:The Chinese Communist Party government has been forcefully promoting itsjihua shengyu program, known as the “one-child policy,” for more than three decades. A distinctive authoritarian model of population governance has been developed. A pertinent question to be asked is whether China’s one-child policy and the authoritarian model of population governance have a future. The answer must be no; they do not. Although there are many demographic, economic, and social rationales for terminating the one-child policy, the most fundamental reason for opposing (...) its continuation is drawn from ethics. The key ethical rationale offered for the policy is that it promotes the common social good, not only for China and the Chinese people but for the whole human family. The major irony associated with this apparently convincing justification is that, although designed to improve living standards and help relieve poverty and underdevelopment, the one-child policy and the application of the authoritarian model have instead caused massive suffering to Chinese people, especially women, and made them victims of state violence. A lesson from China—one learned at the cost of individual and social suffering on an enormous scale—is that an essential prerequisite for the pursuit of the common good is the creation of adequate constraints on state power. (shrink)

Notwithstanding the obvious advantages of controlling population growth and the probable problems with old-age security and female infanticide, the one-child program in China could have latent ramifications. It could drastically reduce the size and significance of the patrilineal lineage, promote the popularity of uxorilocal marriage, and encourage women to make nontraditional career choices. The sum of these effects could finally allow China to make major advances in achieving its unrealized goal of eliminating gender-based inequality.

After four decades of China’s family planning policy, the shrinking family size and increasing life expectancy pose special challenges for the one-child generation in terms of providing care for aging parents. The current study explored young adults’ responses to such pressure by examining their concerns about elder care, attitudes toward nursing homes, and living arrangement after marriage in a sample of 473 Chinese working young adults from six cities in China. Results showed that although most of the young adults reported (...) to have thought about the issue of parents’ elder care, the majority did not worry a lot about it. Only children expressed similar levels of worrying as those with siblings did. However, educational level, rather than sibling status, was systematically related to concerns about parents’ elder care and attitudes toward nursing homes. People with higher education tended to worry less about elder care, and were less likely to consider placing parents in nursing homes as a violation of filial piety. Analyses of the married sub-sample revealed that only children were more likely to co-reside with parents after marriage than those with siblings. And the main reason for co-residence was that the younger generation needed their parents’ help for childcare, rather than to better take care of their parents. Implications for parents’ elder care among Chinese only children were discussed. (shrink)

The reform of China’s one-child policy allows families to have more children and thus may affect anticipation of intergenerational succession of family businesses and drive family firms to improve their corporate social responsibility (CSR). Using a difference-in-differences design, we find that the reform positively affects the CSR of family firms. We also find that the positive impact is more pronounced for family firms whose owners have fewer children, have no son, and have not yet surpassed reproductive age (older than 50), (...) which confirms the theory that anticipation of intergenerational succession drives CSR in such firms. Moreover, we find that the positive impact is more pronounced for firms that operate in environments where CSR is more strategically important. We validate our findings by showing that the reform prompts investment in value-enhancing CSR and curtails short-termism. This study offers novel evidence that government policies conducive to intergenerational succession in family firms can lead to not only strategic CSR but also to truly ethical corporate behaviour. (shrink)

This study examines whether and how board gender diversity can affect corporate wage inequity by drawing on diversity theory and gender socialization and ethicality theories. Building on an exogenous relaxation of China’s one-child policy (OCP) in 2013, which led to a substantial decline in the female labor force participation rate. Our empirical analysis suggests that board gender diversity is negatively associated with corporate wage inequity. This result is robust to various endogeneity and sensitivity analyses. We find that the OCP relaxation (...) only increases average executive pay; it does not affect employee pay. One potential mechanism driving our results is that the decline in board gender diversity caused by the OCP relaxation reduces supervision, restriction, and fairness within the firm, which increases executives’ pursuit of personal interests and ultimately leads to the rise of wage inequity. Our findings are particularly significant for firms in capital-intensive industries, firms with a low level of employee bargaining power, and large firms. (shrink)

This essay criticises ‘modest’ one‐child policies, which would impose sanctions upon parents who create multiple children. Specifically, this article considers what the state owes individuals who would be born (illegally) beneath restrictive procreative policies and argues that such policies would fail to show due respect to second‐ or third‐born individuals created beneath them. First, I argue that modest procreative restrictions (like sanctions) are likely to generate only modest compliance. I then suggest it is reasonable to think (...) a one‐child policy fails to demonstrate due respect to existing second and third children. I argue that such a policy generates an undue burden on any second or third children who would be born beneath them, before concluding by considering whether the state might be able to avoid effectively reinscribing ‘bastardy’ into its law by locating responsibility for the effects of such a policy entirely on the parents, rather than on children. (shrink)

The Chinese traditionally have valued sons over daughters, depending on their sons to support them in old age. Recent changes, however, suggest a shift toward greater gender equality, with daughters also keeping elderly parents. The present study, undertaken in 1979 in the People's Republic of China, assessed attitudes of 48 university staff members toward financial support for aged parents and living arrangements in old age, with an emphasis on gender differences. We found that most sons and daughters gave financial support (...) to their parents regularly and most men and women still believed adult children should share housing with their aged parents. In this sample, the sons assumed this responsibility far more than the daughters, and few of the respondents believed their parents should live with a daughter. However, when asked to project their own preferences in old age, sons thought they would prefer to live with a son, but daughters feel they would like to live with a daughter. These results are discussed in terms of two important cultural changes, the new marriage laws and the one-child policy, that were implemented at the time of the study. (shrink)

At present, Third World countries owe over one trillion dollars to the developed Western nations; much of the debt is held by the leading international commercial banks. The debt of six Latin American countries alone — Argentina, Brazil, Chile, Mexico, Peru, and Venezuela — is over $330 billion, of which $240 billion is owed to commercial banks. Let us immediately narrow our focus to loans made by the major international commercial banks to Third World governments. We shall not be concerned (...) with government-to-government loans, or private-party-to-private-party loans, or with debt owed to the World Bank or the International Monetary Fund. The bank-to-government loans — the so-called “sovereign loans” — are the most economically troublesome and morally interesting. The largest lenders, at least with respect to the Latin American countries, are the American banks Citibank, Chase Manhattan, Bank of America, Manufacturers Hanover, and Chemical Bank. About fifteen Third World countries have serious debt problems, including the largest: Brazil, Mexico, and Argentina. (shrink)

Volume 22, Issue 1, March 2019, Page 106-108.

