2026 Volume 14 Pages 90-97
In modern medical systems, diagnosis represents the gateway to treatment. However, patients often lack access to information regarding who actually makes the diagnostic judgment, creating a structural and ethical blind spot. Under the Japanese Medical Practitioners Act, only licensed physicians are legally authorized to perform “medical acts,” and such acts are to be evaluated based on their substantive content, rather than formal designation. Despite this, in the field of diagnostic pathology―where there is no direct contact with patients―it is not uncommon for non-physician dental practitioners to be involved in core medical diagnostic tasks through mechanisms such as “drafting” diagnostic reports or offering “consultations.” These practices raise significant concerns from both legal and ethical standpoints. This paper examines the legal positioning of medical pathological diagnosis in Japan, the historical and institutional responses of the professional pathology associations, and regulatory precedents in other medical specialties. It argues for the need to clarify the institutional responsibility of diagnostic authorship and reframe the ethics of diagnosis with respect to accountability and transparency toward patients.
