The biological standard of living of Korean men under Confucianism, colonialism, capitalism, and communism

This study focuses on analysing the heights of 10,953 Korean men aged 20 to 40 years who were measured during the Joseon dynasty, the Japanese colonialisation period, and the contemporary period, the latter including both North and South Korea. This study thus provides rare long-term statistical evidence on how biological living standards have developed over several centuries, encompassing Confucianism, colonialism, capitalism, and communism. Using error bar analysis of heights for each historical sample period, this study confirms that heights rose as economic performance improved. For instance, economically poorer North Koreans were expectedly shorter, by about 6 cm, than their peers living in the developed South. Similarly, premodern inhabitants of present-day South Korea, who produced a gross domestic product (GDP) per capita below the world average, were about 4 cm shorter than contemporary South Koreans, who have a mean income above the world average. Along similar lines, North Koreans, who have a GDP per capita akin to that of the premodern Joseon dynasty, have not improved much in height. On the contrary, mean heights of North Koreans were even slightly below (by about 2.4 cm) heights of Joseon dynasty Koreans. All in all, the heights follow a U-shaped pattern across time, wherein heights were lowest during the colonial era. Heights bounced back to Joseon dynasty levels during the interwar period, a time period where South Korea benefitted from international aid, only to rise again and surpass even premodern levels under South Korea's flourishing market economy.

How would you describe a mentally healthy college student based on Chinese culture? A qualitative research from the perspective of college students

BACKGROUND

Promoting college students' mental health remains a significant concern, necessitating a clear understanding of what constitutes good mental health. Variations in the conceptualizations of mental health across cultures, typically derived from academic and authoritative perspectives, have overlooked insights from laypeople. This study aims to investigate the characteristics of mentally healthy college students within Chinese cultural contexts, emphasizing perspectives provided by college students themselves.

METHODS

Undergraduates with self-reported mental health scores ≥ 7 were randomly selected for in-depth interviews. The sample (N = 17, 59% female) had a mean age of 20.82 ± 1.33 years and represented diverse regions, backgrounds, and academic fields. Thematic analysis was used in the analysis of the qualitative data, involving initial coding to identify 168 manifestations of mental health among college students, followed by categorizing them into 18 characteristics through focused coding. These characteristics were then organized into five themes via core coding. The Delphi method was utilized to validate the themes with 3 experts, ensuring the trustworthiness of the final findings.

RESULTS

Eighteen characteristics of mentally healthy college students emerged from the interviews, categorized into 5 themes: (1)Value Pursuit (i.e. Having a sense of responsibility and mission and being willing to dedicate oneself to the country at any time.); (2)Life Attitude (i.e. Staying positive and having the ability and quality to cope with hardships.); (3)Interpersonal Ideals (i.e., Showing filial respect to parents appropriately.); (4)Behavior Ability(i.e., Studying diligently and learning well.); and (5)Self-cultivation (i.e., Possessing good qualities advocated by Confucianism, Buddhism, and Taoism coexist harmoniously.). Most of these characteristics directly reflect traditional Chinese culture or culture that has changed with the times. At the same time, some are a reflection of modern Chinese new culture.

CONCLUSIONS

On the whole, the characteristics of mentally healthy college students are diverse and with rich connotations, focusing on the individual's relationship with the country, family, and others, and are good expressions of Chinese cultural features, such as the balance of Yin and Yang, the coexistence of Confucianism, Buddhism, and Taoism, and highlight moral attributes. In essence, these traits hold profound importance in advancing the mental health of Chinese college students.

The Integration of Medicine and Confucianism in the Late Yuan Period: Focusing on Neo-Confucian Physician Zhu Zhenheng

Zhu Zhenheng, the last generation and sole representative from Southern China among the four masters of Jin-Yuan medicine, synthesized the evolution of Chinese medicine from the Song to the Yuan dynasties, profoundly impacting East Asian medical history. Zhu, identified as a Neo-Confucian scholar, appears in the Scholarly Records of the Song-Yuan Dynasties and in 'the Biographies of Confucians' rather than 'the Biographies of Experts' in the Official History of the Yuan Dynasty. His close association with the Jinhua school of Daoxue is noteworthy. Zhu's career, as well as his medical theory and practice, exemplify the influence of Zhu Xi's Neo-Confucianism, which was a significant intellectual resource among the literati during the late Yuan period, on medicine. Zhu Zhenheng's model of a Confucian physician later became a paradigm in East Asia, as Neo-Confucianism gained mainstream acceptance among the literati. This paper offers a detailed exploration of the specific contexts of Zhu's social and intellectual networks as well as an examination of the characteristics of his medical theories and practices. It explores how Zhu's career and identity as a Neo-Confucian physician were shaped through the local and empire-wide networks of the Jinhua school of Neo-Confucianism within the broader context of the Mongol empire, a global power in the late Yuan period. The paper also examines in depth how Zhu's medical practices were influenced by Neo-Confucianism, and it investigates the real nature and significance of the integration of medicine and Neo-Confucianism, two distinctly different realms of knowledge. Zhu Zhenheng's medical theories were formed through concerns about jufang medicine and the active presentation of alternatives. A notable aspect of his integration of medicine and Confucianism was the adoption of Neo-Confucian terminologies, concepts, and philosophical and ethical theses, while ensuring that the unique and independent domain of medicine was not subordinated to abstract philosophical theories. This is especially evident through his active and effective use of medical cases. Unlike previous studies, this paper demonstrates that Zhu Zhenheng's integration of medicine and Neo-Confucianism was mostly a metalevel process, involving methodology and knowledge reproduction patterns, and was driven by a belief in the possibility of harmonizing with Daoxue's ultimate principle without undermining the autonomy of medical knowledge.

Theory and Meditation of Confucian Mindfulness: Analysis Based on the Concept of Vigilance in Solitude in Chinese Confucianism

Mindfulness has become an area of great interest in Western psychology, but it has been criticized for its de-religionization. Based on Chinese Confucianist Liu Zongzhou's concept of shendu (; vigilance in solitude), this study attempts to present a complete overview of the Confucian mindfulness meditation system from the theoretical basis and training method. The unique value of Confucian mindfulness meditation is that it directly points to morality, which can make up for the deficiency of mindfulness in Western psychology. Furthermore, Confucian mindfulness meditation can provide more suitable training methods for individuals who are culturally Chinese.

