Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 12;17(2):357-367.
doi: 10.1007/s41649-025-00358-0. eCollection 2025 Apr.

Some Asian Value Reflections on Children's Autonomy

Daniel Fu-Chang Tsai  1 , Yu-Chen Chou  1
Affiliations

Some Asian Value Reflections on Children's Autonomy

Daniel Fu-Chang Tsai et al. Asian Bioeth Rev. .

Abstract

This paper provides an ethical reflection on "children's autonomy" from the perspective of cross-cultural bioethics based on theories related to Asian values. The author supports the premise of "children's" autonomy and explores the differences between Western and non-Western cultures regarding claims of children's autonomy. By comparing the legal regulations on children's medical decisions in the USA, the UK, Japan, and Taiwan, the paper illustrates the national legal differences in children's decision-making, even under the influence of similar Asian cultural values. The author further explains, adopting Tsai's "Confucian two-dimensional personhood theory" and Markus and Kitayama's "Construal of Self" theory, that although Asian countries like Taiwan have historically been influenced by relational personhood dimension and interdependent self-construal orientation, individual autonomy and children's medical decisions are significantly affected or limited by family or parental determinism. However, under the influence of global human rights values and universal bioethical principles, the conceptions, legislations, and practices have evolved towards respecting individual rights and autonomous choices. Hereby, Tsai's two-dimensional personhood theory can balance the tension between individual autonomy and family determinism, as well as between children's autonomy and paternalism. This theoretical framework can provide a rational resolution to the long-standing cross-cultural bioethical controversy regarding individual autonomy and family determinism, and offer insights and solutions for pediatric ethics and children's medical decisions under Asian values.

Keywords: Children’s autonomy; Confucian relationships; Cultural differences; Subjectivity.

PubMed Disclaimer

Conflict of interest statement

Conflict of InterestThe authors declare no competing interests

References

    1. Beauchamp, Tom L., and James F. Childress. 1994. Principles of biomedical ethics, 4th ed. New York: Oxford University Press.
    1. Becker, Carl. 1997. Social ethics in East Asia. Drug Information Journal 31: 1089–1096. 10.1177/009286159703100406.
    1. Bou-Habib, Paul, and Serena Olsaretti. 2015. Autonomy and children’s well-being. In The nature of children’s well-being: Theory and practice, ed. Alexander Bagattini and Colin Macleod, 15–33. Dordrecht: Springer.
    1. Chenneville, Tiffany, Kemesha Gabbidon, Stefanie Hornschuh, and Janan Dietrich. 2021. Balancing autonomy and protection in pediatric treatment and research. Advances in Pediatrics 68: 55–69. 10.1016/j.yapd.2021.05.009. - PubMed
    1. Downie, Robert Silcock, K.C. Calman, and Ruth A.K. Schröck. 1994. Healthy respect: ethics in health care. Oxford University Press.