Reflections From Taiwan on Unsought Truth-Telling: Comparison With Lessons From Saudi Arabia

Abstract

The case by Adlan and ten Have (2012) involves an unsought finding of a wife’s alleged infidelity in a family whose daughter has a genetic disorder. In this case, the innocent father has cared for this daughter with all of his heart. Although this father was apparently a victim of misattributed paternity and, because of the genetic disorder for which he feels responsible, had decided not to have any further children, the extreme punishment that society would mete out to the wife and her relatives led the Arabian Human Ethics Committee to recommend against telling the truth. Although people in Taiwan may in general agree with most of the recommendations provided by the Human Ethics Committee in the tribal context of Saudi Arabia, there are similarities and differences in underlying moral rationales. The major difference comes from the Taiwan societal belief in science and related ethical concerns. For the general public in Taiwan, one moral expectation about how scientific research should be conducted can be seen in the assumption that the ordinary lives of research subjects should not be affected before or after voluntary participation, especially when there is no direct medical benefit to the participant. This ethical concern about limiting the effects of participating in research would result in a similar decision in favor of confidentiality rather than truth-telling in a case of misattributed paternity like this one. It is also conceivable that the Taiwanese tradition of prioritizing the family’s interests over individual autonomy may also play a part in the decision to not tell the truth. In consequence, favoring confidentiality over truth-telling as a result of the priority placed on the family is very similar in Taiwanese and Arabian societies, in contrast to the strategic truth-telling (sharing of this “research” finding) with the wife, which would likely be practiced in a Western, individualismoriented context. Taiwan is a rapidly changing society with considerable Western influence; in the last decade, Taiwanese people have been shifting their bioethical cultural standards away from paternalistic family norms toward autonomous, individual decision-making (Sheu et al. 2006; Huang et al. 2008; Hu and Yang 2009). Changes in the public’s attitudes about ethics can be seen in legal reforms related to advance directives as well as do not resuscitate (DNR) orders. Individual autonomy Bioethical Inquiry (2012) 9:415–416 DOI 10.1007/s11673-012-9405-8