This study had two objectives. First, we examined the possibility of animal infectious diseases being caused by humans, clarifying specific links between anthropogenic changes to freshwater ecosystems and the emergence(or spread) of Koi Herpes Virus disease(KHVD). Second, we considered related ethical problems. We concluded that there is no ethical justification for the KHVD case from a utilitarian perspective. Furthermore, we should endeavor to promote precautionary environmental management to decrease the number and spread of animal(and human) infectious diseases.
In this article, I define spiritual care as the "support of the careseeker's subjective/spiritual life." Spiritual care is provided for people in spiritual crises, where their existing foundational/core beliefs are dysfunctional in their situation. Such people are required to let go of their existing dysfunctional foundational/ core beliefs, and to continue their subjective lives without their foundational/core beliefs until new ones have been developed. The spiritual care should support the careseekers in such process. In this article,"the provision of 'Ba'(space/opportunity) for the careseekers' belief-free inner-exploration/self-expression" is proposed as a definition of the spiritual care. This definition can be described also as "the support of the careseekers' subjective/spiritual lives." This definition coincides with the spiritual care that the author has actually provided in his clinical practice, which means that this definition works in the actual clinical setting. Further, it is also shown that the Clinical Pastoral Education program mainly provided in the United States, which is considered to invite their students to be free from their own beliefs by becoming conscious of their beliefs, is effective as training for the ones to provide such spiritual care. Lastly, it is expounded that the proposed definition has affinity with some of the existing definitions of spiritual care widely known by people in the Japanese medical clinical setting.
In this paper, I argue against a recent movement that advocates the enhancement of human character. It holds that character enhancement is a kind of rational self-manipulation, so there is no ethical wrongness in enhancing our character. It also says that many conventional arguments against enhancement (e.g. by US President's Council on Bioethics) rely on a conservative misunderstanding of the nature of enhancement technology. However, in my view, advocators of enhancement fail to capture the elements of the arguments of opponents of enhancement from three perspectives: (1) richness of life, (2) authenticity, and (3) mastery. First, advocators of enhancement hold that character enhancement does not decrease the richness of our life, but it can increase the possibility of living an enriched life. But their conception of the richness is shallow and very limited. The original concept of richness of our life that is intended by opponents of enhancement is deeper, wider and something that is impossible to put into words. Second, advocators of enhancement hold that it is no use arguing whether a certain character is authentic, because character changes naturally and gradually. So the point is whether one can admit the character as one's own. But the concept of authenticity that is used in the context of character enhancement need not be a literal authenticity, but it is a kind of "thick" concept that includes description and evaluation, and is conventionally defined by community. Third, advocators of enhancement hold that character enhancement is not an instance of the drive for mastery because it is only a rational self-manipulation, so it should be seen as a kind of conduct of self-decision. But character enhancement that includes changing the future self cannot be regarded as a selfdecision.
When we discuss medical technology or its application to healthcare, we often refer to "consensus building." However, we rarely hear this term used in the context of discussions concerning ethics. Consensus alone cannot guarantee ethical behavior, however, and so there is a need to consider possible ways of justifying the application of consensus to ethics, as well as to develop a mode of consensus building that is ethically appropriate. At the outset of this study, I introduce prior Japanese scholarship related to this issue, as a means of prefacing my discussion. Next, I suggest that the narrative method can play a positive role in the consensus building process. More specifically, in the context of a discussion of advanced medical technology, I state that "narrative consensus building" plays an important role. This is due to the fact that we are required to evaluate such advanced medical technologies during the long process through which they come to be accepted within societies. The question of whether these technologies should be accepted cannot be answered only through cost-benefit analysis. Therefore, we need to adopt a narrative mode of thought when pursuing a process of consensus building. Finally, I take up the role of bioethicists in the process of consensus building. First, they can be the facilitators of such discussions. Secondly, they can serve as narrators themselves, producing the narratives that make it possible to imagine a future society within which we have adopted advanced medical technologies.
