title: Thai and American doctors on medical ethics: religion, regulation, and moral reasoning across borders.
abstract: Recent scholarship argues that successful international medical collaboration depends crucially on improving cross-cultural understanding. To this end, this study analyzes recent writings on medical ethics by physicians in two countries actively participating in global medicine, Thailand and the United States. Articles (133; published 2004-2008) from JAMA, the New England Journal of Medicine, and the Journal of the Medical Association of Thailand are analyzed to inductively build a portrait of two discursive ethical cultures. Frameworks of moral reasoning are identified across and within the two groups, with a focus on what authority (religion, law, etc.) is invoked to define and evaluate ethical problems. How might similarities and differences in ethical paradigms reflect the countries' historical "semicolonial" relationship, shed light on debates about Eastern vs. Western bioethics, and facilitate or hinder contemporary cross-national communication? Findings demonstrate substantial overlap in Thai and American doctors' vocabulary, points of reference, and topics covered, though only Thai doctors emphasize national interests and identity. American authors display a striking homogeneity in styles of moral reasoning, embracing a secular, legalistic, deontological ethics that generally eschews discussion of religion, personal character, or national culture. Among Thai authors, there is a schism in ethical styles: while some hew closely to the secular, deontological model, others embrace a virtue ethics that liberally cites Buddhist principles and emphasizes the role of doctors' good character. These two approaches may represent opposing reactions-assimilation and resistance, respectively-to Western influence. The current findings undermine the stereotype of Western individualism versus Eastern collectivism. Implications for cross-national dialog are discussed.
authors.affiliation: Department of Sociology, University of Wisconsin-Madison, 8128 Sewell Social Sciences Building, 1180 Observatory Drive, Madison, WI 53706, United States. hgrol@ssc.wisc.edu
authors.forename: Hanna
authors.initials: H
authors.lastname: Grol-Prokopczyk
mesh_terms: D001291:Attitude of Health Personnel; D003431:Cross-Cultural Comparison; D036262:Empirical Research; D004992:Ethics, Medical; D006801:Humans; D035863:Moral Development; D010506:Periodicals as Topic / Q000706:statistics & numerical data*; D010820:Physicians / Q000523:psychology* / Q000706:statistics & numerical data; D012067:Religion; D012926:Social Control, Formal; D013785:Thailand; D014481:United States