Annals of the Japanese Association for Philosophical and Ethical Researches in Medicine
Online ISSN : 2433-1821
Print ISSN : 0289-6427
Volume 29
Displaying 1-24 of 24 articles from this issue
  • Article type: Cover
    2011Volume 29 Pages Cover1-
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
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  • Article type: Index
    2011Volume 29 Pages Toc1-
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
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  • Shinryo N. SHINAGAWA
    Article type: Article
    2011Volume 29 Pages 1-3
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
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  • Noriko OHASHI
    Article type: Article
    2011Volume 29 Pages 4-14
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
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    Advances in the field of genetics have enabled the diagnosis of many genetic diseases, which has led to the benefits of prevention, early detection and treatment in some of them. Nevertheless many are neither preventable nor curable yet, even though we can diagnose them. Moreover, discrimination against patients with genetic diseases and their blood relatives exists. Therefore, a person tested who was diagnose with a genetic disease is sometimes determined to keep the test result from not only his/her employer and insurance company, but also his/her relatives (spouse and blood relatives). However, for blood relatives who are at the same genetic risk, knowing the result may be desirable from the viewpoint of prevention, detection, and treatment in the early stage, when the disease is preventable or curable. In this situation, two conflicting rights, namely, the right to privacy of the tested person and the right of blood relatives to know may be asserted. Although health care providers are responsible for the confidentiality of patient information, they may plan to inform blood relatives of their genetic risk for the sake of the above-mentioned benefits. This paper deals with the subject of how the conflict of interest between the tested person and his/her relatives should be regulated, and what actions health care providers should take. Blood relatives and the tested person share some common genetic information. I think that the genetic information of the tested person can be considered as that of blood relatives themselves under specified strict conditions because of their partial genetic identity. Then access to the genetic information of the tested person can be legally protected as the exercising of the self information control right of blood relatives.
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  • Yoshihiko SUGIOKA
    Article type: Article
    2011Volume 29 Pages 15-25
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
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    The purpose of this article is to discuss the relationship between scientific research and spirituality. Thus far, many epidemiological researchers have studied the positive effects of spirituality on depression. Borg et al. showed a negative association between inter-individual variability of serotonin 5-HT_<1A> receptor binding potential and spiritual acceptance, whereas Karlson et al. reported no association between them. Although the 5-HT_<1A> receptor plays a crucial role in major depression, neither of these studies showed a positive association between the 5-HT_<1A> receptor binding potential and spiritual acceptance. Thus, both these studies deny the possibility that the 5-HT_<1A> receptor may be a confounding factor connecting spirituality and depression. Generally, there are two different negative attitudes to such researches: some think that spirituality is a mystical and non-scientific concept, which is inappropriate for medical research, while others believe that the transcendent(i.e., God) cannot be examined by scientific methods. Our stance depends on neither of these attitudes, but if spirituality does in fact influence our health, we should confirm whether biological research on spirituality is possible because spiritual experiences have a close association with our brain. This viewpoint may resonate with the theological perspective of imago Dei, wherein the human being as a whole is believed to be the bearer of the divine image in a spiritual as well as in a physical dimension. The effects of spirituality on health are open to scientific research. The purpose of introducing the concept of spirituality to medical science is to reject the reductionist view of human beings and to consider each individual as a whole.
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  • Akira TSURUSHIMA
    Article type: Article
    2011Volume 29 Pages 26-34
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
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    In this paper I consider the arguments for the moral status of human embryos from a Christian viewpoint. First I address the position which claims that "the embryo at the moment of conception, i.e. at fertilization, is a person." I focus on the Vatican's strong position which argues vigorously and repeatedly for the protection of early embryos. In this paper I use the word "Vatican" to refer to the teaching authority of the Roman Catholic Church and magisterium, papal pronouncements, the Congregation for the Doctrine of the Faith, the Pontifical Academy for Life and so forth. This is because not all Catholic theologians and ethicists agree with this strong position or reject hES cell research. In this section I take a similar position to the Vatican's. Secondly, I deal with the opposing position which gives the green light to hES cell research because it does not consider the pre-embryo to be a person. And thirdly, I address the response to that criticism by the Vatican. Finally I investigate what the key question is and what kind of issue influences each argument in this debate on the moral status of embryos.
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  • Yasue FUKUDA
    Article type: Article
    2011Volume 29 Pages 35-43
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
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    The great majority of people rely on media reports for health and medical knowledge. However, medical news reports sometimes present extremely biased views. For example, an alliance of pharmaceutical companies sometimes targets the news media to create fear about disease or bring attention to new treatment. Recently, web-based audits designed to improve the quality of medical news reports have been set up in Australia and Canada, under the name "Media Doctor" and a similar system known as a Health News Review has been started in the U.S. In this paper, firstly we will examine the background to the setting up of the evaluation projects on medical news reports. Secondly we will also attempt to clarify the nature of the current Media Doctor review. Thirdly, we will examine the regulation on direct to consumer advertising of prescription drugs in Canada, Australia, and the United States. Finally, the role of online-based evaluation systems will be considered. They provide objective analysis of health news and the results produce feedback for journalists, General Practitioners and Health Consumers. The projects are intended to contribute to the education of journalists and to bring about better collaboration between the medical profession and journalists, in order to improve the quality of health news.
