Abstract
In Japan, public health insurance system prohibits doctors who work at institutes included in this system to provide experimental medical care. They can provide only regulatory authorized methods and medicinal products for series of treatments for a specific condition of patient, if any part of these treatments is paid by public insurance. In case a patient pays themselves or a doctor pays using research fund, use of unauthorized methods is not prohibited, but public insurance payment should not be included any part of the expenditures for the series of care. Because of this, patients who needs medicines which have not been authorized in Japan but is "best proven method" in other countries has to pay so expensive fee for their treatment. However, such system protects patients from being involved easily in experimental methods, where safety and efficacy have not been assured. In this context, such insurance system in Japan has been discussed for reformation. In this article, the author describes the outlines of these discussions, analyzes the points to consider, and propose solutions from bioethical perspectives.