The essays in this special issue of HEC Forum provide reflections that make explicit the implicit anthropology that our current pandemic has brought but which in the medical ethics literature around COVID-19 has to a great extent ignored. Three of the essays are clearly “journalistic” as a literary genre: one by a hospital chaplain, one by a medical student in her pre-clinical years, and one by a fourth-year medical student who reports her experience as she completed her undergraduate clerkships and (...) applied for positions in graduate medical education. Other essays explore the pandemic from historical, sociological, and economic perspectives, particularly how triage policies have been found to be largely blind to structural healthcare disparities, while simultaneously unable to appropriately address those disparities. Central issues that need to be addressed in triage are not just whether a utilitarian response is the most just response, but what exactly is the greatest good for the greatest number? Together, the essays in this special issue of HEC Forum create a call for a more anthropological approach to understanding health and healthcare. The narrow approach of viewing health as resulting primarily from healthcare will continue to hinder advances and perpetuate disparities. Health outcomes result from a complex interaction of various social, economic, cultural, historical, and political factors. Advancing healthcare requires contextualizing the health of populations amongst these factors. The COVID-19 pandemic has made us keenly aware of how interdependent our health as a society can be. (shrink)

Recent social policy discourses in Aotearoa New Zealand focus on vulnerable children’s well-being and the detrimental, long-term and costly impacts of child poverty. The discourse pervading much of the policy labels children and young people as ‘vulnerable’ or ‘at risk’ or ‘in crisis’, a view, which we argue, is both disempowering and marginalising. We propose a shift in focus which views children and young people as agentic, capable and competent. Drawing on several small-scale research projects and reports we demonstrate how, (...) when asked, children and young people can participate effectively in discussions about policy matters that concern them. We have much to learn from the insights children share with us when asked, but very often existing structures, at both government and community level, do not include adequate processes to hear their voices, let alone act on what has been communicated. (shrink)

“Best interests of the child” is a key concept in international law, developed by and through institutions which maintain a stake in international solidarity. This article explores the quality of that solidarity, working to understand the modes of interrelationship between peoples and institutions which it instantiates, and which it could possibly be imagined to instantiate. Focusing on one context—the way that “best interests of the child” has developed within international politics and domestic Australian politics, through an examination of the discourses (...) produced by policy-makers working within child refugee and asylum-seeker realms—this article examines the ways that this concept has relied on, and produced, racialized hierarchical ideas of what “best interests” entails. Looking through a history of Australian settler-colonial governmentality, this article explores the tensions between discourses of security and discourses of “best interests of the child,” historicizing the figure of the refugee child and reimagining the relationships of dependency and solidarity which could be produced. (shrink)

The maxim “parents should do what is in the best interests of their child” seems like an unassailable truth, and yet, as I argue here, there are serious problems with it when it is taken seriously. One problem concerns the sort of demands such a principle places on parents; the other concerns its larger social implications when conceived as part of a national policy for the rearing of children. The theory of parenting that creates these problems I call “optimizing parentalism.” (...) To avoid them, I define and defend a new and more morally appealing theory, “satisficing parentalism.”. (shrink)

After more than three decades of implementation, China’s one-child policy has generated a large number of only children. Although extensive research has documented the developmental outcomes of being an only child, research on the parent–child relational quality of the only child is somewhat limited. Using China Education Panel Survey (2014), this study examined whether the only child status was associated with parent–child relationships among Chinese junior high school students. It further explored whether children’s gender moderated the association between the only (...) child status and parent–child relationships. Two-level ordered logit models suggested that only children were more likely to report a close relationship with their mothers and fathers compared to children from multiple-child families (including two-child families). Taking birth order into consideration, we found that, only children were more likely to have close parent–child relationships than firstborns, whereas no significant differences were found between only children and lastborns. Interaction analyses further suggested that the only child advantages were gender-specific: the positive effects of the only child status were stronger for daughters than for sons, that is, daughters benefited more from being only children. Our findings highlight the importance of considering children’s gender and birth order in exploring the only child effects in the Chinese context. Additional analyses about sibling-gender composition indicated female children were more likely to be disadvantaged with the presence of younger brothers, whereas male children benefited more from having older sisters. This reveals that the son preference culture is still deep-rooted in the Chinese multiple-child families. (shrink)

ABSTRACTIn this paper, we utilize a rhetorically grounded textual analysis to study the Open Letter, the first publicized text sent out from the Central government to all the Party and Communist Youth League members on 25 September 1980. By reading through the text, we identify three individual figures – the ‘people’ as ‘the origin of problems,’ the people as ‘reasonable and considerate,’ and those charged with advocating compliance as ‘active propagandists and responsible educators’ – that have been crafted in the (...) text. We argue that by constructing three subject positions that served to identify the people via both language and social practices, the Central government in China after Mao Zedong’s death constructed the discourses of urgency and necessity of adhering to the one-child policy to both convince and compel people to exercise responsibility in having only one child. (shrink)

Using data from the authors' 1998-99 survey of 1,040 eighth graders in Wuhan, China, this study explores the differences between single-girl and single-boy families with regard to parental expectation and investment in children's education, children's own educational aspirations, and mathematics performance. The authors found that contrary to the known intrafamily discrimination against girls common among families of pre-one-child generations and still common among contemporary rural families with more than one child, there are no gender differences related to education between single-girl (...) and single-boy families in modern urban China. The authors found equally high educational aspirations and similar mathematical performance for male and female only children. They suggest that this gender equality in education is an unintended consequence of the one-child-per-family policy and that under China's current social and economic conditions, girls are better off living in one-child families in the big cities of modern China. (shrink)