Confucianism and Gender Ratios of Suicide in the World: A WHO Data-Based Study

This study explores how Confucianism affects suicide rates by gender. Data for the study come from the World Health Organization document "Suicide Worldwide in 2019", which provides frequency and gender ratios for suicide rates in 183 member countries. One-way ANOVA and multiple linear regression analysis were used to examine potential differences in suicide rates and male to female ratio of suicides. Independent variables include region, income level, culture, and Confucian values that may be related to suicide. Suicide rates for Confucian countries do not show significant differences from European countries. However, these countries have lower suicide gender ratios.

Heterosexual Marital Intention: The Influences of Confucianism and Stigma Among Chinese Sexual Minority Women and Men

In traditional Confucianist culture in China, marriage and offspring are highly valued, placing sexual minority adults under tremendous pressure to marry an opposite sex partner. This study explored how Confucianism and stigma were associated with the intention to pursue a heterosexual marriage among Chinese sexual minority individuals as well as the moderating mechanisms of gender and age. Cross-sectional data were collected from 747 participants via online social networks from March to June 2020. Items assessed Confucianism values (communalism, filial piety, traditional gender roles); stigma (rejection sensitivity, social discrimination); and heterosexual marital intention (HMI). A total of 1.7% (n = 12) participants had ever been married, 11.6% (n = 87) planned to marry a different-sex partner, 60.4% (n = 451) had no intention to pursue a heterosexual marriage, and 26.4% (n = 197) had no specific marital plan. Bisexual participants scored significantly higher than homosexual individuals in HMI. Sexual minority adults with high levels of Confucianism and stigma were more likely to intend to marry. Importantly, both individual stigma (rejection sensitivity) and interpersonal stigma (social discrimination) partially mediated the relationship between Confucianism and HMI. Confucianism had a stronger impact on HMI for men than women, and age moderated the influence of Confucianism (including communalism and filial piety) on HMI, with a stronger impact for younger than older generations. This study contributes to a better understanding of how Confucianism and stigma may be connected to the intention to pursue a heterosexual marriage, suggesting culture-modified theories of stigma and sexual minority stress are needed to explain the experiences of sexual minority people in contemporary China.

Influence of the Integration of Aesthetic Education by Zhu Xi's Neo-Confucianism on the Ideological and Political Education and Internalized Psychology of College Students

The purpose is to study the influence of Zhu Xi's neo-Confucianism on the ideological and political education (IPE) of college students. Firstly, the aesthetic connotation of Zhu Xi's Neo-Confucianism is studied. Secondly, an interview is performed with teachers of the IPE course in a university in Xi'an, and a questionnaire survey is conducted on some students of the IPE course in the school. It aims to investigate the current situation of college students' IPE, and the impact of integrating aesthetic education into IPE of college students on the improvement of students' overall quality and internalized psychology. Finally, the reasons for this situation are analyzed and solutions are given. The survey results reveal that the aesthetic education thoughts based on Zhu Xi's neo-Confucianism are integrated into the construction of college students' internalized psychological mechanism, and most students think that their mental health status has changed a lot. The proportion of boys who choose "improved" is 57.95%, and the proportion of girls is 53.45%. The aesthetic education is integrated into the IPE of college students, and the proportion of students who think "no effect" after integration and before integration has decreased by 2.01%. The proportion of the number of people who chose the three indicators of "increasing the innovation of teaching methods", "advancing aesthetic ability", and "improving the effectiveness of ideological education" increased by 5.88%, 5.5%, and 3.98%, respectively. It demonstrates that the effect of IPE on college students has been greatly improved after integration into aesthetic education.

How Does Confucianism Influence Health Behaviors, Health Outcomes and Medical Decisions? A Scoping Review

The aim of this study is to analyze the influence of Confucianism on health behaviors, health outcomes and medical decisions. The research was conducted using the following databases: PubMed, Scopus, CINHAL, PsycINFO and Web of Science, without restrictions of language and year of publication. The search process identified 833 publications matching the search criteria, and after the review process, 40 articles were included. Family is a central aspect of Confucianism, and it seems to affect participation in medical decisions, taking care of relatives, ethical dilemmas and mental health problems. Although most Confucianist influence seems to be positive, some ways of thinking could increase suffering, burnout and a delay in healthcare seeking. Understanding these values could help health professionals to deal with the growing contingent of patients with different cultures and religious beliefs.

Health and Chinese Beliefs: A Scientometric Analysis of Health Literature Related to Taoism and Confucianism

Taoism and Confucianism both exited simultaneously as philosophies of living in dynastic China. Although there has been an increasing popularity in scientometric studies, religion and health (R&H) literature lacks a holistic evaluation investigating articles relevant to Taoism and Confucianism. All publications produced in Taoism and Confucianism literature and indexed in Web of Science (WoS) databases between 1975 and 2018 were included in this study. Database search on health and Taoism literature retrieved 199 documents from WoS databases. Main research areas were Psychology, Religion and Behavioral Sciences (24.121, 21.608 and 20.603, respectively). The USA ranked first with 38 papers followed China, Taiwan and the UK (n = 35, 20 and 6 documents, respectively). Hong Kong Polytechnic University from China was the most contributor institution in health and Taoism literature. A total of 448 documents were published in health and Confucianism literature between 1975 and 2018, and original articles covered 93.08% of all literature. China was leading country with 126 articles followed by the USA, South Korea and Taiwan (n = 97, 35 and 35 items, respectively). The most productive institutions were City University of Hong Kong (China), Karolinska Institute (Sweden) and University of Hong Kong (China). Researchers from developing and least developed countries should be encouraged to carry out novel scientometric studies in R&H literature.

