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Hong Kong's Covid-19 epidemic circumstances have given us a valuable opportunity to reflect on Hong Kong's elderly care policies. This essay argues that Hong Kong should learn from the West and provide a subsidy to family caregivers for proper elderly care. We rebut the social and moralistic reasons for not introducing such a subsidy in Hong Kong. We indicate that providing cash subsidy to family caregivers does not monetize or tarnish Confucian filial obligation to take care of elderly people, but enable adult children from low-income families to undertake this obligation effectively. In addition, we contend that providing such a subsidy would not significantly affect the job market in Hong Kong and that incurred financial and manpower costs for monitoring family care are controllable. [ABSTRACT FROM AUTHOR]

This issue of The Journal of Medicine and Philosophy brings together an international group of scholars from Hong Kong, Mainland China, and North America, critically to explore whole-body/head transplantation. The proposed procedure raises significant philosophical, ethical, and social/political questions. For example, assuming transplant is successful, who survives the surgery? Does personal identity necessarily follow the head? The contributors to this special thematic issue explore the nature and ground of personal identity, what it would mean to preserve personal identity, given such a significant set of physical changes, as well as the morality of such a procedure. As the authors make clear, careful conceptual philosophical analysis is essential for understanding whether whole-body/head transplantation is a life-saving/life-enhancing technological innovation, or a bioethical morass that should not be attempted. How we come to terms with such conceptual and moral concerns will have a significant impact on the future of medicine and medical technological innovation. [ABSTRACT FROM AUTHOR]

This essay draws on classical Confucian intellectual resources to argue that the person who emerges from a head transplant would be neither the person who provided the head, nor the person who provided the body, but a new, different person. We construct two types of argument to support this conclusion: one is based on the classical Confucian metaphysics of human life as qi activity; the other is grounded in the Confucian view of personal identity as being inseparable from one's familial relations. These Confucian ideas provide a reasonable alternative to the currently dominant view that one's personal identity "follows" one's head. Together, these arguments imply that head transplantation is ethically inappropriate. [ABSTRACT FROM AUTHOR]

Morphine is usually preferred to treat moderate or severe pain for late-stage cancer patients. However, medically unindicated or excessive morphine use may result in respiratory depression and death. This essay contends that a clear distinction between relieving pain and performing active euthanasia in the use of morphine should be made in practice. By drawing on Confucian virtue resources, we construct a Confucian conception of human dignity, including both intrinsic and acquired dignity, to analyze the circumstances of morphine use in current China. We argue that not only the Confucian view of intrinsic dignity but also that of acquired dignity would not support morphine euthanasia. [ABSTRACT FROM AUTHOR]

This special thematic issue of The Journal of Medicine and Philosophy brings together a cross-cultural set of scholars from Asia, Europe, and North America critically to explore foundational questions of familial authority and the implications of such findings for organ procurement policies designed to increase access to transplantation. The substantial disparity between the available supply of human organs and demand for organ transplantation creates significant pressure to manipulate public policy to increase organ procurement. As the articles in this issue explore, however, even if well intentioned, the desire to maximize organ procurement does not justify undermining foundational elements of human flourishing, such as the family. While defending at times quite different understandings of autonomy, informed consent, and familial authority, each author makes clear that a principled appreciation of the family is necessary. Otherwise, health care practice will treat the family in a cynical and instrumental fashion unlikely to support social or individual good. [ABSTRACT FROM AUTHOR]

This essay indicates that Confucian family-based ethics is by no means a stumbling block to organ donation in China. We contend that China should not change to an opt-out consent system in order to enhance donation because a "hard" opt-out system is unethical, and a "soft" opt-out system is unhelpful. We argue that the recently-introduced familist model of motivation for organ donation in mainland China can provide a proper incentive for donation. This model, and the family priority right that this model supports, is ethically justifiable in terms of Confucian family-based ethics. [ABSTRACT FROM AUTHOR]

The steroidal saponin DT-13 (25( R,S )-ruscogenin-1-O-[β- d -glucopyranosyl-(1 → 2)][β- d -xylopyranosyl-(1 → 3)]-β- d -fucopyranoside), one of the major active compounds of the herb Liriope muscari (Decne.), exhibits significant anti-inflammatory, anti-tumor and cardioprotective effects. This study aimed to explore the protective effect of DT-13 on endothelium through regulating of nitric oxide production induced by Tumor necrosis factor-α (TNF-α). The results demonstrated that DT-13 inhibited inflammatory cell infiltration and thus played a protective effect on endothelial cells in vivo , as shown by hematoxylin-eosin (H&E) staining and immunohistochemical staining. Enzyme-linked immunosorbent assay (ELISA) results demonstrated that DT-13 could suppress the TNF-α-induced upregulation of reactive oxygen species (ROS), tumor necrosis factor receptor (TNFR), interleukin-8 (IL-8), monocyte chemoattractant protein-1 (MCP-1) and nitric oxide in vivo dose-dependently and suppressed production of nitric oxide in vitro as shown by DAF-FMDA. Western blotting results indicated that DT-13 could down-regulate phosphorylation of endothelial nitric oxide synthase (eNOS) significantly in TNF-α-induced human umbilical vein endothelial cells (HUVECs). Taken together, we speculate that DT-13 inhibits endothelium vascular inflammation through regulating nitric oxide production and the expression of ROS, TNFR, IL-8, MCP-1, which are associated with inflammation. [ABSTRACT FROM AUTHOR]

