A sense of autonomy is preserved under Chinese reproductive policies.

China has had a one-child family policy since 1979 and a National Family Planning Law since 2002. This paper presents analysis of comments from members of the general public and experts in China on the question of reproductive autonomy. The Chinese concept of 'Yousheng' (healthy birth) is more appropriate than eugenics as an expression of Chinese social policy and public attitudes. The widespread support for healthy birth has policy implications. None of the persons interviewed said that they had ever used ultrasound to choose the gender of their child nor had an abortion for the reason of a fetus's gender. Despite the bad impression of abortion from their experience, most would abort a fetus with a genetic disease. Respondents in rural areas were less likely to use prenatal care, pointing to more important social problems in reproduction in China. The impressions given from the survey stands in contrast to the implications of the majority of Western papers on the Chinese situation, and indicate that people are generally satisfied with the ethical balance towards the societal needs over individual autonomy, but they still have a sense of reproductive autonomy. There needs to be further study into these issues with larger surveys and interview studies.

Heroes of SARS: professional roles and ethics of health care workers.

OBJECTIVES: To examine the professional moral duty of health care workers (HCWs) in the outbreak of severe acute respiratory syndrome (SARS) in 2003. METHODS: Descriptive discussion of media reports, analysis of ethical principles and political decisions discussed in the outbreak, with particular emphasis on the events in mainland China and Taiwan. RESULTS: There were differences in the way that Taiwan and mainland China responded to the SARS epidemic, however, both employed techniques of hospital quarantine. After early policy mistakes in both countries HCWs were called heroes. The label 'hero' may not be appropriate for the average HCW when faced with the SARS epidemic, although a number of self-less acts can be found. The label was also politically convenient. CONCLUSIONS: A middle ground for reasonable expectations from HCW when treating diseases that have serious risk of infection should be expected. While all should act according to the ethic of beneficence not all persons should be expected to be martyrs for society.

Policy and ethical issues in applying medical biotechnology in developing countries.

A brief review of some of the key issues in policy relating to the ethical issues raised by medical biotechnology in developing countries is presented, using India as an example. A series of some key issues is discussed, including information obtained from interviewing Indian government policy makers. Some of the issues discussed include: Economic and social incentives to encourage biotechnology; Health policy and ethics review; Patents on drugs; Medical genetics; Relationship to traditional medical practices; Positive public attitudes to biotechnology; Limited public participation; Infrastructural hurdles; Indian progress in stem cell research; and dilemmas of expensive technologies. The results show that although the needs of developing countries are different to those of rich countries, government policy utilizing guidelines and ethics committees has evolved as mechanisms to aid ethical health care delivery in India. In all countries there may be some of these concerns that are raised here, however, the integration of traditional medicine and advanced medical technology, and access to medical services by people in need, are particularly important challenges in developing countries. Better public involvement in policy making will require education and infrastructural organization as well as mutual willingness on the part of policy makers and citizens.