The One-Child Policy dramatically changed the Chinese family structure, and the literature indicates that only children may have an advantage in terms of family resource dilution. Moreover, as Chinese families traditionally prioritize investing in sons, only daughters are found to have been empowered by the policy because they did not need to compete with their brothers for parental investment. However, the literature is limited to only teenage children when they were still living in their parents' homes. It is unclear whether—when (...) the generation of only children grew up and married—their family structure differed from that of children with siblings and whether married only daughters retained more family resources from their parents. Based on the data analysis of a 2016 survey, “Study of Youths in 12 Cities of Mainland China,” including a sample of 1,007 fathers and 2,168 mothers born between 1975 and 1985, this study explores the empowerment of married only daughters, employing the theory of family resource dilution in expanded Chinese families. Using educational investment in children as an example, and with random intercept models, this study presents empirical evidence that the dilution of family resources in Chinese expanded families still benefits males and patrilineal practices. Thus, this study demonstrates that Chinese families still tend to sacrifice the interests of married daughters to ensure support for their adult sons. However, it also illustrates that married only daughters could still connect to their parents' resources, giving them a relatively dominant position for decision-making regarding the family's educational expenditure on her own children. Thus, this study extends our understanding of the family resource dilution theory to Chinese expanded families, underscoring the need for further research on Chinese only children after they marry and form families of their own. (shrink)

Empirical evidence clearly shows that child poverty is a growing concern in the industrialized world and that the well-being of children is deeply affected by growing up in poverty in at least two ways. On the one hand, a low socioeconomic status jeopardizes the access to goods and services that are necessary for the current well-being of children. On the other hand, growing up in poverty also, in various ways, negatively affects the well-being in later life. On the basis of (...) the capability approach, we will show that the systematic protection and advancement of the wellbeing of children, and hence the reduction of child poverty, is a key task of social justice, which should therefore guide policy design and implementation. However, we will also discuss the special composition of the well-being of children and point out how it poses difficulties for state action in this regard. In particular, we will argue that the importance of love and affection for a child’s well-being limits considerably the possible political measures to provide fair life chances to all children. This again reflects the insight that poverty should not be reduced to economic inequality. (shrink)

Social policy includes many aspects, some of which are related to welfare, as well as many social responsibilities and rights that are considered the basis of the early childhood stage, as social policy aims to secure a kind of stimulating, safe and equal environment for children, especially in the first years of their lives, as these early stages greatly affect their growth, development and future capabilities. It aims to study the current facts related to a phenomenon, situation or group of (...) individuals. This study relied on the social survey method by sample and used the questionnaire tool to identify the extent of the impact of social legislation to protect early childhood. A field study in the city of Baghdad, where the study sample amounted to (200) individuals, males and females. The results of the study showed that the highest percentage of the research community are females at 54.4%. The results of the study showed that providing health care to mothers before and after birth is the health system for child health by 60.4%. The results of the study indicate that the early childhood care policy contributed to reducing child mortality rates by 63.2%. The results of the study indicate that one of the most important ways is the contribution of the social care policy to correcting some wrong practices by holding educational courses for workers in health centers by 43.6%. The results of the study concluded that there are educational programs provided for early childhood with cognitive and cognitive stimulation by 58.4%. And the contribution of government efforts to provide development programs for the early childhood stage by encouraging enrollment in education by 55.2%. One of the most important difficulties facing the implementation of policies and strategies for sustainable development for early childhood is the absence of activation of the national strategy by 36%. Therefore, we recommend the establishment of a higher council for childhood that takes on the responsibility of drawing up policies related to children and following up on strategies and programs related to them. (shrink)

Despite its profound importance for individuals and populations, children’s mental health remains under-appreciated as a public policy priority, to a degree that violates children’s rights. Using a working definition of policymaking as collective ethical decision-making for the one and the many, we elaborate by describing an individual child’s story and reviewing the pertinent population health research evidence. We then outline three central public health ethical challenges: addressing the high prevalence and impact of childhood mental disorders; addressing the avoidable social adversities (...) that underlie many childhood mental disorders; and addressing stark shortfalls in prevention and treatment services for children. We end with discussing opportunities for progress, including addressing the attendant children’s rights issues. (shrink)

A child poverty rate of ten percent could mean that every tenth child is always poor, or that all children are in poverty for one month in every ten. Knowing where reality lies between these extremes is vital to understanding the problem facing many countries of poverty among the young. This unique study goes beyond the standard analysis of child poverty based on poverty rates at one point in time and documents how much movement into and out of poverty by (...) children there actually is, covering a range of industrialised countries - the USA, UK, Germany, Ireland, Spain, Hungary and Russia. Five main topics are addressed: conceptual and measurement issues associated with a dynamic view of child poverty; cross-national comparisons of child poverty rates and trends; cross-national comparisons of children's movements into and out of poverty; country-specific studies of child poverty dynamics; and the policy implications of taking a dynamic perspective. (shrink)

Procreation with donor gametes is widespread and commonly accepted, but it involves ethical questions about the child's best interest. Understanding the historical structures of the moral discussion of gamete donation may contribute to reflecting on the child's best interest. This is why I have analysed the debate on gamete donation in the Netherlands, and this analysis has uncovered some striking discontinuities. Notions of the child's best interest have undergone a radical swing. In the past, it was considered acceptable to conceal (...) the truth about the child's biological origin, but in the past two decades the general opinion has changed to the common belief that this information should be shared with the child. This changed notion of the child's best interest will be analysed using a framework encompassing three views of the child, which derive from the debate on children's rights. These three views each provide a different interpretation of the child's moral and political status. I conclude that the changed notion of the child's best interest results from a view of the child that focuses on autonomy and citizenship, and which frames the child's interests according to its legal status. I comment on this view and I champion an alternative one, namely ‘the embedded child’. This is a relational view based on care ethics that goes beyond what can be articulated in law, and that will help to establish a more balanced interpretation of the child's best interest at the practice and policy levels of gamete donation. (shrink)

I am concerned with a very problematic concept of identity which one encounters in studies of practical problems concerning the adoption of children. The notion is problematic in the extreme, as I shall try to show. It seems to crop up not only in the work of researchers on this topic, but in the spontaneous and (apparently) untutored accounts of themselves given by adoptees. The question is whether there is a concept here at all: by which I mean not, instead, (...) a family of concepts linked by family resemblances, but rather some disparate ideas linked only by verbal similarities, and run together for mistaken theoretical purposes. The notion arises crucially in attempts to deal with practical questions arising in determining policies with regard to adoption: with regard to the placement of children for adoption, and the advice to be given to adoptive parents and to adopted children, whether young or adult, who encounter, or perhaps do not even encounter, difficulties. (shrink)