[The Physician of the Shao Xing School in the Late Qing Dynasty -- Zhao Qingchu]

Zhao Qingchu, a Confucian physician from the Kuaiji area at the end of the Qing Dynasty, learned from famous physicians of the Shao Xing School on exogenous febirle disease (Shang Han) and the You's of the Shi Cai School, drawing from the knowledge of the both medical schools. He quickly became popular for being a physician after giving up his research of Confucianism. He had a wide physician-patient network because of his art of healing as many politicians and celebrities such like Shao Youlian, Zeng Guoquan, Ren Daorong, Xu Yingkui and Ren Fuchang,were his patients. He was taken as a typical example of being good at the medical communication among doctors and doctors-patients in the Yangtze River area in the late Qing Dynasty. For instance, he once had a variety of medical communication with famous physicians, such as Wang Yuezhen, Ma Peizhi, He Lianchen, Zhang Wanxiang, Ling Jialiu and Zhou Bodu. He investigated medical theories in terms of exogenous febirle disease (Shang Han) and integrated his thinking with various medical schools, even attempting to involving western medicine. He was also skilled in teaching his medical thinking to his disciples, such as Zhao Shuan, Yang Zhian, Lu Dongchuan and He Jiren. Zhao Qingchu compiled his medical understanding based on his practice and experiences throughout his life and published this knowledge in Cun Cun Zhai Yi Hua Gao. He had it published many times, leading to a profound influence in Shaoxing and the Jiangnan area at that time.

Evangelical Protestant Women's Views on Homosexuality and LGBT Rights in Korea: The Role of Confucianism and Nationalism in Heteronormative Ideology

Much scholarly attention has been devoted to understanding the demographic, religious, and socio-economic factors that may lead to homonegativity. However, little is known about how and why people oppose homosexuality and LGBT rights. To fill this gap, this work examines how heterosexual religious mothers perceive homosexuality and LGBT rights focusing on the role of indigenous culture. Drawing on qualitative interviews with 30 evangelical Protestant women in South Korea, my findings indicate that evangelical women's perceptions of LGBT rights and their justification display evangelical notion of procreation, motherly moral concerns about the rapid change in heteronormative ideals, and ambivalence about an individualistic, expressive culture. I argue that heteronormative ideology forms a key construct that determines the responses of evangelical women. In addition, such an idea is not only guided by evangelical teaching but also reinforced by a complex amalgamation of Confucian tradition and nationalism, thus restricting sexual drive and emotions for the sake of families and the nation. Heterosexual family norms operate in a way that it is synchronized with a combination of Confucian-family-oriented collectivism and nationalism. This study contributes to complicating a simple, one-dimensional understanding of public attitudes on homosexuality by offering a nuanced look into the configuration of heterosexual ideologies, which are unique in the Korean context.

'It's like a double-edged sword': understanding Confucianism's role in activity participation among first-generation older Chinese migrants in the Netherlands and Belgium

While activity participation in later life has attracted considerable attention from policymakers and scholars, indoor and outdoor engagement among older Chinese migrants in Europe is understudied. Using in-depth interviews with 21 older Chinese migrants in the Netherlands and seven in Belgium, this study is among the first to explore older Chinese migrants' activity participation experiences from the perspective of Confucianism, the cornerstone of Chinese culture. More specifically, the impact of four acknowledged principles of Confucianism are considered: hierarchical relationships, family system, benevolence and emphasis on education. The findings show that, like a double-edged sword, these four principles have positive and negative effects on older Chinese migrants' activity participation. Hierarchical relationships promote formal organisational participation, yet concurrently dividing the Chinese community into smaller subgroups and endangering solidarity within the community. With regard to family system, which emphasizes intergenerational responsibility and obligation, older Confucianist migrants prioritise taking care of their grandchildren, resulting in less time to participate in outdoor activities. Benevolence, the third principle of Confucianism, restrains older Chinese migrants from political participation while encouraging them to attend community meetings where food is shared. Lastly, emphasis on education, of which self-cultivation is an important aspect, helps older Chinese migrants overcome feelings of loneliness and makes them prefer self-learning activity above formal learning settings (e.g. language learning) organised by the government. The article ends with policy recommendations on how to increase older Chinese migrants' outdoor activities.

Confucian values, trust, and family farm adoption of green control techniques

Encouraging farmers to adopt green control techniques (GCTs) helps to reduce and control the use of chemical pesticides. However, there is a lack of attention regarding the promotion of culture as an informal institution. As an important part of Chinese culture, Confucian values affect the behavior and decision-making of Chinese people imperceptibly, and these values are more visceral for farmers. We apply a mediation model with categorical variables to a dataset of 443 family farms in Shandong and Henan provinces to systematically investigate the relationships among Confucian values, trust, and the family farm adoption of green control techniques. We use the conditional mixed process and two-stage least square estimation methods for instrumental variables to address potential endogeneity problems. Our findings show that Confucian values have significant positive effects on trust and the family farm adoption of GCTs. Trust has a positive effect on the family farm adoption of GCTs and a mediating effect on the relationship between Confucian values and the family farm adoption of GCTs. Therefore, Confucian values should be emphasized for creative transformation and innovative development. To strengthen the spread of Confucian culture and improve education about it, traditional folk and cultural activities should be established, Confucian self-study by family farms should be encouraged, favorable external conditions should be created, the Confucian values of family farms should be guided and cultivated, and the trust level of family farms should be enhanced to improve the efficient extension of GCTs.

Engineers' Moral Responsibility: A Confucian Perspective

Moral responsibility is one of the core concepts in engineering ethics and consequently in most engineering ethics education. Yet, despite a growing awareness that engineers should be trained to become more sensitive to cultural differences, most engineering ethics education is still based on Western approaches. In this article, we discuss the notion of responsibility in Confucianism and explore what a Confucian perspective could add to the existing engineering ethics literature. To do so, we analyse the Citicorp case, a widely discussed case in the existing engineering ethics literature, from a Confucian perspective. Our comparison suggests the following. When compared to virtue ethics based on Aristotle, Confucianism focuses primarily on ethical virtues; there is no explicit reference to intellectual virtues. An important difference between Confucianism and most western approaches is that Confucianism does not define clear boundaries of where a person's responsibility end. It also suggests that the gap between Western and at least one Eastern approach, namely Confucianism, can be bridged. Although there are differences, the Confucian view and a virtue-based Western view on moral responsibility have much in common, which allows for a promising base for culturally inclusive ethics education for engineers.

