In this paper, I attempt to address what we should do as parties in a healthcare professional-patient relationship in order to secure trusting relationship. The word "trust" is frequently used to express an ideal healthcare professional-patient relationship, e.g. "we can't provide good treatment without securing a trusting relationship with a patient" or "we have to do this and that in order to secure a trusting relationship". However, what can be done to secure a trusting relationship with someone? Further, what does a "trusting relationship" mean? Since there is much ambiguity regarding what a trusting relationship means, we will encounter problems even if we accept "trusting relationship" as an ideal healthcare professional-patient relationship. Thus, in the first section, I will try to identify what the "trust-relationship" means when it is used to refer to an ideal relationship. In the second section, I will clarify what we can do to secure an ideal trusting relationship. Finally, I will explore what we should do to secure an ideal healthcare professional-patient relationship.
All individuals would like to receive competent and safe medical care and treatment from caregivers whom they trust. However, some recent medical accidents that have been published have resulted in a loss of trust in medical caregivers. This paper examines the trust between a patient and his/her caregiver with reference to medical errors, considers from the following respects. 1. When a person suffers an unexpected adverse outcome of treatment, he/she expects his/her medical caregiver to have a faithful attitude toward him/her. In particular, he/she expects the caregiver to be completely honest and clearly explain the effects of the treatment given to him/her and whether his/her condition could deteriorate. I believe that medical caregivers are responsible for informing patients who have suffered adverse outcomes of treatment. This is based on the ethical principles of doing no harm and respecting the patient's right to know. 2. Medical errors may occur because a substantial number of medical treatments involve high risks. Moreover, errors may also result due to organizational factors. 3. In Japan, large hospitals, where medical errors may frequently occur, have begun to investigate and examine the causes of such errors to reduce their occurrence and to improve patient safety. However, it appears that little attention is being given to policies concerning the disclosure of such errors. 4. All healthcare organizations should establish a strong, proactive policy to support individuals who have suffered errors in treatment by completely and honestly disclosing such errors to patients. If healthcare organizations do not support individual patients, they are not being honest with them. Moreover, ethical support from organizations may protect individuals from the shame, guilt, fear, and loneliness that they may experience.
In this paper, I would like to take up the issue of "White Stork Cradle" (Kounotori-no-yurikago) or "Baby-Post," which was established at Jikei Hospital in Kumamoto City in May 2007. I examine its current situations and problems in contrast to "Babyklappe" in Germany, as its precedent. The problems addressed include the follwing: the conflict between the mother's right to anonymity and the baby's right to know where he or she came from; the style and policy of disclosing information on the usage of "Baby-Post"; and how the entire system can be legalized. Furthermore, I consider "anonymous birth" in the hope that it could be the next best way after "Baby-Post." Through addressing these problems, I would like to review aspects of family and life appropriate for a Japanese society in the future, which would exhibit tolerant compassion for the weak and never abandon them.
This paper aims to criticize abortion and to present a vision of what our society and life should be. In Japan, abortion is technically illegal, but loopholes result in about as many as 300,000 approved pregnancy terminations a year. This paper insists that most abortions (including shady abortions) in Japan should not be approved (the paper does not dwell on abortion in cases of rape or when there is danger to the mother's life because space is limited). Broadly speaking, the main issues in the abortion debate are whether the fetus is a "person" or not, whether "rights" such as the reproductive rights of women and the fetal right to live should be recognized and whether a relationship between a pregnant woman and her fetus is formed. This paper argues against abortion from a relationalistic viewpoint; it criticizes the past relationalistic views and develops a new relationalistic view. Abortion is an act where adults unilaterally deny "the life of a child who is growing and affirming his/her own being", thereby destroying any relationship with the child. Moreover, it is an act of adults refusing a child's participation in society simply because the child was accidentally conceived by parents who did not want him/her, or simply because the child was diagnosed with a disability, etc. In brief, abortion ruins our conception of "society being a place that welcomes life hospitably". Welcoming life hospitably is to accept it unconditionally; just as it is. In order to actually solve the abortion problem, one must establish relationships where one can affirm one's own life, the opposite sex person's life, and the fetus' life, as well. This is much more important than abstractly arguing over rights, personhood, and such.
