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Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA (N.V., R.T.L.).

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This commentary explores how Confucian values influence shared decision-making (SDM) in Chinese healthcare, particularly in oncology. It highlights two key cultural foundations: , which underscore the deep-rooted involvement of families in medical decision-making, often prioritizing collective decisions over individual autonomy; and , which explains the cultural roots of power imbalances in healthcare relationships, where patients typically defer to the authority of doctors, and the role of nurses in SDM is limited. The paper argues that for SDM to be effectively integrated into Chinese healthcare, strategies must be adapted to align with cultural norms while encouraging patient empowerment.

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Introduction: In the face of evolving public health challenges, including emerging diseases, pervasive health disparities, and escalating environmental threats, the integration of learning health system (LHS) principles emerges as a vital strategy for enhancing the adaptability and efficacy of public health initiatives. Traditional approaches within these systems often overlook the potential to deeply involve community-based organizations (CBO) that are led and staffed by the communities they serve as equal and essential partners in the public health discourse.

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