The Impact of Two Different Cultures on Juvenile Attitudes Toward the Police in China

This study examines juvenile attitudes toward the police (JATP) from an unconventional angle by examining the possible effect of two different cultures along with more conventional factors typically associated with youth attitude formation. A unique feature of this study is the inclusion of measures of attachment to both the traditional Chinese culture and Western popular culture. The data were collected from 30 minority middle schools with more than 6,500 students in a southern autonomous region in China in 2014. The primary findings indicate that juveniles who are more firmly attached to the traditional Chinese culture and who show respect for parents/teachers tend to hold a more positive view of the police. In contrast, juveniles who endorse Western popular culture and are perceived as a fan of that culture are more likely to hold a negative view of the police, societal actors who are viewed as primary representatives of the mainstream culture.

Confucianism and organ donation: moral duties from xiao (filial piety) to ren (humaneness)

There exists a serious shortage of organs for transplantation in China, more so than in most Western countries. Confucianism has been commonly used as the cultural and ethical reason to explain the reluctance of Chinese and other East-Asian people to donate organs for medical purposes. It is asserted that the Confucian emphasis on xiao (filial piety) requires individuals to ensure body intactness at death. However, based on the original texts of classical Confucianism and other primary materials, we refute this popular view. We base our position on the related Confucian norms of filial piety and ren (humaneness, humanity or benevolence), the tension between differentiated love and universal love, and belief in the goodness of human nature. In light of this, we argue that the Confucian ethical outlook actually calls for organ donation at an individual level, and supports an opt-out (presumed consent) system at the level of social policy. Furthermore, because the popular view is based on a number of dominant but misleading modes of thinking about cultural differences, our revisionist account of Confucian moral duties regarding organ donation has implications for developing a more adequate transcultural and global bioethics. These will be discussed and expanded upon.

From Confucianism to psychology: Rebooting Internet addicts in China

Coined in the 1990s, the term "Internet addiction" encapsulates a brief but influential human history of technological advancement and psychological development. However, most studies have treated Internet addiction as a "global" concept in the realm of science without taking into consideration its sociocultural meanings and local history. In China, obsessive online gaming behavior among youth is viewed as a national issue of public health and social control. This article examines the special development of interventions to address Internet addiction in China within a broader local history of culturally inflected social control, market reform, the one-child policy, and psychology. Based on historical review and ethnographic data from a treatment center specializing in Internet addiction, this article presents a deep analysis of what Internet addiction means in Chinese lives. It argues that Internet addiction is, in fact, a cultural idiom of distress related to social control rather than a universal syndrome of self-control. It represents the dynamic interactions between Confucian family values and market reform, the one-child policy, and recent trends in psychology and technology. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

To relieve or to terminate? A Confucian ethical reflection on the use of morphine for late-stage cancer patients in China

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.

Responsibility and Sustainability in Brain Science, Technology, and Neuroethics in China-a Culture-Oriented Perspective

The China Brain Project is in development. Integrating an ethical framework to identify and assess ethical challenges and plan for solutions is a priority. Here Wang et al. discuss ethical questions emerging from brain research in the context of traditional Chinese culture and juxtapose the legacy of Confucianism with contemporary thinking.

Choe Han-gi's Discourse on Singi and His Criticism on Chinese Medicine and Western Medicine: Focusing on the Relationship with Seo Gyeong-deok's Philosophy

This study examines how Choe Han-gi (1803-1879) developed his medical discourse which integrated the concepts of traditional Chinese medicine with modern Western anatomy, based on the philosophy of Seo Gyeong-deok (1489-1546), a scholar of the Neo-Confucianism of Joseon (1392-1910). Seo emphasized gi (C. qi, vital, material force) rather than yi (C. li, the principle of things) as a way of understanding the world. Since Choe's early academic interests pertained to Neo-Confucianism, it is reasonable to examine his philosophy in this context. Similar to Seo, Choe assumed that the most essential component of the world was the intrinsic and mysterious gi. Although Seo spoke of gi as a damil cheongheo ji gi (the gi which is profound, uniform, clear, invisible, and empty), Choe preferred to use the word singi (C. shenqi, the intrinsic, invisible, and mysterious gi). He believed that the earth, moon, and stars operated through the action of singi and that all creatures could only exist by relying on it. Singi was the most important premise in Choe's medical discourse, a fact demonstrating that although he could be very critical of traditional Chinese medicine, his perspective was part of that tradition. He believed that singi integrated and operated the entire human body and that it perceived external objects. He also emphasized the role of hyeongjil (C. xingzhi, a visible object with a form and quality; here it means all human bodies). This was the medium through which singi could appear in reality. Choe thought that singi could not reveal itself in reality without hyeongjil, and that hyeongjil became a dead thing without singi. His perception of the role of hyeongjil was expressed in his interest in modern Western anatomy, an interest that complemented his focus on singi. In light of his understanding of the singi-hyeongjil relationship, Choe criticized both modern Western anatomy and traditional Chinese medicine. He thought that modern Western anatomy lacked awareness of singi and that traditional Chinese medicine lacked accurate knowledge of human anatomy. Although he was not completely sympathetic toward any forms of medicine, he was open to ideas from both Western and Chinese medicine. Choe could not accept Western anatomy as fully as Japanese intellectuals did. The study of anatomy in Japan had developed in relation to the idea of Ancient Learning (C. guxue), which denied such theories of systematic correspondence as Yin and Yang and the Five Elements (C. yinyang wuxing) and tended to focus on the action of hyeongjil itself. Because Choe accepted modern Western anatomy without accepting Ancient Learning, his perspective was unique in the history of East Asian anatomy. From a medical history perspective, how does Choi Han-gi's medical discourse distinguish itself from other medical discourses, and what are its characteristics? In addition to other explanations, focusing on the political imagination associated with medicine can help illuminate the differences between the medical discourse of Choe and those of others. Discussion of medicine and the human body was tied to political thought, manifesting the political imagination of the society in which that discussion took place. The development of Western and Japanese anatomy reflected a vertical and hierarchical political order, exemplified by the belief that the brain was the center of the body. However, Choe doubted that organs like the brain or heart dominated the body. In his view, the singi ruled the body; it was not a specific organ, and it was equally inherent in all people. His political thought also emphasized the horizontal and equal order among people. His view of singi simultaneously influenced both his perspective on medicine and his perspective on society. Choe Han-gi's belief in this horizontal and equal political order was inherent in his singi-centered medical discourse.