In bioethics, especially in discussions of advanced technology such as genetic engineering, religious phrases like 'Playing God,' 'Creation,' and 'Image of God' are often used. In this paper, I deal with the phrase 'Playing God'. This phrase is often used as a slogan, 'You should not play God,' to oppose advanced technologies such as cloning and genetic manipulation. 'Playing God' is thus considered a human behavior that goes beyond boundaries ordained by God and involves knowing things that human beings should not know. 'You should not play God' is a sentence providing warning against this. Sometimes it is used as a basis for deriving specific conclusions. However, it is ambiguous. The implications of this phrase are unclear and depend on the interpretation of the user. As a consequence, people use the phrase frequently to mean different things without indicating exactly what 'Playing God' means, and sometimes come to different conclusions. Therefore, if the meaning of this sentence is not specified, it is of no use to consider its validity. Therefore, in this paper I analyze the phrase 'Playing God' and clarify its meaning, contents, and function in some contexts in which it is used. The following points are made. The sentence 'You should not play God' is just a warning to promote awareness of human fallibility, incompleteness, and finitude. There is some difficulty in using this phrase as a basis for reaching specific conclusions. If people wish to make this phrase function effectively, they must clarify the domain of God, offer rational and theological reasons for treating a domain as God's field, and clarify the Will of God or natural process presupposed behind the phrase 'Playing God.'
Because the word 'care' is often used in nursing as a daily word and in polysemic fashion, usage of it needs to be organized, refined, and modified for inclusion of it as an academic term. In this paper, an attempt is made to clarify the meaning of the word 'care' by considering what specific meanings and roles those within the nursing discipline may assign this word, so that desirable nursing practice can be clearly explained. In reference to 'nursing care', nursing has been explained using everyday interpretations of the word 'care'. While discussing appropriate nursing, on the other hand, intangibles such as qualities required in those who do nursing care, etc. have been mentioned as crucial to making nursing care true nursing. For the past twenty years, there has been an unfortunate tendency to use the word 'human caring' as equivalent to nursing, and the word 'care' as a catch-all to conveniently indicate both the nature and the goodness of nursing, as a result of which the nature of nursing remains unclear. If in nursing the word 'care' is redefined in accordance with the continuing and evolving application of its previous usage in academic discipline, while avoiding discrepancies from practical wisdom, it would then be appropriate to define it as aid extended to advance the well-being and autonomy of each individual patient before us who lives wishing for health. Considering the current situation in which nurses care for multiple patients, it is not possible to discuss the entirety of desirable nursing if we rely solely on the word 'care'.
In this article, I discuss F. Nightingale's thoughts on what to do for the sick by examining her "Notes on Nursing." F. Nightingale begins her thoughts from the definitions of disease, and her consideration of the sick person is based on these definitions. The first definition is "all disease is a reparative process by Nature," the second that "diseases are conditions." The first shows that the relationship between the sick and people in charge of care for them is equal and complementary, since imposed on both of them is the same duty to obey Nature in healing the sick. The second shows that all in a society have an interest in the conditions causing disease. In conclusion, it is clear that that F. Nightingale's consideration of the sick person is "a look not isolating a sick person."
We selected case A as the subject of our research: this schizophrenic individual had been hospitalized for about 12 years in a private psychiatric hospital. In order to determine factors crucial to his discharge, we used the method of vocabulary analysis to examine his medical and nursing records over 1,450 days. In this case, we focused in particular on eleven words concerning recovery and discharge. Our findings suggest the following: (1) the need for adequate assessment of his improvement, (2) the need for empowerment enabling improvement of his interpersonal relationships, and (3) the importance of resolving large gaps in intention regarding discharge between the patient and health professionals.