Charlene Tan, Ruth Neo

DOI: https://www.doi.org/10.64332/ujbb.2.2.6

Abstract
Background: Beauchamp and Childress’ principle of respect for autonomy has been criticised by scholars for privileging individualism due to its Anglo-American (‘Western’) origin and orientation. Consequently, researchers in clinical ethics need to consider alternative normative models and culturally diverse approaches to autonomy.

Aim: Guided by philosophical inquiry, this paper seeks to re-envision the concept of autonomy in biomedical contexts by focusing on the contributions of Confucian perspectives to its understanding and application in clinical contexts.

Methods: The research methodology is philosophical inquiry based on a textual analysis of the Analects (Lunyu), which records the teachings and conduct of Confucius. The research methodology of philosophical inquiry comprises philosophical retrieval and philosophical reconstruction. Philosophical retrieval aims to review, shed light on, and analyse key concepts, theories, and presuppositions with respect to one or more classical texts. Philosophical reconstruction, on the other hand, is geared towards applying ancient intellectual ideas and practices to contemporary issues and challenges.

Results: The textual analysis of the Analects reveals that Confucius’ notion of autonomy is relational, embodied, and authentic. Rather than ‘self-rule’, Confucius’ interpretation of autonomy advocates ‘selves-rule’ by harmonising interdependence, mind-body integration, and moral self-cultivation. What makes Confucius’ relational autonomy unique is its emphasis on morality, particularly the all-encompassing virtue of ren (an achieved state of humanity).

Conclusion: A major implication of Confucian ideas in clinical settings is the need to respect and consider the consent of patients as well as that of their family members based on the value of ren (an achieved state of humanity). Confronted with complex ethical dilemmas, especially in clinical scenarios, medical professionals need to recognise that the autonomy of an individual is intrinsically tied to that of their family and inseparable from pre-existing ethical commitments. In other words, medical professionals should be mindful of the relational, embodied, and authentic aspects of autonomy by giving balanced recognition to both patient autonomy and shared decision-making, which contributes to the realisation of ren. Confucian bioethics converges with Christian bioethics by underscoring the relational dimension of autonomy, especially in settings involving family, healthcare professionals, and the patient.

Keywords: autonomy, Confucius, interdependence, mind-body integration, ren, self-cultivation