Healthcare policy and academic literature have promoted improving the transitional care of young people leaving child and adolescent mental health services. Despite the availability of guidance on good practice, there seems to be no readily accessible, coherent ethical analysis of transition. The ethical principles of non-maleficence, beneficence, justice and respect for autonomy can be used to justify the need for further enquiry into the ethical pros and cons of this drive to improve transitional care. The objective of this systematic review (...) was therefore to systematically search for existing ethical literature on child- to adult-orientated health service transitions and to critically appraise and collate the literature, whether empirical or normative. A wide range of bioethics, biomedical and legal databases, grey literature and bioethics journals were searched. Ancestral and forward searches of identified papers were undertaken. Key words related to transition, adolescence and young adulthood, ethics, law and health. The timeframe was January 2000 to at least March 2016. Titles, abstracts and, where necessary, full articles were screened and duplicates removed. All included articles were critically appraised and a narrative synthesis produced. Eighty two thousand four hundred eighty one titles were screened, from which 96 abstracts were checked. Forty seven full documents were scrutinised, leading to inclusion of two papers. Ancestral and forward searches yielded four further articles. In total, one commentary, three qualitative empirical studies and two clinical ethics papers were found. All focused on young people with complex care needs and disabilities. The three empirical papers had methodological flaws. The two ethical papers were written from a clinical ethics context rather than using a bioethical format. No literature identified specifically addressed the ethical challenges of balancing the delivery of transitional care to those who need it and the risk of pathologizing transient and self-limited distress and dysfunction, which may be normal during adolescence. There is very little research on ethical aspects of transitional care. Most existing studies come from services for young people with complex care needs and disabilities. There is much scope for improvement in the amount and quality of empirical research and ethical analysis in this area. (shrink)

Global reproductive landscapes and with them cross-border routes are rapidly changing. This paper examines the reproductive routes and choices of fertility travellers from China to Russia as reported by medical professionals and fertility service providers. Providing new empirical data, it raises new ethical questions on the facilitation of cross-border reproductive travel and the commercialisation of reproductive treatment. The relaxation of the one-child policy in 2014 in China, the increasing demand for ART exceeding the capacity of national fertility clinics and the (...) difficulty of accessing treatment with donor eggs concomitant with a growing economic power of the upper–middle class are shaping the ART industry in Asia in new ways. A new development is Chinese citizens increasingly seeking ART treatment in Russia, which has a long-standing practice of ART governed by a liberal legislation. Furthermore, as China prohibits the export of gametes, Chinese fertility travellers rely on acquiring donor gametes once starting treatment abroad. Clinicians in Russia report three strategies amongst their Chinese patients: One group is using donor eggs of women of Asian appearance living in Russia or is hiring women of resembling appearance from third-party countries to donate their eggs in Russia to create resemblance in their offspring. Another group is buying white donor gametes to create Eurasian mixed children and thus ‘enhance’ their offspring. Providing novel empirical data, this article informs ethical deliberation and raises imminent questions for further research in this understudied geographic region and on cross-border reproductive treatment. (shrink)

Nurses have an important role in preventing and responding to child abuse and neglect. This paper reports on nurses' perceptions of how organisational systems and hierarchies shaped their capacity to respond to child abuse and neglect. This is one of four key themes identified through an inductive analysis of data from a broader qualitative study that explored nurses' perceptions and experiences of keeping children safe. The study was guided by social constructionist theory, and data were collected through in‐depth interviews with (...) nurses working with children in Australia (n = 21). Key findings showed that nurses experienced many challenges to responding to child abuse, including difficulties sharing information, fear of making mistakes and inflexible systems of care. This was underpinned by an organisational ‘rule‐centred’ culture of following policies at the expense of maintaining an explicit focus on children's needs. These findings demonstrate first the importance of creative and flexible thinking from individual professionals, so policies are enacted with a clear child focus. Second, they highlight the need for leadership to enact organisational and systemic cultural change that maintains a genuinely child‐centred approach. (shrink)

In the People’s Republic of China, an approach has been adopted to ensure that all children born as a result of the one-child policy are healthy. The World Health Organization/United Nations Children’s Fund (WHO/UNICEF) has encouraged the Chinese Government to embrace this philosophy. Part of this approach has resulted in an attempt to increase the breastfeeding rates. This report describes a visit by two nursing faculty members of a Canadian university to an urban hospital maternity unit in the northeast of (...) China, where the staff were attempting to incorporate this philosophy into their maternity care with the assistance of nursing faculty members from the local university. The method chosen to integrate this philosophy was the Baby-Friendly Hospital Initiative initiated by WHO/UNICEF. (shrink)