Confucian Ethics on the Commercial Use of Human Bodies and Body Parts: Yi (Righteousness) or/and Li (Profit)?

In China as elsewhere in the world, human bodies and body parts have long been used for a wide range of medical and non-medical purposes. In recent decades, China has played a considerable role in some of the public exhibitions of plastinated bodies and body parts, and the commercial trade in organ donations. These contemporary developments have raised numerous challenging ethical and governance questions. In spite of the growing role of China in these, there have been few studies devoted to Chinese ethical thinking that might govern its policies on the use of human bodies and body parts, and in particular on the issue of commercialization. The present study is an attempt to bridge this gap, and concludes that Confucian thinking stresses the primacy of righteousness over profits and utilities. This conclusion is reached directly by drawing on Confucian ethical responses to the peculiar practice of using human body parts, such as placenta and flesh, as drugs in traditional Chinese medicine in imperial China and what has been called "yili zhibian," the major Confucian discourse on yi (righteousness or justice) and li (profit or interest) in its long history. The principle of prioritizing righteousness over profit leads to a general moral opposition to the commodification of human bodies and body parts. While Confucianism may not place an absolute prohibition on any such use, it does require that any commercial uses are made subject to the fundamental moral principles, such as righteousness, as well as adequate ethical governance procedures.

The Change of the Status of Joseon Medical Bureaucrats in the 15th and 16th Centuries

In the 15th century, Joseon dynasty's goal for the stabilization of the ruling system, the ideological freedom of the era, and the necessity of medicine due to the introduction of Jin and Yuan dynasty's medicine led to the increased interest in medicine by the nobility along with tolerant practice. The practice of reading medical books is a good example of this institutional demonstration. However, by the end of the 15th century, a noticeable change had taken place. Within the nobility, there was an ideological rigidity regarding technology other than those of Confucianism, as the nobility became concentrated on the principles of Neo-Confucianism. In addition, as the publication of large-scale editions such as Ŭibangyuch'wi (the Classified Collection of Medical Prescriptions) came to an end, they have become less inclined to nurture talent at the level of the central government as in the previous period. In addition, as the discrimination against illegitimate children became stronger, technical bureaucrats such as medical officials, which were open to illegitimate children, came to be seen in increasingly disdainful and differentiated manners. From the late Sejong period to the early Seongjong period, the entrance of illegitimate sons into the medical bureaucracy solidified the negligence of medicine by the nobility. After then, the medical bureaucracy came to be monopolized by illegitimate sons. As for illegitimate sons, they were not allowed to enter society through Confucian practices, and as such, the only way for them to enter the government was by continuing to gain experience as technical bureaucrats. Technical posts that became dominated by illegitimate sons became an object of contempt by the nobility, and the cycle reproduced itself with the social perception that legitimate sons of the nobility could not become a medical official. Medical officials from the Yi clan of Yangseong had been legitimate sons and passers of the civil service examination in the 15th century. However, in the 16th century, only illegitimate sons became medical officials. The formation of Jungin (middleclass) in technical posts since the middle of the Joseon period is also related to this phenomenon. The Yi clan of Yangseong that produced medical officials for 130years over four generations since Yi Hyoji, a medical book reading official, is an exemplary case of the change in the social perception in the early Joseon period regarding medical bureaucrats.

The role of Confucianism in South Korea's emergency management system

Numerous Western researchers have examined the influence of Confucianism on development in Asia, but almost no South Korean researchers have studied the topic in regard to emergency management in their own country. This study begins by considering Confucianism as a social culture. Next, it goes on to evaluate its role in South Korea's emergency management system, contributing, ultimately, to efficiencies in emergency management. Drawing on a literature review and a case study, the paper assesses the double- and single-faced approaches, using four major Confucian components: destiny; family; ritual; and relation. The double-faced approach includes the positive and negative aspects of emergency management, whereas the single-faced approach incorporates only its positive aspects. This paper provides, for the first time, a systematic analysis of the relationship between Confucianism and emergency management in South Korea. Its key finding is that the double-faced approach needs to be transformed into a single-faced approach through active facilitation of behavioural change.

From staff nurse to nurse consultant: Spiritual care part 5: Confucianism

John Fowler, Educational Consultant, explores the role of clinically based nurses in providing spiritual care to patients who identify with the principles of Confucianism.

The effects of China's universal two-child policy

In October, 2015, China's one-child policy was replaced by a universal two-child policy. The effects of the new policy are inevitably speculative, but predictions can be made based on recent trends. The population increase will be relatively small, peaking at 1·45 billion in 2029 (compared with a peak of 1·4 billion in 2023 if the one-child policy continued). The new policy will allow almost all Chinese people to have their preferred number of children. The benefits of the new policy include: a large reduction in abortions of unapproved pregnancies, virtual elimination of the problem of unregistered children, and a more normal sex ratio. All of these effects should improve health outcomes. Effects of the new policy on the shrinking workforce and rapid population ageing will not be evident for two decades. In the meantime, more sound policy actions are needed to meet the social, health, and care needs of the elderly population.

Intra-Family Gamete Donation: A Solution to Concerns Regarding Gamete Donation in China?

Gamete donation from third parties is controversial in China as it severs blood ties, which are considered of utmost importance in Confucian tradition. In recent years, infertile couples are increasingly demonstrating a preference for the use of gametes donated by family members to conceive children-known as "intra-family gamete donation." The main advantage of intra-family gamete donation is that it maintains blood ties between children and both parents. To date there is no practice of intra-family gamete donation in China. In this paper, we investigate intra-family adoption in China in order to illustrate that intra-family gamete donation is consistent with Confucian tradition regarding the importance of maintaining blood ties within the family. There are several specific ethical issues raised by intra-family gamete donation. It may, for example, result in consanguinity and the semblance of incest, lead to confused family relationships, and raise concerns about possible coercion of familial donors. Confucian tradition provides a new approach to understand and deal with these ethical issues in a way that Western tradition does not. As a result, we suggest intra-family gamete donation could be an acceptable solution to the problem of infertility in China. However, further discussion and open debates on the ethical issues raised by intra-family gamete donation are needed in China.

