The Ethical Dilemma of Truth-Telling in Healthcare in China
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ORIGINAL RESEARCH
The Ethical Dilemma of Truth-Telling in Healthcare in China Zanhua Zhang & Xiaoyan Min
Received: 8 July 2019 / Accepted: 15 April 2020 # Journal of Bioethical Inquiry Pty Ltd. 2020
Abstract Truth-telling is often regarded as a challenge in Chinese medical practices given the amount of clinical and ethical controversies it may raise. This study sets to collect and synthesize relevant ethical evidence of the current situation in mainland China, thereby providing corresponding guidance for medical practices. This study looks into the ethical issues on the basis of the philosophy of deontology and utilitarianism and the ethical principles of veracity, autonomy, beneficence, and nonmaleficence. Chinese philosophy, context and culture are also discussed to provide some suggestions for decision-making about disclosure in a medical setting. This study holds that, in order to respect the basic rights to which critically ill patients are entitled, decisions regarding truth-telling and their implementation should be carried out with thorough consideration, which can be achieved by critical thinking, welldeveloped and effective communication skills, the consideration of cultural context, an understanding of individual differences, and compliance with relevant laws and regulations. Z. Zhang Department of Emergency Intensive Care Unit, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou 325000, China e-mail: [email protected] X. Min (*) Department of Intensive Care Unit, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, 109 Xueyuanxi Road, Wenzhou 325000, China e-mail: [email protected]
Keywords Truth-telling . Ethics . Healthcare . China
Introduction In the past decades, the subject of ethics has seen dramatic development. Along with this, healthcare professionals have gained a relatively more comprehensive understanding of ethical issues (Hawley 2014). Ethics, as one part of philosophy, answers the question regarding what is deemed right (good) or wrong (bad) in human behaviour (Kordahl and Fougner 2017). In the medical sector, ethical codes of conduct for practitioners is a branch of philosophy that involves the analysis of moral phenomena, moral language, and ethical foundations and through which ethical decisions are made by clinical practitioners (Fry, Veatch, and Taylor 2010). Nowadays, medical practitioners are confronted with an overwhelming amount of ethical conflicts during patient care, resulting in rather negative experiences and impacts (McCrink 2008), especially when it comes to truth-telling. In many cases, a patient’s family members are involved in clinical treatment and are subsequently involved in decision-making about truth-telling (Catherine et al. 2017; Fjose et al. 2018; Mu et al. 2014). The decision on whether to tell the patient about his or her diagnosis and treatment options truthfully is approached differently in different countries, partially due to which a global conse
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