title: Medical professionalism in China and the United States: a transcultural interpretation.
abstract: 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.
authors: Bioethics Centre of the University of Otago, Dunedin, New Zealand. jing-bao-nie@otago.ac.nz.
authors: Jing-Bao
authors: JB
authors: Nie
authors: Division of Health Promotion and Behavioral Sciences, University of Texas Health Science Center Houston, School of Public Health, Houston, Texas USA.
authors: Kirk L
authors: KL
authors: Smith
authors: Department of Medical Humanities, Peking University Health Science Center, Xueyuan Road, Haidian District, Beijing, People's Republic of China.
authors: Yali
authors: Y
authors: Cong
authors: Department of Medical Ethics, Peking University Health Science Center, No. 38 Xueyuan Road, Haidan District, Beijing, People's Republic of China, hulinying@bjmu.edu.cn.
authors: Linying
authors: L
authors: Hu
authors: University of North Carolina at Chapel Hill, Division of Infectious Diseases, 130 Mason Farm Road (Bioinformatics), CB# 7030, Chapel Hill, North Carolina 27599-7030 USA. jdtucker@unc.edu.
authors: Joseph D
authors: JD
authors: Tucker
mesh_terms: D000328:Adult; D002681:China; D032781:Codes of Ethics; D003431:Cross-Cultural Comparison; D003466:Cultural Characteristics; D003657:Decision Making / Q000941:ethics*; D004645:Empathy; D005190:Family / Q000208:ethnology / Q000523:psychology; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D028681:Moral Obligations; D009014:Morals; D026684:Personal Autonomy; D010817:Physician-Patient Relations / Q000941:ethics*; D010820:Physicians / Q000941:ethics*; D010818:Practice Patterns, Physicians' / Q000941:ethics*; D012068:Religion and Medicine; D057566:Self Report; D012935:Social Justice / Q000941:ethics; D012945:Social Values / Q000208:ethnology; D011795:Surveys and Questionnaires; D020458:Third-Party Consent / Q000941:ethics; D035502:Trust; D014342:Truth Disclosure / Q000941:ethics; D014481:United States; D028722:Virtues