This essay explores how evidence-based policy can be developed for sport-related concussion (SRC), focusing particularly on the role and influence of the Consensus Statements of the Concussion in Sport Group (CiSG). Three credible policy purposes are suggested: (i) to mitigate acute health impacts of concussion events in sport; (ii) to reduce or eliminate the identified causes of SRC (direct blows to the head, neck, or body); and (iii) to improve long-term brain health outcomes for athletes. Eight of ten systematic reviews (...) commissioned for the most recent Consensus Statement, and ten of its thirteen headings, address the first purpose. The primary influence of the CiSG Consensus Statements has been to improve SRC acute response practice and protocols in professional/elite sport, which has always been their primary policy purpose, although evidence of improvement is more limited in child/adolescent and recreational sport. But a primary focus on mitigating acute health impacts has crowded out other credible policy purposes of concern to stakeholder groups with whom evidence-based policy for SRC must be co-produced. No recommendations are made to improve long-term brain outcomes for athletes because concerns about imperfections in evidence are cited to question the link between such outcomes and SRC. Modifications to reduce or eliminate purposive blows to the head, neck, or body that are permitted as a structural part of the way some sports are played are given very limited attention, even when discussing prevention, where they are just one approach considered alongside protective equipment, neuromuscular strengthening, and concussion management strategies. The essay concludes that the CiSG should shift the primary policy purpose of its Consensus Statements to address the identified causes of SRC: purposive blows to the head, neck, or body. Reducing or removing causes of SRC both better safeguards children/adolescents and renders debates about the link between SRC and long-term brain health outcomes superfluous. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Morality in Flux: Medical Ethics Dilemmas in the People's Republic of ChinaRen-Zong Qiu (bio)IntroductionModern China is undergoing a fundamental change from a monolithic society to a rather pluralistic one. It is a long and winding road. Marxism is facing various challenges as the influence of Western culture increases. Confucianism is still deeply entrenched in the Chinese mind but various religions, including Buddhism, Islam, and Christianity are experiencing a revival. (...) Almost fifty minorities coexist in the country in addition to the majority Han people. Tension and conflict are inevitable as diverse—and sometimes incompatible—values come to the fore at this historic juncture. Many fields, including medicine, face new challenges, and in this environment the field of bioethics is flourishing.Like many countries, China is groping with the effects of new medical technology and skyrocketing health care costs. But in the context of the Chinese sociocultural environment, some unique—as well as more familiar—issues arise. None of the classic texts provide ready-made answers to these dilemmas; we must find the answers ourselves. The only reasonable way to resolve the conflicts between opposing values is through dialogue, consultation, and negotiation among the various social and cultural groups.The bioethical dilemmas receiving the most attention in China now relate to the two ends of life: birth and death. On one end are issues relating to reproductive technology, especially birth control and family planning; at the other end is euthanasia.Dilemmas Surrounding Reproductive TechnologyAccording to traditional Chinese belief, not having a child results from not having virtue. In fact, the most serious violation of the Confucian [End Page 16]principle of filial piety is to be without offspring. A Chinese man without a child experiences heavy psychological pressure, and the burden is especially onerous for women because infertility is always blamed on the wife. Wives who do not bear a child are stigmatized and mistreated—even abused—in families that stick to traditional values.In China today, this widely held belief is colliding with another reality: an apparent increase in infertility among newly-married couples. The rate may be about 5 percent. These couples turn to doctors for help.Artificial insemination by donor (AID) and by husband is now widely practiced. Eleven provinces have established sperm banks, and private doctors are performing AID for considerable fees. But procedures to address legal and ethical problems associated with the procedure have lagged behind. With the exception of a few centers in large cities, AID is undertaken without established procedures or policies relating to the selection of donors and recipients, records about those involved, or clarification of the status of the child. The legal status of the child remains unresolved.The status of the child within the community is also unresolved as traditional values clash with the application of modern technology to childbearing. The case of "The Child Who Did Not Belong" (see box), illustrates how an AID child is not accepted by the family that embraces traditional values because he is not the husband's biological child.In vitro fertilization (IVF) is another alternative. Two IVF centers are in operation, one in Beijing and the other in Changsha, and both have succeeded in producing live births. This technology has received considerable media attention and is generally accepted even among those with traditional views.But much of this medical technology is not widely accessible—especially in rural areas—and so some infertile couples resort to surrogate motherhood to ensure an heir. An infertile couple enters into a contract with a woman who has intercourse with the husband in order to bear a child for the couple. This practice is called "borrowing a wife." In some villages, the "borrowed wife" receives as much as 10,000 yuan (five times a professor's monthly salary or about $250) for a girl and double that for a boy.But the more common and thorny problems involved with the beginning of life relate to birth control, family planning, and the "one couple, one child" policy that the Chinese government instituted to curb overpopulation. The goal of that policy is to prevent China's population from exceeding 1.2 billion in the year 2000... (shrink)

This paper reviews the practice of late abortion in China and summarizes the arguments for morally justifying the ‘one couple, one child’ policy.

Thomson, Kelvin You might be surprised to learn that China, home of the much derided one-child policy, has a higher birth rate than Italy, home of the Vatican. This suggests Chinese families are quietly defying their political leaders and Italian families are quietly defying their religious ones. But the overall global picture is one of rapid population growth.

BackgroundFollowing the SARS pandemic, jurisdictions around the world began developing ethical resource allocation frameworks for future pandemics—one such framework was developed by Thompson and colleagues. While this framework offers a solid backbone upon which decision-makers can rest assured that their work is driven by rigorous ethical processes and principles, it fails to take into account the nuanced experiences and interests of children and youth (i.e., young people) in a pandemic context. The current COVID-19 pandemic offers an opportunity to re-examine this (...) framework from young people’s perspectives, informed by advances in childhood ethics and children’s rights.Main bodyIn this paper, we revisit the Thompson et al. framework and propose adaptations to the ethical processes and values outlined therein. This work is informed by expertise in clinical ethics and literature related to impacts of COVID-19 and other pandemics on the health and well-being of children around the world, though with particular attention to Canada. During the processes of drafting this work, stakeholders were consulted—aligned with the approach used by Thompson and colleagues—to validate the interpretations provided. We also propose a new principle, namely practicability, to indicate the complex balance between what is possible and what is convenient that is required in ethically sound decisions in the context of services affecting young people. We outline and discuss the strengths and limitations of our work and indicate next steps for scholars in the areas of childhood studies and child health.ConclusionEfforts to ensure frameworks are truly child-inclusive should be the status-quo, so pandemic impacts and policy implications can be considered in advance of emergency preparedness contexts. (shrink)

Georges Bataille (1887–1962) is one of the most significant thinkers of the 20th century, whose anti-humanist anthropology influenced subsequent existentialist and post-structuralist philosophy. His wide-ranging writings (across philosophy, archaeology, economics, sociology, poetry, erotica and history of art) frequently mention children, childhood and childishness, and yet there has hitherto been little to no attention paid to this aspect of his work. This article opens up a neglected theme in Bataille studies, and also explores the consequences of Bataille's presentation of the human (...) condition for our understanding of the pedagogical relationship. Of particular interest is the idea of the agentic child, which occupies such an important place in childhood studies, educational theory and public policy. In the light of Bataille's anthropology, I shall explore the idea that the pursuit of children's agency is the victim of its vaunting ambition. (shrink)

Heath Robinson could perhaps draw a diagram that made sense of the legislative and regulatory structure Bonnicksen describes in this book. However Heath Robinson machines, no matter how baroque, actually achieve something: in the four years covered by this contemporary history the American “system” seems to have achieved very little. That we have not yet seen a confirmed cloned child produced in the USA or elsewhere does not seem due in any part to the activity that Bonnicksen describes. This is (...) not a history of America’s progress towards crafting a policy; it is an account of its failure to make one.The bulk of this book details the legal and regulatory responses to emerging reproductive technology in America following the announcement of the birth of Dolly the cloned lamb in 1997. The remainder gives an overview of the position of other countries around the world, and a brief concluding chapter outlines the options open to the US in the future. Lest anything that follows might suggest otherwise, I found this book interesting and informative, and …. (shrink)