Viktor von Weizsacker's significance as an originator of "anthropological medicine" and as a critic of medicine oriented solely to the scientific-biological standpoint encourages us in the present critical situation caused in connection with many problems in medical ethics to seek an adequate paradigm of medical ethics in his works. True, he wrote no systematic ethics of anthropological medicine as such. But his 'Euthanasia' and Experiments on Human Beings (1947) was a salient contribution to the foundation of that field, since in it he asserts that the real, though invisible, defendant on the Nuremberg bench was no particular doctor, but the general spirit of scientific-biological medicine, and declares his guiding principle that the solidarity and mutuality of doctor and patient should guide medical practice. Therefore, in this article I intend to describe the origin of the medical ethics inherent in Weizsacker's "Medical Anthropology" (Medizinische Anthropologie) where he formulates the concepts of solidarity and mutuality. First I try to show clearly how he proves, with the help of the principle of solidarity, that there was no "as such justification" for the 'euthanasia' and human experiments Nazi doctors had put into practice, and further how he tested, in every morally doubtful case, whether it complied with the law of mutuality. Secondly I will clarify in what kind of context medical practice must occur under the law of solidarity, if one is taking the law of mutuality seriously in the association between doctor and patient. And thirdly after showing that the concept of "the solidarity of death" tends to reduce various aspects of the personal and social structure of death to an abstract common denominator, I will consider the meaning of Weizsacker's utterance that the order of life is a fusion of "the solidarity of death" and "the mutuality of life."
In this article, I show the significance of Hans Jonas' ethics of responsibility in the situation wherein the ethical problems of technology extend from the present to the future generations. Jonas used his consideration of the problem of bioethics of experiments on a human body as his opportunity to begin his study of ethics in earnest. At the same time, he criticizes the re-definition of death as this enables and promotes the practice of organ transplants from an irreversibly comatose donor. Both human body experiments and the re-definition of death are considered from the viewpoint of the defenseless victim who is sacrificed in the name of medical progress to save lives and conquer disease. Jonas insists on the "-descending order of permissibility-" as a general principle to prevent sacrificing the defenseless victim. According to Jonas' philosophy of life, it is not appropriate to understand the human mind and body as separate entities. Life itself is not lost even if it is assumed that consciousness does not recover if the body lives. Extraction of organs from such a person who is incapable of putting up a defense constitutes a sacrifice of the defenseless victim. Jonas positions future generations as the ultimate victim in "the principle of responsibility" and advocates a new ethic to forbid the act that offers them in a one-sided sacrifice. He reforms ethics from a form that assumes the individual and autonomous subject to a form that considers the relationship between the subject and object of the responsibility. Jonas shows that the fundamental human character, that is, two paradigms of the responsible subject, "parent" and "politician" enables one to make a self-sacrifice through one's identification with his/her problem. The ethics of Hans Jonas is imbued with the idea of prevention of sacrifice of the victim.
Members of the Watchtower Bible and Tract Society, also known as Jehovah's Witnesses, refuse blood transfusions based on their religious principles. In Japan, their refusal has posed challenges since the 1980s. The only court ruling on this matter by the Supreme Court was made in 2001, which ruled that the refusal of blood transfusion based on religious reasons should be respected as a personal right. The Supreme Court apparently chose the words cautiously and addressed exclusively the refusal of blood transfusion based on religious principles, as the Japanese judicial system has a way of judging exclusively the contested issue. Nevertheless, the ruling has mostly been regarded as a celebrated case of recognizing the superiority of an autonomous decision by a patient over other values or obligations. Although typical blood transfusion refusal in an operation planned in advance by competent adult Jehovah's Witnesses has been established since the court ruling, it has been understood in an expansive way without justification. That is, the religiosity of blood transfusion refusal by Jehovah's Witnesses has been ignored for the most part, with their religious refusal understood as merely an autonomous decision or self-determination. I argue against rapid expansive interpretation of the said court decision, citing court rulings and related cases in other countries, especially the United States. In doing so, I show the need to revisit the implications of the religious aspects of refusals in potentially controversial cases.
In Japan, there is little discussion about gamete donation for Assisted Reproductive Technology (ART) amongst the general public. Nevertheless, gamete donors' situations and rights should be considered when the government regulates ART. A report by a committee of the Health, Labour and Welfare Ministry in 2003 made recommendations for the regulation of ART, and also made proposals for the Informed Consent (IC) of gamete donors. A report by The Ethics Committee of the American Society for Reproductive Medicine and a guideline by the New York State Department of Health contribute to the understanding of the protection of donors' autonomy and rights. Through interpreting these documents and other papers, gamete donors' rights of anonymity, remuneration, etc. involve ethical issues concerning the welfare of the resulting children. These rights of gamete donors also affect the relationships among the people concerned including the resulting children. Through discussing the theme of gamete donors' rights and the protection of autonomy in this paper, it became clear that gamete donors should recognize their responsibilities and liabilities in relation to the welfare of the resulting children. The resulting children's welfare should be considered when determining gamete donors' rights and IC in regulating ART and gamete donation in Japan.