This essay offers a Confucian evaluation of Article 14 of the UNESCO Declaration on Bioethics and Human Rights, with a focus given to its statement that "the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being." It indicates that "a right to health" contained in the statement is open to two different interpretations, one radically egalitarian, another a decent minimum. It shows that Confucianism has strong moral considerations to reject the radical egalitarian interpretation, and argues that a Confucian nonegalitarian health distribution ethics of differentiated and graded love and obligation can reasonably be supported with a right to the decent minimum of health at the international level. [ABSTRACT FROM AUTHOR]

The article discusses papers published within the issue, including one on families, dependencies and the moral ground of health savings accounts and another on the role that Confucianism and its emphasis on traditional family structures plays in informing the Singaporean health care system with its varieties of medical savings accounts and insurance programs.

This essay explores a proper Confucian vision on genetic enhancement. It argues that while Confucians can accept a formal starting point that Michael Sandel proposes in his ethics of giftedness, namely, that children should be taken as gifts, Confucians cannot adopt his generalist strategy. The essay provides a Confucian full ethics of giftedness by addressing a series of relevant questions, such as what kind of gifts children are, where the gifts are from, in which way they are given, and for what purpose they are given. It indicates that Confucians should sort out different types of enhancement and bring them to the test of the Confucian values in terms of both Confucian virtue principles and specific ritual rules. It concludes that Confucians can accept some types of enhancement but must reject others. [ABSTRACT FROM AUTHOR]

The article presents a dialogue that discusses the question of whether Confucianism can be made compatible with liberal individualism. One person asserts that a rapprochement between the two positions is possible and suggests that a combination of the two views might produce an ethic which improves on both Confucian and liberal-individual morality. The other person, a Confucian, resists the claim and insists that any combination of different positions would lose the core values upon which each is founded. He also claims that liberal Confucianism would be no more than a modified liberalism and not a form of Confucianism at all. The author declares that the dialogue offers an evidence that Western and Chinese values cannot be readily assimilated within a single value perspective.

There is a prevailing conviction that if traditional medicine (TRM) or complementary and alternative medicine (CAM) are integrated into healthcare systems, modern scientific medicine (MSM) should retain its principal status. This paper contends that this position is misguided in medical contexts where TRM is established and remains vibrant. By reflecting on the Chinese policy on three entrenched forms of TRM (Tibetan, Mongolian and Uighur medicines) in western regions of China, the paper challenges the ideology of science that lies behind the demand that all traditional forms of medicine be evaluated and reformed according to MSM standards. Tibetan medicine is used as a case study to indicate the falsity of a major premise of the scientific ideology. The conclusion is that the proper integrative system for TRM and MSM is a dual standard based system in which both TRM and MSM are free to operate according to their own medical standards. [ABSTRACT FROM AUTHOR]

This paper examines the management and practice of traditional medicine in three autonomous regions of the People's Republic of China: Inner Mongolia; Tibet; and Xinjiang. On this basis, the paper considers how established medical traditions might best be integrated into modern health care systems. It holds that indigenous forms of medicine that have been practiced successfully across many generations should be treated as different but equal within wider health care systems. China has made important progress toward this ideal but, at the same time, has quite a long way to go. It is highly recommended that Chinese policymakers increase their efforts to give all established traditional medicines different but equal status within regional health care systems. [ABSTRACT FROM AUTHOR]

Presents the Confucian view regarding environmental ethics, especially one that affords appropriate dominion of humans over nature. Assertions that Confucian view of the environment is often taken to be anthrpocosmic rather than anthropocentric; Identification of three different possible senses of ethical anthropocentrism in order to clearly identify the Confucian view; Suggestion that principles are best understood as Confucian moral requirements that reflect the virtue of supernatural personal power rather than the causal necessity of Daoist natural law.

