Family-Oriented Informed Consent by Ruiping Fan

Author:Ruiping Fan
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Ilhak Lee (李日學)

Email: [email protected]

9.1 Introduction

Humans are “social animals”: one is born into the human relationship, nurtured with the support of other human beings, and has a chance to live life in its fullest sense only when he/she remains in this relationship. The family is at the core of this relationship. There is little doubt about the importance of family in one’s life. In Asian countries, where family ties are strong, the younger generation regards it as their moral duty to care for their elderly parents in return for the grace they receive in the early days of their lives. This sense of responsibility and thankfulness to one’s parents also extends to one’s ancestors.

This concept is expressed especially well in the Confucian social order. Confucianism has influenced Korean society in every aspect of life. It has served as the backbone of social relationships, as well as political and socio-cultural standards. Among its values, filial duty (孝) guides children in the care of their parents. Filial duty was once regarded as a natural representation of the loving and caring relation between parents and children on which the whole social relationship was built. However, due to rapid and inevitable social changes this basic value seems obsolete and even oppressive (especially against women), because current culture put emphasis on personal autonomy and independence. Making the situation worse, filial duty has been (mis)understood as an unconditional, unlimited commitment and sacrifice, meaning children should do what, in the opinion of “others,” is best for their parents, not what the parents prefer. It seems in this case children have little chance of demonstrating obedience, which is the proper understanding of filial duty. They also seem to have little chance for a discussion with their parents about the treatment they prefer, or what the parent would want. If we are to preserve the family as the core of Korean social life and address the undesirable tendencies mentioned above, we must renew society’s understanding of filial duty and its implications.

The idea of filial duty represented in the Xiao Jing’s Book of Filial Duty (孝經) explores what it means to care for elderly patients . The concept of “filial duty(孝)1” can serve as moral justification for children’s obligation to care for their parents and provides good reason to involve family members in end-of-life care decision-making . However, as family members are included as principal decision makers, there is a need to support the patient actually receiving end-of-life care. It should be remembered that family members as decision makers are another form of substitute decision making and it is better to set limits on their authority. This issue will arise when we consider how elderly parents are cared for in Korea, especially when they become critically ill.

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