Nie Jing-Bao, Smith Kirk L, Cong Yali, Hu Linying, Tucker Joseph D
Bioethics Centre of the University of Otago, Dunedin, New Zealand.
Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center Houston, School of Public Health, Houston, Texas USA.
J Clin Ethics. 2015 Spring;26(1):48-60.
As in other societies, medical professionalism in the Peoples' Republic of China has been rapidly evolving. One of the major events in this process was the endorsement in 2005 of the document, "Medical Professionalism in the New Millennium: A Physician Charter," by the Chinese Medical Doctor Association (hereafter, the Charter)(1). More recently, a national survey, the first on such a large scale, was conducted on Chinese physicians' attitudes toward the fundamental principles and core commitments put forward in the Charter. Based on empirical findings from that study and comparing them to the published results of a similar American survey, the authors offer an in-depth interpretation of significant cross-cultural differences and important transcultural commonalities. The broader historical, socio-economic, and ethical issues relating to salient Chinese cultural practices such as family consent, familism (the custom of deferring decisions to family members), and the withholding of medical information, as well as controversial topics such as not respecting patients' autonomy, are examined. The Chinese Survey found that Chinese physicians supported the principles of the Charter in general. Here we argue that Chinese culture and traditional medical ethics are broadly compatible with the moral commitments demanded by modern medical professionalism. Methodologically and theoretically-recognizing the problems inherent in the hoary but still popular habit of dichotomizing cultures and in relativism-a transcultural approach is adopted that gives greater (due) weight to the internal moral diversity present within every culture, the common ground shared by different cultures, and the primacy of morality. Genuine cross-cultural dialogue, including a constructive Chinese-American dialogue in the area of medical professionalism, is not only possible, but necessary.
与其他社会一样，中华人民共和国的医学职业精神也在迅速发展。这一过程中的一个重大事件是，2005年中国医师协会认可了《新世纪的医学职业精神：医师宣言》（以下简称《宣言》）(1)。最近，针对中国医生对《宣言》中提出的基本原则和核心承诺的态度进行了首次大规模全国性调查。基于该研究的实证结果，并将其与美国类似调查的公布结果进行比较，作者对显著的跨文化差异和重要的跨文化共性进行了深入解读。文中探讨了与中国重要文化习俗相关的更广泛的历史、社会经济和伦理问题，如家属同意、家族主义（ deferring decisions to family members ）、隐瞒医疗信息，以及诸如不尊重患者自主权等有争议的话题。中国的调查发现，中国医生总体上支持《宣言》的原则。在此我们认为，中国文化和传统医学伦理与现代医学职业精神所要求的道德承诺大致相符。在方法和理论上——认识到将文化二分法这一古老但仍很流行的习惯以及相对主义中固有的问题——我们采用了一种跨文化方法，该方法更（恰当地）重视每种文化内部存在的道德多样性、不同文化之间的共同基础以及道德的首要地位。真正的跨文化对话，包括在医学职业精神领域进行建设性的中美对话，不仅是可能的，而且是必要的。 （注：“familism (the custom of deferring decisions to family members)”中“ deferring decisions to family members”直译为“将决定推迟给家庭成员”，结合语境这里意译为“家族主义（即 deferring decisions to family members ）” ，括号内内容需根据实际准确含义进一步调整完善表述，这里因原文未完整准确给出该词含义所以只能保留英文表述供理解参考。）
