May diabetes care tasks be performed by the patient's family at home based on the law of Japan?

Abstract

As a result of rapid population aging, the number of elderly diabetic patients with decreased self-management ability is increasing in Japan. Currently, family members primarily perform blood glucose checks for patients that require these procedures and administer insulin at home. It is expected that it will become difficult to receive assistance from family members as aging progresses and birthrates further decline. Discussion on this matter at the national level and development of urgent measures are required. As a prerequisite, it is necessary to summarize the medical legal system with respect to performing self-injection at home and self-measurement of blood glucose. In other words, insulin injections administered by family members are not considered to be in violation of the Medical Practitioners' Act based on the notification by the Ministry of Health, Labour and Welfare. Although the self-measurement of blood glucose performed by family members technically meets the constitutional requirements for the violation of the Medical Practitioners' Act, in practice, it is performed based on the administrative interpretation of the Central Social Insurance Medical Council, which states that its illegality is dismissed and it is not in violation of the Medical Practitioners' Act. At the same time, self-injection at home and self-measurement of blood glucose performed by non-medical or non-nursing care workers are in violation of the Medical Practitioners' Act and their illegality is not dismissed in Japan.