The aim of the present article is to explain the role of the judiciary in forming the family policy in Lithuania. For this purpose in the first part of the article the legal basis for the state family policy formation is discussed. The conclusion is drawn that the judiciary is not separated from the formation of the family policy by any constitutional means. The article further describes how this function is actually implemented by the judiciary. The actual influence of the (...) judiciary is demonstrated by an analysis of the Lithuanian case law in three different areas: dissolution of marriage, child maintenance and the protection of the rights of children born outside marriage. The results of the analysis suggest that the influence of the judiciary on the state family policy works in diverse ways: when filling in legal gaps overlooked by the legislator; determining specific criteria which are important to the state family policy (while the legislator has determined only general principles); introducing international human rights standards in the national legal system, etc. One of the most controversial ways for the case law to influence the state family policy is through the modification of the legal regulation models prescribed by the laws. (shrink)

Demographic transition faced by modern economies, including China, are among the most important long-term socio-economic challenges. In 2022, China observed its population decline for the first time since the early 1960s. The low fertility rate was of critical importance. The unprecedented one-child policy is quite commonly indicated as the main reason for the low fertility rate. However, the departure from this restrictive policy and the actions introduced under the two-child policy implemented from 2016, and then the three-child policy from mid-2021, (...) have not brought an improvement in fertility rates. The aim of the paper is to answer the following research questions: Should the decline and persistent low fertility rate in China be attributed solely or mainly to the unprecedented one-child policy, which was in force for over three decades? Fertility transition in China is the effect of several factors and depends largely on the studied period. In the 1970s and 1980s, the government’s family policy was a key determinant of the decline in fertility. However, contrary to the prevailing belief about the determining influence of the one-child policy, the first stage of the implementation of the birth control policy, the Wan, Xi, Shao program, had a greater impact. Since the 1990s, the low fertility rate has been mainly explained by the extraordinary socio-economic changes and rapidly increasing prosperity of the Chinese people. Since the beginning of the 21st century, cultural changes resulting mainly from the integration of the Chinese economy with the global system have been crucial. Cultural changes have affected reproductive behaviour, marriage patterns, marriage postponement, birth postponement, fertility, and family size in Chinese society, which is observed below-replacement fertility. China’s demographic future depends on the fertility trajectory. However, due to the size of the population, but also the position of the Chinese economy in the global economic system, Chinese demographic transition may also bring significant consequences for the global economy. (shrink)

The child was 2 years, 8 months old and weighed 25 pounds, one-fifth the weight of her mother, for whom she was to be the bone marrow donor. The mother had suffered a relapse of acute myelogenous leukemia; her physicians recommended a bone marrow transplant. The child was the closest human leukocyte antigen match and thus the best donor candidate for her mother's transplant.

The ideal of filiality ( xiao) – care and reverence for elderly parents and ancestors – is one of the central values in Confucianism. It has been hugely influential in Chinese society. However, it has often been misused and vulgarized in practice, leading to significant human suffering. Hence, there is a need to articulate a morally defensible and realistic interpretation of filiality that is appropriate for the Chinese context. In this article, I articulate an account of filiality that can be (...) deployed to enhance understanding of the ideal, criticize misuses and promote healthy relations among family members. I argue that filiality comprises five parts that have been influential in Confucian philosophy and Chinese society. For each component, I demonstrate that a morally defensible and realistic interpretation must be sensitive to the age and health condition of family members, as well as the particularities of modern Chinese society such as the legacy of the one-child policy. I support my argument with empirical research findings from China. I do not deny the possibility that my argument may be valid outside of China, but I leave it as an open question. (shrink)

One of the global challenges addressed in this article, particularly in the Global South, is the high prevalence of child marriage. The author is situated in an area with one of the highest rates of child marriage in Indonesia. The rationale for selecting this case study is to examine the concept of spiritual freedom and its potential to empower women to challenge the oppression they face with regard to their bodies, rights, and futures. Child marriage should be regarded as a (...) criminal act in the context of Christianity. However, this issue does not appear to be a prominent topic in educational institutions, places of worship, or global discourse. This research employs a qualitative methodology, utilising interview techniques with women who have experienced child marriage. The author then engaged in a process of reflection with feminist philosopher Iris Marion Young, concurrently addressing theological concerns and the role of Christian education. The findings indicate that Christianity and government policy on health are inextricably linked, as health is a divine mandate for humanity to fulfil its responsibilities.Contribution: This article makes a contribution to the field of research in Central Kalimantan and serves to proclaim to the global community that Christian education must address the issue of child marriage as a matter of urgency. (shrink)

The crisis in donor organ and tissue supply is one of the most difficult challenges for transplant today. New policy initiatives, such as the driver's license option and requiredrequest, have been implemented in many states, with other initiatives, such as mandatedchoice and presumedconsent, proposed in the hopes of ameliorating this crisis. At the same time, traditional acquisition of organs from human cadavers has been augmented by living human donors, and nonheartbeating human donors, as well as experimental animal and artificial sources. (...) Despite these efforts, the crisis persists and is perhaps most tragic when it threatens the lives of children, driving parents to sometimes desperate measures. Herein, we address one very controversial step some parents have taken to obtain matching tissue or organs for their needy children—that is, having a child, in part, for the purpose of organ or tissue procurement. (shrink)