Informed Consent in China: Status Quo and its Future

Informed consent is one of the fundamental rights of a patient. However it used to be ignored in mainland China and was neither academically discussed nor a matter of practical concern until recent years. Paternalism was dominant in the practice of traditional Chinese medicine which was intensely influenced by Confucianism. The historic medical paternalism was reinforced under communism and the planned economy due to the communist beliefs. But it has been frequently challenged in recent years with patients' awakening awareness of rights and the advent of rights-defending litigation culture in the course of the transformation to market economy. Nevertheless, the current Chinese laws lag behind this patients' awakening awareness and litigation culture. The resulting deficiency in Chinese laws governing medical relations has created dilemmas and chaos in the resolution of medical disputes. In conclusion, the author appeals for the amendment of Chinese law and tries to point out how it should be amended.

Uncovering Metaethical Assumptions in Bioethical Discourse across Cultures

Much of bioethical discourse now takes place across cultures. This does not mean that cross-cultural understanding has increased. Many cross-cultural bioethical discussions are marked by entrenched disagreement about whether and why local practices are justified. In this paper, I argue that a major reason for these entrenched disagreements is that problematic metaethical commitments are hidden in these cross-cultural discourses. Using the issue of informed consent in East Asia as an example of one such discourse, I analyze two representative positions in the discussion and identify their metaethical commitments. I suggest that the metaethical assumptions of these positions result from their shared method of ethical justification: moral principlism. I then show why moral principlism is problematic in cross-cultural analyses and propose a more useful method for pursuing ethical justification across cultures.

Does Marriage Make Us Healthier? Inter-Country Comparative Evidence from China, Japan, and Korea

OBJECTIVES

This study focuses on East Asian countries and investigates the difference in the marriage premium on the health-marriage protection effect (MPE) between younger and older generations and the intra-couple education concordance effect (ECE) on the health of married individuals. This study used inter-country comparative data from China, Japan, and Korea.

METHODS

This study focused on individuals (n = 7,938) in China, Japan, and Korea who were sampled from the 2010 East Asian Social Survey. To investigate MPE and ECE, four health indicators were utilized: a physical and mental components summary (PCS and MCS), self-rated health status (Dself), and happiness level (Dhappy). Ordinary least squares regression was conducted by country- and gender-specific subsamples.

RESULTS

We found that the MPE on PCS, MCS, and Dself was more significant for the older generation than for the younger generation in both China and Japan, whereas the results were inconclusive in Korea. With regard to the ECE on happiness (Dhappy), for both men and women, couples tend to be happier when both the husband and the wife are well educated ("higher balanced marriage") compared to couples with a lower level of educational achievement ("lower balanced marriage"). Significant benefits from a "higher balanced marriage" on MCS and Dself were observed for women only. In contrast, no statistically significant differences in health status were observed between "higher balanced marriage" couples and couples with different levels of educational achievements ("upward marriage" or "downward marriage").

CONCLUSIONS

This study found that (1) the MPE was more significant for the older generation, and (2) the health gap, particularly the happiness gap, between higher- and lower-balanced married couples was significant. The inter-country comparative findings are useful to explain how the role of marriage (and therefore of family) on health has been diluted due to the progress of industrialization and modernization.

[Takeki Kudoh's Research on Modern Medical Science and Japanized Confucianism in Colonial Korea (Chosŏn)]

This paper reviews Kudoh Takeki's activity critically during the colonial Korea period, regarding his research on Medical Science and Japanized Confucianism. He managed 'The Seoul Gynecological Hospital'for approximately 35 years in the Chosŏn period as a Japanese resident with Chosŏn status. He published medical knowledge about obstetrics through more than 280 articles, and attempted to improve the hygiene and health of 'Korean Women'. He tried to complete his will toward 'One Unity of Chosŏn and Japan'by terminating the Chosŏn culture 'gene'as an intention. The purpose would enlighten Chosŏn by Japanese blessing. This paper aims to confirm his intention by two aspect of analysis by 'Medical Science'as an occupation and 'Confucianism'and the background of his thought. The content of Kudoh Takeki's research in Chosŏn regarding Medical Science-Confucianism is described as below. First, the purpose and mission of Kudoh Takeki regarding Chosŏn was analyzed. The papers revealed the Kudoh Takeki mentioned only the 'HusbandMurders of Corean Women', which was defined by Kudoh Takeki as 'A Special Crime of Corea'. This paper examined his intensions. Second, writings by Kudoh Takeki were listed to verify the 'medical'field and 'non-medical'field according to the subject. No list of contents was found for his more than 280 articles or essays in magazines/newspapers/ publications, and these papers only described the Kudoh paper "A Special Crime of Corea"and studied the separate book publication by Kudoh THE GYNAECOLOGICAL RESEARCH OF HUSBANDMURDERS OF COREAN WOMEN, A SPECIAL CRIME OF COREA. Third, the genealogy of Confucianism of Kudoh Takeki was analyzed as his background of mental·thought by his hometown and the school he graduated from. The people from Kumamoto and Seiseiko school who were influenced by 'Yi Toegye'of Chosŏn Confucianism were more active than general Japanese. Fourth, the practical activity of Kudoh Takeki in Chosŏn was described. The paper revealed that his brother Tadaske and Shigeo also stayed in Chosŏn to act as an important assistants for the Colonial Chosŏn Government-general. Kudoh was an important man in Japanese society in Chosŏn, acting as a member of 「Group of Same Origin」 and 'Chosŏn Association of great Asia'which was an important organization assisting Colonial Chosŏn Government-general and was a representative position in Seoul district of Bukmichang-jeong(now Bukchang-dong) Fifth, Kudoh Takeki's precise activity to terminate Chosŏn cultural 'gene'and lead to enlightenment was analyzed by an examination of his Medical Science as an occupation and Confucianism as a background of his thought. Even he attempted to enlighten the brutal Chosŏn people in cultural aspects but it was only a tool to assist the colonial policy of Japan by emphasizing 'Kyoikuchokugo(Imperial Rescript on Education)'to implant the Kodo-Seishin(Imperial Spirit). Analyzing the relationship of Kumamoto Practical Party with Yi Toegye, the intention of a deep connection toward 'One Unity of Japan and Chosŏn'by colonial policy was revealed. In conclusion, the paper revealed the Japanese modernization frame to complete 'One Unity of Japan and Chosŏn'and 'Make people to obey the Japan Emperor'by enlightening the dark Chosŏn and merging them with Japan as Kudoh intended.

