‐relationship’ and the dominant role Chinese families play in medical decision‐making (MDM) are best understood in terms of the tendency to hierarchy and parental authoritarianism in traditional Confucianism. This ethic has been confirmed and endorsed by various Chinese writers (...) from Mainland China and Hong Kong. Rather than giving an unqualified endorsement to this ethic, based more on cultural sentimentalism than rational moral reasoning, we warn that a strong familism in MDM, which deprives ‘weak’ family members of rights, represents the less desirable elements of this tradition, against which healthcare professionals working in this cultural milieu need to safeguard. Specifically for APs, we suggest that parental authority and family integrity should be re‐interpreted in terms of parental responsibility and the enhancement of children's interests respectively, as done in the West. This implies that when parents refuse to consent to necessary treatment and deny their adolescent children's right to consent, doctors, as the only remaining advocates of the APs' interest, have the duty to inform the state, which can override parental refusal to enable the doctors to fulfill their professional and moral obligations. In so doing the state exercises its ‘parens patriae’ power to defend the defenseless in society and the integrity of the medical profession. (shrink)