While the unprecedented lockdown measures were at the heart of the debate in the first year of the pandemic, the focus since then has shifted to vaccination issues. The reason, of course, is that vaccines and vaccinations have become available by now. All experts agree: If mankind had failed to develop vaccines against SARS-CoV-2, the death toll would have been much higher. This issue seeks to explore what could be described as a “generational approach to vaccinations”. The question “What can (...) we do to avoid future pandemics?” is related to different aspects of the failures and successes of humanity’s vaccination strategy against SARS-CoV-2. Pathogens are among the existential risks to humanity that could potentially kill a large part of it in a very short time. For all the tragedy and horror it has brought upon the world, the Corona virus has not been lethal on such a large, all-encompassing scale. But it could serve as a wake-up call for more and better prevention in the future, put differently: as a call to build a “preventive society”. When people look back to the year 2022 from the year 2200, will they think of the absence of mandatory vaccination as a dangerous anachronism? And will the unequal global distribution of vaccines be seen as an unbearable vice of our epoch? And will “human infection studies” still be dismissed as unethical if a dangerous new virus boards human bodies? If intergenerational justice means improving the life chances and living conditions of future generations to the largest possible extent, then its link to (the avoidance) of infectious diseases is obvious. We should protect future generations from foreseeable damage if we have the power to do so. “We” is humankind in its entirety. Politically, humanity is divided into many single nations. But biologically, as members of the same species, we share the same vulnerability regardless of ethnicity. The regular reader of this journal might wonder why this issue of IGJR has a different structure. An unprecedented pandemic calls for an unprecedented reaction and therefore IGJR 1/2021 and 2/2021 are special issues that deal with this disruptive event. We have invited several health experts, politicians and scholars alike to share their perspectives in short opinion pieces (instead of regular peer-reviewed articles). And we are exploring something new: the publication of a FRFG policy paper. This policy paper starts off with a historical overview on how pandemics have afflicted humanity in the past. It separates moral from legal duties and formulates “epidemiological imperatives” – the way of thinking of a responsible and solidary individual facing the task of preventing an outbreak of epidemics in a community. With the discovery of vaccines, and their availability, the catalogue of duties is increased by one more: to get the jabs as an act of solidarity with others, including future generations. This would prevent states from being forced to take disease control measures that bring about drastic collateral damage. During the first two years of the Corona pandemic, states have imposed lockdowns. The closure of schools has put a special burden on the youngest members of society. This could have been prevented during the second and the further waves. The policy paper also calls for more government funding for prophylactic vaccine research and for the designation of vaccines as “global public goods”. The issue then moves on to a section dedicated to opinion papers by various different authors. The first paper, written by Agnes Binagwaho and Kedest Mathewos (both from University of Global Health Equity, Rwanda), focuses on the issue of health inequity, a concern which has gained more and more traction during the Covid-19 pandemic. The paper examines how vaccine distribution during the pandemic was mainly focused on the global north and how such actions might affect future generations’ perception of what is just, fair and morally correct. The second paper, by Samantha Vanderslott (University of Oxford), focuses on the right and wrongdoings connected to pandemic preparedness and response. The third paper, authored by Rajeev Sadanandan (Health Systems Transformation Platform, India), talks about the lessons that can and should be drawn from child immunisations. The fourth paper, by Adriano Mannino (LMU and Parmenides Foundation, Munich), delves into the question how future generations will assess our actions and our response to the current pandemic. The fifth and final paper, written by Jörg Tremmel (FRFG and University Tübingen), is centered around the question whether human infection studies could have been implemented during the early stages of the pandemic to minimise deaths and severe infections. The issue concludes with two reviews on recent books by Alberto Giubilini and Katie Wright. In his review of Giubilini’s The Ethics of Vaccination, Marius Kunte notes that it contains a “thought-provoking plea” for individual, collective and institutional obligations to reach high vaccination rates. Judith Kausch-Zongo concludes her review of Wright’s Gender, Migration and the Intergenerational Transfer of Human Wellbeing with a special emphasis on the book’s empirical findings, and praises it in its entirety as “undoubtedly important”. Both books serve as poignant reminders of how sustainable societies can only emerge once the challenges revolving around its most vulnerable members have been properly addressed. (shrink)

The social interface between reproductive medicine and embryonic stem cell research has been investigated in a pilot study at a large IVF clinic in central China. Methods included observation, interviews with hospital personnel, and five in-depth qualitative interviews with women who underwent IVF and who were asked for their consent to the donation of embryos for use in medical (in fact human embryonic stem cell) research. This paper reports, and discusses from an ethical perspective, the results of an analysis of (...) these interviews. The participants talked of extreme social pressure to become pregnant. Once they had a baby, ‘spare’ embryos lost practical significance due to the Chinese one-child policy. In the context of decision making about donating embryos to research, the women used the clinical distinctions between ‘good and bad quality’ embryos and also between frozen and transferred embryos, as guiding moral distinctions. In the absence of concrete information about what sort of research their embryos should be used for, the women interviewed either refused consent (for fear that the embryo would be given to another couple) or accepted, expressing motives of solidarity with other women in a similar situation. This reveals that they filled the knowledge gap with an image of research improving fertility treatment. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 13.4 (2003) 393-406 [Access article in PDF] U.S. Defunding of UNFPA:A Moral Analysis Ronald M. Green Ethical decisions made inside the Beltway sometimes have global consequences. Nowhere is this more true than with respect to the decision by Secretary of State Colin Powell on 21 July 2002 to halt $34 million in U.S. funding for the United Nations Population Fund (UNFPA). Behind this decision (...) lay the forces of America's abortion politics as well as tangled issues in law and bioethics.I became involved in this debate when, in early September 2003, I served as a member of a nine-person delegation of U.S. religious leaders and ethicists that traveled to China to meet with those associated with the UNFPA program there. The delegation was assembled by Frances Kissling, of Catholics for a Free Choice, which also provided support and funding for the necessary travel and administrative services. In China, our contacts included UNFPA administrators, Chinese government officials, and ordinary villagers touched by UNFPA efforts. In the middle of its week-long stay, the delegation left Beijing in three separate groups to travel to remote provincial regions (Hubei, Gansu, and Ningxia). Our goal was to respond to the Bush administration's defunding decision by deepening our understanding of the current Chinese population program and UNFPA's relationship to it. In the course of this enquiry, I encountered challenging questions that drew on my own training in ethics in novel ways. Historical Background UNFPA is the world's largest organization providing family planning and reproductive health services. It was established in 1969 as the United Nations Fund for Population Activities. In 1987, the Economic and Social Council decided to rename it the United Nations Population Fund, but to retain the original abbreviation-acronym. UNFPA works to improve access to and the quality of family planning services in more than 140 of the poorest countries in the world. It is also very active in providing services aimed at preventing the spread of HIV/AIDS. It does not provide abortion services, but works to prevent abortion through family planning and to help countries provide services for women suffering from the complications of unsafe abortion. [End Page 393]Although UNFPA is officially an agency of the United Nations, its budget, currently about $200 million per year, comes from voluntary payments by donors, including UN member states. U.S. funding has been irregular. In 1985, the U.S. House of Representatives passed a foreign operations appropriations measure that has come to be known as the "Kemp-Kasten Amendment." This measure, which has been repassed in substantially unchanged form every year since, forbids funding for "any organization or program which, as determined by the President of the United States, supports or participates in the management of a program of coercive abortion or involuntary sterilization."1 From 1986 on, the Reagan and Bush administrations halted all U.S. funding for UNFPA activities around the world on the grounds that the agency's activities in China caused it to be involved in supporting or participating in the management of a program of coercive abortion or involuntary sterilization, and, hence, put it in violation of Kemp-Kasten.Efforts by the People's Republic of China to slow the increase of its population date from the early 1970s when, in a striking departure from classical Marxist theory, which had insisted on the positive value of added labor power and denied the need for demographic controls, the government imposed a policy of delayed marriage and birth spacing. In 1979, these efforts intensified with the advent of the "one child policy." (In fact, this name is misleading since the number of children allowed a couple varies significantly from urban to rural areas, with rural residents and members of ethnic minorities permitted to have larger families.) To implement this program, the government established a National Family Planning Commission (now National Population and Family Planning Commission) which, among other things, set up a network of family planning service centers around the country, where birth control... (shrink)