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  • Akira MURAMATSU
    Article type: Article
    2011Volume 29 Pages 44-52
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
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    Due to ever-pervasive gene studies and researches and the wide use of biobanks, the introduction of general consent is an urgent issue for promoting medical researches. However, in light of the conditions of IC, general consent is seen as an unorthodox or problematic consent form. This paper discusses the standards and forms that are required in order to respect the self-determination and protect the personal information of a subject(patient), and thereby presents a plausible argument for "a two-part consent process". Furthermore, this paper shows, using the Havasupai Case that some serious problems can be caused by communication gaps. To give general consent a definite form, it is not sufficient to take the consent's formal conditions into consideration; it is necessary to consider the role of medical coordinators. The stress is upon the need to create a common understanding and perception of the framework of medical studies shared by a subject(patient) and medical staff.
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  • Kashimi YOSHIDA
    Article type: Article
    2011Volume 29 Pages 53-62
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
    JOURNAL FREE ACCESS
    This paper studies a movement in Japan in the 1970s and 1980s for a new adoption system to give women reproductive freedom by providing an alternative to abortion. The study examines why the adoption movement resulted in failure and reveals how concurrent campaigns to restrain abortion influenced this failure. In 1973, Dr. Noboru Kikuta publicly confessed to arranging 100 illegal adoptions using false birth certificates in cases of unwanted pregnancy to protect the mothers and save their fetuses. Subsequently, he started a movement to deny abortion to any woman past her seventh month of pregnancy, when a fetus can survive outside of the womb, and to establish a new adoption system protecting women's privacy in records of childbirth and adoption to provide an alternative to abortion. However, jurists did not embrace the protection of unmarried mothers from stigma and the Special Adoption Law established in 1987 did not reflect Kikuta's proposal. In the 1970s and 1980s, while Kikuta developed his movement, some religious groups and politicians criticized the Eugenic Protection Act, which was enacted in 1948 and allowed abortion within the seventh month. They campaigned to amend the act to prohibit most abortions and include disabled fetuses in eugenic policies instead. However, feminist and disabled people's groups protested against and frustrated the campaigns. As a side effect of this controversy, Kikuta's movement for a new adoption system was seen as being radically pro-life or anti-feminist. Moreover, obstetricians making a living by performing abortion and feminists did not actively support him. Kikuta's new adoption system was a simple proposal to protect fetuses' lives and add to women's choices, but the concurrent anti-abortion campaigns made Kikuta's beliefs and actions seem overly political. Kikuta's failure and the present situation of adoption in Japan are representative of the limitations of women's reproductive freedom in Japan.
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  • Kumiko YOSHITAKE
    Article type: Article
    2011Volume 29 Pages 63-72
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
    JOURNAL FREE ACCESS
    In consensus building process in medicine, it is crucial for its participants to understand why each of the stakeholders has his/her opinion. The aim of this paper is to develop the notion of "reason of opinion" and to propose the idea of "history of reason" to understand what a satisfactory consensus is in conflict resolution in medicine. The notion and the idea contain four factors, that is, 1) when one started to form the reason of an opinion, 2) how one formed the reason, 3) what the relationship between the present opinion and its reason is, and 4) what kind of result is supposed to come out after the decision. Knowing the stakeholder's history of reason makes it possible 1) for stakeholders to understand more deeply the patient's needs and to find the better solution for the situation, 2) for the patient to become aware of his/her own sense of value and to confirm what he/she expects after the decision, 3) for all the stakeholders to decrease the risk of misunderstanding and to share their expectations, 4) and for them to find the way to the final solution. This new approach, which includes the notions of the history of reason and the expectation in stakeholders, leads to the way to integrate both the evidence based medicine and the narrative based medicine.
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  • Hitoshi ARIMA
    Article type: Article
    2011Volume 29 Pages 73-76
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
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  • Hirobumi TAKENOUCHI, Izumi OTANI
    Article type: Article
    2011Volume 29 Pages 77-78
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
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  • Masao SUZUKI
    Article type: Article
    2011Volume 29 Pages 79-80
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
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  • Masahiro IKEDA
    Article type: Article
    2011Volume 29 Pages 81-82
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
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  • Tetsuo OHMURA
    Article type: Article
    2011Volume 29 Pages 83-84
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
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  • Yasunori ANDO
    Article type: Article
    2011Volume 29 Pages 85-86
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
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  • Article type: Appendix
    2011Volume 29 Pages 87-89
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
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  • [in Japanese]
    Article type: Article
    2011Volume 29 Pages 90-
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
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  • Article type: Appendix
    2011Volume 29 Pages 91-
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
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  • Article type: Appendix
    2011Volume 29 Pages 92-
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
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  • Article type: Appendix
    2011Volume 29 Pages App1-
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
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  • Article type: Appendix
    2011Volume 29 Pages App2-
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
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  • Article type: Index
    2011Volume 29 Pages Toc2-
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
    JOURNAL FREE ACCESS
    Download PDF (692K)
  • Article type: Cover
    2011Volume 29 Pages Cover2-
    Published: September 30, 2011
    Released on J-STAGE: February 01, 2018
    JOURNAL FREE ACCESS
    Download PDF (692K)
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