- Confucian Reflective Equilibrium:Why Principlism is Misleading for Chinese Bioethical Decision-Making1
I. The Roots of the Contrast between Confucian Bioethics and Principlist Bioethics
Though the dominant approach to biomedical decision-making in North America and West Europe has been profoundly shaped by the principlism of Beauchamp and Childress (1979), there remains within Chinese culture quite a different approach to bioethical issues. This approach, which can be characterised as a Confucian bioethics, is rooted in Confucian understandings of a life of virtue (dé) and is embedded within a tradition of moral reflection that has been sustained for at least two and half millennia since Confucius (551-479 BCE). The contrast between these two approaches is profound and complex. In part, the contrast is derived from the attempt by Beauchamp and Childress to fashion a bioethics focused primarily on resolving controversial cases by appeal to their now famous four principles, namely the principles of respect for autonomy, beneficence, nonmaleficence, and justice. Though Beauchamp and Childress assume there is a common morality, their engagement in bioethics is controversy-directed. They are interested in resolving apparent moral conflicts posed by particular bioethical cases in terms of a background morality which they take for granted. Interestingly, while their approach lives on controversies, they deny any foundational moral controversies or moral pluralism across cultures.
In contrast, Confucian morality is embedded in a way of life directed towards virtue and sustained by rituals or rites (lĭ). The focus is not primarily on resolving controversial cases, but instead on understanding properly what [End Page 4] it is to live as a virtuous human. The contrast is not simply between a virtue ethics focusing on virtue cultivation versus an ethics grounded in concerns to honour right-making decisions while pursuing the good and avoiding harm. More fundamentally, Confucian thought appreciates that the moral life is not just directed by general principles, but is learned and manifested in a concrete way in which specific ritual practices play a fundamental function. Unlike ordinary practices in which humans work on natural objects (to consider the practices of agriculture, industry, and scientific research as examples), ritual practices are those special activities in which humans directly deal with one another or deal with supernatural subjects (to consider Confucian wedding, sacrifices to ancestors and Heaven, and the mini-ritual of greeting as examples). Through learning and observing ritual practices, humans receive specific guidance to shape mutual relationships and conduct interactive activities, so as to transmit culturally-shaped ritual habits and conventions from generation to generation. This does not mean that rituals do not or should not change from time to time. Neither is this to imply that Confucian virtue ethics does not offer general principles to direct human actions. Instead, in a complete picture of the Confucian virtue ethics, what is offered is a comprehensive account of both rituals and principles so as to expose a dialectical interplay between rituals and principles in a Confucian moral deliberation. In this way, a Confucian moral reflective equilibrium is developed and the Confucian rituals are maintained in the Confucian way of life (see section III for details).
From this Confucian perspective, tradition has a central standing in determining appropriate action in particular circumstances. The standing of tradition as prior to, and independent of, an articulated rationalist theory of the right and the good is due in part to the view that the survival and strength of a moral tradition reflects its appreciation of a way of life that is in fact truly human. The survival of a moral tradition for over two and half millennia is powerful testimony to its success to adapting humans to the resolution of moral concerns and the achievement of moral flourishing. This does not mean that when one poses the question as to how to live the life of virtue, a Confucian sage would direct the inquirer only to rituals, but not to principles. Principles do have a position in Confucian virtue ethics. However, such principles would have to be understood with reference to an actual life of virtue to which one has access through rituals. In contrast, Beauchamp and Childress presuppose that one can engage their four...