Child poverty reduction is one of the most important and urgent tasks that requires attention in most regions of the world, nations and Anambra state specifically. The population of impoverished children is progressively increasing in Nigeria because of economic recession and poor security situations that lead to displacement and death of their parents. Although children constitute half of the entire population, commensurate attention is not given to them to match the dimensions of poverty they face. This study argued that child (...) poverty is multidimensional, evidenced in lack of safe drinking water, adequate nutrition, shelter, decent sanitation, medical advice or health services and education, to mention a few. The article highlighted the laudable efforts of the United Nations International Children’s Emergency Fund and Anambra government and maintained that multiple strategies can help in solving this problem. To complement these efforts, the enforcement of biblical policies or principles about children’s rights would in no small measure reduce child poverty. It was concluded that a proper repositioning of children would be matched with implementation of biblical strategies. Biblical intervention could help children socially, mentally and psychologically and in their general well-being. Biblical principles would erase wrong socio-cultural notions about children. (shrink)

There has been an exponential rise in use of the term vulnerability across a number of political and policy arenas, including child protection, sexual offences, poverty, development, care for the elderly, patient autonomy, globalisation, war, public health and ecology. Yet despite its increasing deployment, the exact meaning and parameters of this concept remain somewhat elusive. In this article, we explore the interaction of two very different strategies—one in which vulnerability is relied upon by those seeking improved social justice as a (...) mechanism by which to identify, problematise and compel state responses to a universal condition of precarious dependency, and the other in which it is used as a category of neo-liberal governance which legitimates state encroachment whilst constructing ‘vulnerable’ individuals as ‘risk-managers’ who must behave ‘responsibly’ in the face of disadvantage. We suggest that the co-existence of these divergent approaches highlights the fluidity and malleability of the concept of vulnerability. Using sex work as a specific case study, we explore the ways in which vulnerability bears multiple meanings, and has been used in recent times in the furtherance of moralistic and regressive agendas, which collude with, rather than challenge, state power. Without seeking to reject the label or normative import of vulnerability, we call, therefore, for a more circumspect approach to its usage, and a more critical evaluation of recent claims which hail it as a mechanism, preferable to the conventional use of equality paradigms, by which to secure progressive feminist outcomes. (shrink)

The ratification of the United Nations Convention on the Rights of the Child (UNCRC) demands that those participating nations, adopt the aims of the convention as state responsibilities toward their child citizens. The central premise of the convention is clear: that it is the right of all children to develop to their full potential. The authors propose six basic interdependent developmental requirements if the child is to reach ‘full potential’. Without prioritising any one need, but instead concentrating on the facilitation (...) of complete care of the child, the paper aims to examine how the UNCRC may finally be realised. This is achieved by highlighting several key situations and associated factors, which contribute to deficient care. Whilst the factors leading to the creation of such situations are often culturally specific, the consequences for the child, and the implications for care providers (parents, aid agencies, and policy makers), are often very similar within and between continents. (shrink)

Sen’s essay concerns the existence of extensive hunger amidst unprecedented global prosperity in the contemporary world, but he argues that the problem would be decisively solvable if our response were no longer shaped by Malthusian pessimism. Effective famine prevention does not turn on food supply per head and the automatic mechanism of the market: there can be plenty of food while large sections of the population lack the means to obtain it. Effective famine prevention thus requires “entitlements.” Economically, governments can (...) and should provide public employment programs so that those threatened by famine can be empowered to command food. Politically, democratic participation and a free press can work to ensure government accountability for famine prevention. The choice that Sen urges, however, is not for the state over the market—the experience of the Indian state of Kerala demonstrates that a voluntaristic approach can work as well or better than China’s compulsory “one child policy” in limiting the rapid population growth that contributes to world hunger. Rather, a reasoned solution to the problem of hunger must acknowledge the complementary importance of both well-functioning markets and open and democratic public action. (shrink)

ABSTRACTIt was only in the early twentieth century that China discovered that it had a population, at least if a population is understood not as a simple number of people but instead in terms of such features as variable levels of health, birth and death rates, age, sex, dependency ratios, and so on—as an object with a distinct rationality and intrinsic dynamics that can be made the target of a specific kind of direct intervention. In 1900, such a developmentalist conception (...) of the population simply did not exist in China; by the 1930s, it pervaded the entire social and political field from top to bottom. Through a reading of a series of foundational texts in population and family reformism in China, this paper argues that this birth of the Chinese population occurred as a result of a general transformation of practices of governing, one that necessarily also involved a reconceptualization of the family and a new logic of overall social rationalization; in short, the isolation of a population–family–economy nexus as a central field of modern governing. This process is captured by elaborating and extending Foucault's studies of the historical emergence of apparatuses into a notion of fields of governability. Finally, this paper argues that the one‐child policy, launched in the late 1970s, should be understood not in isolation from the imposition of the “family‐responsibility system” in agriculture and market reforms in exactly that period, but as part—mutatis mutandis—of a return to a form of governing that was developed in the first half of the twentieth century. (shrink)