Who makes the decision? Patient's autonomy vs paternalism in a Confucian society.

Through the ages health professionals have depended on patients' co-operation and obedience as essential aspects of cure. The Code of Ethics of the American Medical Association in 1848, section 6, stated that "the obedience of a patient to the prescription of his physician should be prompt and implicit..." But A Patient's Bill of Rights published by the American Hospital Association in 1973 said that "the patient has the right to refuse treatment to the extent permitted by law..." At a quick glance, these two statements seem to put these two parties in conflict. The situation could even be more complicated when cultural elements are added to the consideration of who makes the final decision. A survey taken in the summer of 2002 in Taiwan showed that in a Confucian society, the family element often determines the course of decision and the patient's autonomy is overlooked. The head of the family, not the patient himself or herself, usually makes the decision, especially when the medical decision has something to do with a life or death situation.