A Confucian Perspective on Public Health Ethics.

Debates in public health ethics have been dominated by the assumptions of Western liberalism: a priority given to liberty and autonomy over other values, an individualistic view of social ontology, a focus on personal responsibility, a minimal set of obligations (only created through consent), and a marginalization of social, cultural, and religious context. Examining issues in public health ethics from the perspective of a different moral tradition reveals that such assumptions are not timeless truths, but rather choices that require justification. In this paper, we briefly outline a view of Confucianism and explore how this approach can be used to articulate a critical approach to much contemporary public health ethics. Confucianism suggests a radically different perspective toward obligations, agency, and responsibility, as well as a more relational conception of social ontology and a shared notion of well-being. Of course, some discussion in public health ethics, within the constraints of Western traditions, has pushed in this direction before. In offering a Confucian perspective on public health ethics, we are not suggesting that Confucianism is the one true approach to ethics and that everyone should become a Confucian. We are, however, seeing our discussion as a source of epistemic critique of Western liberalism, exposing the need for more active defense of assumptions at its core, as well as providing an opportunity to broaden the set of values that inform justifiable public health policy.