抄録
Japan is a country at the forefront of the super-ageing society. Currently, Japan has the longest life expectancy in the world with an average of 83 years of age, and in 2015, twenty-five percent of population will be over 65 years of age. Zaitaku (home care) Medicine, which was developed in Japan, is a style of home care and medical practice that integrates medicine and welfare. In an era where external environment is changing so rapidly, Zaitaku Medicine can become a powerful tool in solving the problems that arise from future unprecedented society. Zaitaku Medicine is important because, in a super-ageing society, the goals of medicine change dramatically from curing diseases and saving lives to that of supporting daily life and living of patients. We are living in times where medicine will share the same goals as welfare. Medicine and welfare will no longer be coordinated, but rather become integrated with each other. Zaitaku Medicine is deeply rooted in the ideas of Primary Health Care (PHC) and Aging in Place (the ability to live in one’s own home and community safely, independently, and comfortably, regardless of age, income, or ability level), and places emphasis on Death education. While medical treatment in hospitals is lead by doctors and done intensively, Zaitaku Medicine places patients and their families at its center, and its ideas correspond with the values of Bioethics, which began as a patients’ rights movement. The spirit of Bioethics later evolved to concept of values such as Informed Consent and American Hospital Association Statement on A Patient’s Right Bill (1972), and also includes the value of Health for All (a PHC strategy of WHO to promote health). With that respect, the value of Zaitaku Medicine and Bioethics is deeply connected with PHC. In order for patients to achieve “life with dignity”, a coined opposite term for “death with dignity”, Death education for medical students is indispensable. Other requirements include shifting emphasis to the community and daily life, constructing a new type of care and system that incorporates medicine and welfare and implementing coordination between specialists. Zaitaku Medicine is exactly what will serve as the foundation for these measures. The new 21st-century model of medicine and its systems will be lead by Japan’s Sanya district, which is the microcosm of future Japan.
