Abstract
Recent medical developments in Japan have been astonishing. Especially in diagnosis and treatment technology, Japan ranks top-level in the world. Nevertheless, for such incurable conditions as "progressive cancer" and "terminal cancer", even with the highest possible level of medicine, care which is really adequate is not easily available. Patients with no prospects of recovery are often forced to stay alive as long as possible without receiving pain relief and adequate psychological care, and many end up dying a painful and lonely death. Being anxious to improve this situation, not only medical and nursing staff but also the general public have become increasingly interested in hospice/palliative care during the past two decades. In the 1970s, a small number of physicians began to develop a special interest in hospice care and they decided to initiate a team approach to the dying patient. The work of St. Christopher's Hospice in UK was reported in the newspapers and public interest in hospice intensified gradually. The first hospice facility was established in 1981. Within the last decade, gradual yet remarkable progress has taken place in perception of the need for palliative care services in Japan. In 1990 palliative care services in Japan entered a new era when the national government authorized medical insurance coverage for palliative care. Under a new insurance system which is applied only to those special government-approved Hospice and Palliative Care Units, a daily payment of 38,000 Japanese yen (US$ 310) is designated for each patient regardless of the cost. In 1996, the Japanese Society for Palliative Medicine was organized and members already number about 1,800. As of the end of August 2001, Japan has 89 Hospices and Palliative Care Units which have been established during a 20-year period. Although many difficulties have been encountered in establishing them, public and medical professionals have begun to recognize the importance of palliative care. Thus palliative care has the origin in hospice care. The definition of palliative care of WHO is as follows : "Palliative care is the active total care of patients whose disease is not responsive to curative treatment. Control of pain, of other symptoms, and psychological, social and spiritual problems is para. mount. The goal of palliative care is achievement of the best possible quality of life for patients and their families. Many aspects of palliative care are also applicable earlier in the course of the illness, in conjunction with anticancer treatment."