Truth-telling to competent patients is widely affirmed as a cardinal moral and biomedical obligation in contemporary Western medical practice. In contrast, Chinese medical ethics remains committed to hiding the truth as well as to lying when necessary to achieve the family's view of the best interests of the patient. This essay intends to provide an account of the framing commitments that would both justify physician deception and have it function in a way authentically grounded in the familist moral concerns of Confucianism. It reflects on the moral conditions and possibilities for sustaining a Confucian understanding of truth-telling and consent in mainland China. [ABSTRACT FROM AUTHOR]

The article throws light on the different approaches to informed consent and truth telling in the U.S., Hong Kong and mainland China. There appear to be some interesting similarities. Each of these approaches finds some place for family authority and direction by the physician. Each incorporates some form of therapeutic privilege for the physician. Each attempts to protect the interest of the patient. These similarities, however, are overwhelmed by quite distinct approaches to the appropriate role to be played by patients. their families, and physicians in medical decision-making. In addition, these approaches are set within quite different cultural and moral assumptions.

Comments on the monostandard integration of Chinese medicine into the health care system in China. Standards of the integrated Chinese medicine; Inappropriateness of the monostandard integration for an integrative health care system; Difference between traditional Chinese medicine and scientific medicine.

Focuses on the implications of Confucianism for establishing an appropriate health care system and assesses the features of health policies in China, Hong Kong and Singapore. Reconstruction of the foundational elements of Confucian moral commitments; Family-oriented, non-individualist account of resource allocation that takes family authority and responsibility seriously.

Compares the Aristotelianism concept of ideal human relations from the Confucianism concept. Approach of American thinking to surrogate decision making; Comparison of the Western and Chinese traditions of medical ethics; Details of the Aristotelian concept; Discussion on the Confucianism account.

Examines the bioethics of health care reform in Hong Kong. Distinct features of Hong Kong's health care compared to Western countries; Ability of Hong Kong to do so well with little resources; Important achievements made by the Hong Kong health care system included in the Harvard Report; Areas where improvements are still required.

Discusses major ethical issues and perspectives involved in Asian critical care medicine. Claims concerning justice in health care; Argument that patients' self determination is not required as the unique appropriate mode of exercising informed consent; Impact of Asian values of familism on critical care; Characterization of just health care delivery.

Presents an article on Christianity. Description of the encounters with western Christianity and the eastern Orthodox Christianity; Discussion on contemporary western secular bioethics; Difference between the concepts of anonymous Christianity and anonymous paganism.

The author presents a reply to comments about his article "A Confusion Reflection on Genetic Enhancement." He responds that Confucians believe that virtue is not elected by humans but mandated by Heaven. He discusses the Confucian understanding of family bonds, genetic enhancement and yin-yang metaphysics.

Recently implemented Chinese health insurance schemes have failed to achieve a Chinese health care system that is family-oriented, family-based, family-friendly, or even financially sustainable. With this diagnosis in hand, the authors argue that a financially and morally sustainable Chinese health care system should have as its core family health savings accounts supplemented by appropriate health insurance plans. This essay’s arguments are set in the context of Confucian moral commitments that still shape the background culture of contemporary China. [ABSTRACT FROM PUBLISHER]

Highlights • YQFM inhibits particulate matter (PM)-induced lung inflammation in mice. • YQFM inhibits particulate matter (PM)-induced lung autophagy in mice. • YQFM modulates particulate matter (PM)-induced TLR4-MyD88 and mTOR pathways in mice. Abstract Acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) are the serious diseases that are characterized by a severe inflammatory response of lung injuries and damage to the microvascular permeability, frequently resulting in death. YiQiFuMai (YQFM) lyophilized injection powder is a redeveloped preparation based on the well-known traditional Chinese medicine formula Sheng-Mai-San which is widely used in clinical practice in China, mainly for the treatment of microcirculatory disturbance-related diseases. However, there is little information about its role in ALI/ARDS. The aim of this study was to determine the protective effect of YQFM on particulate matter (PM)-induced ALI. The mice were intratracheally instilled with 50 mg/kg body weight of Standard Reference Material1648a (SRM1648a) in the PM-induced group. The mice in the YQFM group were given YQFM (three doses: 0.33, 0.67, and 1.34 g/kg) by tail vein injection 30 min after the intratracheal instillation of PM. The results showed that YQFM markedly reduced lung pathological injury and the lung wet/dry weight ratios induced by PM. Furthermore, we also found that YQFM significantly inhibited the PM-induced myeloperoxidase (MPO) activity in lung tissues, decreased the PM-induced inflammatory cytokines including interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α), reduced nitric oxide (NO) and total protein in bronchoalveolar lavage fluids (BALF), and effectively attenuated PM-induced increases lymphocytes in BALF. In addition, YQFM increased mammalian target of rapamycin (mTOR) phosphorylation and dramatically suppressed the PM-stimulated expression of toll-like receptor 4 (TLR4), MyD88, autophagy-related protein LC3Ⅱand Beclin 1 as well as autophagy. In conclusion, these findings indicate that YQFM had a critical anti-inflammatory effect due to its ability to regulate both TLR4-MyD88 and mTOR-autophagy pathways, and might be a possible therapeutic agent for PM-induced ALI. [ABSTRACT FROM AUTHOR]