Explaining attitudes about homosexuality in Confucian and non-Confucian nations: is there a 'cultural' influence?

The majority of research on attitudes about homosexuality has concentrated on the global North and on Christian and Muslim majority nations. Little research attention has been given to the factors that shape tolerance in societies with a Confucian heritage. Residents of Confucian counties are less tolerant than Europeans and Americans. One reason given for this difference is the emphasis on Confucian values in many Asian societies. Using data from the World Values Survey, we examine whether values that could be described as Confucian influence attitudes in Confucian and non-Confucian nations. We find a unique Confucian cultural effect, which can partially be explained with concerns about keeping the family intact. Conversely, in Confucian societies values related to obedience, conformity, and filial piety are unrelated to attitudes. There is also a small Buddhist contextual effect, resulting in more tolerant attitudes, and the Confucian influence cannot be reduced to an Asian regional effect.

[Obstetric medical book and women's childbirth in Qing dynasty: the case of the treatise on easy childbirth]

Ye Feng composed what was to become one of the most famous and widely-circulating medical works of the late imperial period, the Treatise on Easy Childbirth. Ye Feng proposed the idea of natural childbirth, When the correct moment for birth had arrived, the child would leave its mother's body as easily as "a ripe melon drops from the stem". He argued attempts to facilitate birth were therefore not only unnecessary, and female midwives artificial intervention was not required. However, this view is to overlook the pangs of childbirth, and women bear responsibility for the failure of delivery. So his views reflect the gender order in male-dominated. Also he constructed the negative image of the midwife and belittle her childbirth techniques. As a result, midwife are excluded from the childbirth field, male doctors grasp guardianship rights of the female body. Ye Feng declared that the key to safe and successful delivery could be summed up in just a few words: "sleep, endure the pain, delay approaching the birthing tub". This view must be consistent with the Confucian norms, women to export to equip the 'patience' and 'self-control'. These norms were exposed desire men want to monitor and control the female body, effect on consolidation of patriarchal family order. In sum, the discourse of "a ripe melon drops from the stem"and "sleep, endure the pain, delay approaching the birthing tub" comprised an important intellectual resource that male doctors drew on to legitimate themselves as superior overseers of women's gestational bodies.

Understanding the fluid nature of personhood - the ring theory of personhood

Familial determination, replete with its frequent usurping of patient autonomy, propagation of collusion, and circumnavigation of direct patient involvement in their own care deliberations, continues to impact clinical practice in many Asian nations. Suggestions that underpinning this practice, in Confucian-inspired societies, is the adherence of the populace to the familial centric ideas of personhood espoused by Confucian ethics, provide a novel means of understanding and improving patient-centred care at the end of life. Clinical experience in Confucian-inspired Singapore, however, suggests that personhood is conceived in broader terms. This diverging view inspired a study of local conceptions of personhood and scrutiny of the influence of the family upon it. From the data gathered, a culturally appropriate, clinically relevant and ethically sensitive concept of personhood was proposed: the Ring Theory of Personhood (Ring Theory) that better captures the nuances of local conceptions of personhood. The Ring Theory highlights the fact that, far from being solely dependent upon familial centric ideals, local conceptions of personhood are dynamic, context dependent, evolving ideas delineated by four dimensions. Using the Ring Theory, the nature of familial influences upon the four dimensions of personhood - the Innate, Individual, Relational and Societal - are examined to reveal that, contrary to perceived knowledge, conceptions of personhood within Confucian societies are not the prime reason for the continued presence of this decision-making model but remain present within local thinking and practices as a sociocultural residue and primarily because of inertia in updating ideas.

Financial compensation for deceased organ donation in China

In March 2010, China launched a pilot programme of deceased donor organ donation in 10 provinces and cities. However, the deceased donor donation rate in China remains significantly lower than in Spain and other Western countries. In order to provide incentive for deceased donor organ donation, five pilot provinces and cities have subsequently launched a financial compensation policy. Financial compensation can be considered to include two main forms, the 'thank you' form and the 'help' form. The 'thank you' form is an expression of gratitude on behalf of the Red Cross Society of China for consenting to donation. The 'help' form is social welfare support for needy families.

Building a bridge for nursing education and clinical care in Taiwan--using action research and Confucian tradition to close the gap

BACKGROUND

Nursing workplaces in Taiwan are unable to retain talent. An examination of this problem has revealed that the causes of this phenomenon are that nursing education fails to cultivate the skills that meet workplace requirements and that there are gap between nursing education and clinical practice.

OBJECTIVES

This paper is an action research that aims is to design educational programs that can close the gap between nursing education and clinical practice in Taiwan.

DESIGN

In this action research project, 4 action cycles were used to design educational programs including concept mapping and focused discussion strategies.

SETTINGS

Participants were invited to join the research in three teaching hospitals and one university.

PARTICIPANTS

Two groups of participants, student nurses (SN) and nursing staff personnel (NS), were sampled and invited to participate in the research.

METHODS

Participant observation, focus groups, and qualitative interviews were used to collect data. Qualitative data were not only profiled by content analysis, but they were also compared continuously between the two groups as well as between the 4 cycles.

RESULTS

The qualitative data collected for the 135 participants were analysed. The themes of an effective nursing program were summarized.

CONCLUSIONS

Many fundamental values of traditional Chinese education have gradually faded due to the Westernization of education. In this study, we discovered that Western educational models may play a critical role in improving traditionally taught nursing education programs.

Challenges to culturally sensitive care for elderly chinese patients: a first-generation Chinese-American perspective

Physicians and medical institutions in the United States are placing increasing emphasis on providing culturally sensitive care for patients, such as implementing a Confucian family-based model of medical decision making when caring for elderly Chinese patients. In this article, I articulate various reasons why deferring to the family is not a guarantee of culturally sensitive care, particularly when family members are first-generation Chinese-Americans. Nonetheless, I offer several suggestions to help physicians, medical institutions, and family members to provide more culturally sensitive care for elderly Chinese patients.

