Hong Kong Experts Call for End-of-Life Autonomy to Be Returned to Patients
HK01 · 1 SOURCESabout 3 hours ago6 MIN
Summary
In Hong Kong and broader Chinese societies, when elderly patients are diagnosed with terminal organ failure or malignancies, their families frequently implore medical staff to withhold the truth, believing that ignorance shields their loved ones from psychological devastation. Professor Feng Zhi-hao (馮志豪), writing in a HK01 column on life-and-death education, contends that this widespread "protective concealment" paradoxically deepens patient suffering by trapping them behind an "information wall" while denying them the opportunity to settle affairs, reconcile with family members, and articulate end-of-life preferences .
Key Points
- Families in Hong Kong often request that medical staff refrain from disclosing terminal diagnoses to elderly relatives, citing protection and filial duty .
- Professor Feng references Cicely Saunders, the founder of modern hospice care, whose "Total Pain" concept encompasses physical symptoms, psychological distress, social role loss, and existential anxiety—all intensified by information deprivation .
- The article introduces Dartmouth College Professor Glyn Elwyn's "relational autonomy" framework, which posits that individual autonomy is co-constructed within intimate relationships rather than exercised in isolation .
- Feng proposes "quality filial piety" (品質孝道) as a cultural reframing that shifts focus from life extension at all costs to preserving dignity and respecting patients' authentic end-of-life preferences .
- Healthcare social workers are positioned as mediators who can employ indirect communication, storytelling, and family dialogue to transition households from passive concealment to collaborative facing of terminal illness .
Why It Matters
As Hong Kong's legal framework for advance care planning matures, the tension between traditional family protection instincts and patients' right to informed consent presents an urgent clinical ethics challenge. Professor Feng's relational approach offers a pragmatic pathway: rather than imposing Western-style individual autonomy, it honors Chinese family dynamics while gradually integrating patient-centered decision-making into end-of-life care practices across Hong Kong's hospitals and palliative services .
As Hong Kong's legal framework for advance care planning matures, the tension between traditional family protection instincts and patients' right to informed consent presents an urgent clinical ethics challenge. Professor Feng's relational approach offers a pragmatic pathway: rather than imposing Western-style individual autonomy, it honors Chinese family dynamics while gradually integrating patient-centered decision-making into end-of-life care practices across Hong Kong's hospitals and palliative services .