Effects of national culture on human failures in container shipping: the moderating role of Confucian dynamism

Recent reports on work safety in container shipping operations highlight high frequencies of human failures. In this study, we empirically examine the effects of seafarers' perceptions of national culture on the occurrence of human failures affecting work safety in shipping operations. We develop a model adopting Hofstede's national culture construct, which comprises five dimensions, namely power distance, collectivism/individualism, uncertainty avoidance, masculinity/femininity, and Confucian dynamism. We then formulate research hypotheses from theory and test the hypotheses using survey data collected from 608 seafarers who work on global container carriers. Using a point scale for evaluating seafarers' perception of the five national culture dimensions, we find that Filipino seafarers score highest on collectivism, whereas Chinese and Taiwanese seafarers score highest on Confucian dynamism, followed by collectivism, masculinity, power distance, and uncertainty avoidance. The results also indicate that Taiwanese seafarers have a propensity for uncertainty avoidance and masculinity, whereas Filipino seafarers lean more towards power distance, masculinity, and collectivism, which are consistent with the findings of Hofstede and Bond (1988). The results suggest that there will be fewer human failures in container shipping operations when power distance is low, and collectivism and uncertainty avoidance are high. Specifically, this study finds that Confucian dynamism plays an important moderating role as it affects the strength of associations between some national culture dimensions and human failures. Finally, we discuss our findings' contribution to the development of national culture theory and their managerial implications for reducing the occurrence of human failures in shipping operations.

Can familism be justified?

This paper argues against the continued practice of Confucian familism, even in its moderate form, in East Asian hospitals. According to moderate familism, a physician acting in concert with the patient's family may withhold diagnostic information from the patient, and may give it to the patient's family members without her prior approval. There are two main approaches to defend moderate familism: one argues that it can uphold patient's autonomy and protect her best interests; the other appeals to cultural relativism by construing the principle of 'family autonomy' to be incommensurable with that of individual autonomy. We respond to the first approach by explaining how the familist arguments either depend on some unreasonable assumptions or simply fail to articulate. The critique of the second approach is based on our recent survey showing that there is no dichotomy of relevant values between the East and the West: we believe that the result can effectively block the familist's reliance on certain traditional or cultural values to explain their resistance to the incorporation of pluralist values. Despite our disagreement with familism, we consider the Eastern emphasis on the family to be conducive to the communication between patient, family members and medical personnel, which is indispensible to the patient's well being and autonomy. We conclude that respect for patient autonomy is perfectly consistent with the involvement of the family in making medical decision as long as the family plays a merely consultant role.

[Applying the human dignity ideals of Confucianism and Kant to psychiatric nursing: from theory to practice]

Literature articles and clinical observation suggest disease and environmental factors as primary causes of the low self-esteem and stigmatization that typify most psychiatric patients. These patients are at risk of injury when subjected to inappropriate physical restraint. Hospital staffs, including nurses, are in immediate and close contact with psychiatric patients. Mencius's and Kant's thoughts on human dignity can enhance reflections on clinical nursing practices. Mencius's belief that preserving life is not the most desirable thing and death is not the most hated thing can help nurses realize the human dignity of psychiatric patients by understanding that, as an unrighteous act is more detestable than death, the meaning and value of righteousness are greater than life itself. In light of Kant's views on human dignity, nurses should treat patients as goals rather than means. Exploring such ideas can raise nursing quality, restore a positive sense of humanity to psychiatric patients, and develop nursing values and meaning to a higher plane.

'Missing persons': technical terminology as a barrier in psychiatry

Several fields contributing to psychiatric advances, such as psychology, biology, and the humanities, have not yet met to produce a cohesive and integrated picture of human function and dysfunction, strength and vulnerability, etc., despite advances in their own areas. The failure may have its roots in a disagreement on what we mean by the human person and his or her relationship with the world, for which the incommensurate language of these disciplines may be partly to blame. Turns taken by western philosophy over the past 400 years may help to explain this. Language is such an important tool for psychiatrists, that examination of it may afford an insight into the reasons for divisions in the field. This paper aims to examine and compare psychologies (and hence psychiatries) derived from modern western philosophy, with similar concepts in other cultures, through the study of developments in terminology, in terms of the simplest facts about what it means to be human. Terminology used in mental health in western cultures is examined, with particular consideration of the term "self" as it has come to be used in a technical sense. Analogous terms from non-English speaking European languages, and some non-western cultures are studied. Western philosophy and psychology have evolved a meaning for the term "self" which is quite different from equivalent terms in non-western cultures. It is a moot point whether or not the development in western psychiatry of what are now technical terms to describe normal human experience has become needlessly obscure and ambiguous. It is not evident that this "new" language represents a genuine advance in understanding; it distances mental health professionals from those who are not familiar with it; and it makes transcultural dialogue difficult.

The Confucian bioethics of surrogate decision making: its communitarian roots

The family is the exemplar community of Chinese society. This essay explores how Chinese communitarian norms, expressed in thick commitments to the authority and autonomy of the family, are central to contemporary Chinese bioethics. In particular, it focuses on the issue of surrogate decision making to illustrate the Confucian family-grounded communitarian bioethics. The essay first describes the way in which the family, in Chinese bioethics, functions as a whole to provide consent for significant medical and surgical interventions when a patient has lost decision-making capacity. It is argued that the practice of not having an established order for surrogate decision makers (e.g., spouse, children, and then parents), as it is done in the United States, reflects the acknowledgment that the family as a social reality cannot be reduced to a stereotype of the appropriate order of default decision makers. This description of the family as being in authority to make surrogate decisions for an incompetent family member is enriched by an elaboration of the differences among the concepts of patient autonomy, family autonomy, and moral autonomy. The Chinese model, as well as the Confucian communitarian life of families, engages a family autonomy that is supported by a Confucian understanding of moral autonomy, rather than individual autonomy. Finally, the issue of possible conflicts between patient and family interests in relation to a patient's past wishes in the Chinese model is addressed in light of the role of the physician.