As a Christian, I tell my conversion story and my belief. Then I present three case-stories of aged patients who closely face death, and testify to their lifes dynamic power to make life-changing decision. Then I try to explain the Biblical view of Ethics from Romans 12 : 2 as follows : Fundamental structure of Biblical Ethics the will of God. Three points of the will of God. (1) Absolute good and bad which God sets for the blessing of mankind (2) God's situational ethics of love, prayer patience and care (3) God's terminal ethics-hope of perfection in eternity

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Recently we frequently hear the word "informed consent". I give an example for discussing this theme based on clinical experience in Germany. In many institutes, doctors use panphlets for explaining the disease, operative procedure and complication to the patients or families. These panphlets are very useful for explaining and saving time. The patients are supposed to come to the doctor after reading this panphlet for further inquiries. But in comparison to Japan, the time spent for explaining these matter is very short in Germany. In case of heart transplantation, doctors try to explain very minute details about the procedure, preope and postoperative course to the patient or family. I think, the most important thing about informed consent is to explain all the details repeatedly, over and over again, with great eagerness.

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In the area of the medical health care, doctors have many various legal and ethical obligations to help and care for patients, to inform patients of their diseases, to keep the confidence of patients and to report infectious diseases designated by law etc. Therefore doctors face often a conflict of obligations, in which they can not carry out any one of their obligations in a specific situation without the breach of one or more other obligations. In the case of the conflict of obligations, the obligation of comparatively higher value ought to be fulfilled. But in the case of the conflict between obligations0, which are of equal value, cases ought to be classified. In the case of the conflict between obligations of active conduct, which are of equal value, and in the case of the conflict between obligations of omission, which are of equal value, one or other obligations of active conduct or one or other obligations of omission ought to be fulfilled. But in the case of the conflict between obligation of active conduct and omission, which are of equal value, the obligation of omission ought to be fulfilled. For example in the case of the conflict between obligation of active conduct to save the life of one person and obligation of omission not to kill an other person, the obligation of omission not to kill an other person ought to be fulfilled. Therefore there is no obligation to save the life of a person by killing an other person. For the evaluation of the behaviour under the conflict of obligations, there is a need to evaluate, how the obligation was fulfilled, in addition to a comparison of the obligations. To justify a medical operation, there needs firstly to be the informed consent of patients, and secondly the necessity, adequacy, and the highest mildness for the objective of the medical treatment.

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Medical care for terminal cancer patients has been discussed using such vague expressions as terminal care, hospice care and palliative care. The word "terminal care" is frequently used in Japan, This word gives a very passive and negative image to care of the dying, in which the patient's family and medical personnel give psychological and physical care to the patients, who is going to die. In other words, "terminal care" is, in a sense, a metaphor for "anti-ordinary, anti-normal medical care." Contrary to this, a new concept called "palliative care" has appeared recently in cancer therapy. Palliative care is a realistic, medical, sociopsychological and behavioral-science approach which improves the quality of life (QOL) of patients in cancer therapy from the progressive to terminal stage of cancer. The word "Palliative" does not simply mean "alleviation of symptoms, " it also has a broader meaning of "alleviation of holistic problems." Concretely speaking, palliative care aims at (1) prolonging life, (2) relieving the symptoms and (3) placing a high value on the QOL. Hospice care showed independent progress in the past, but it is now considered to have the same meaning as palliative care as a result of the common ground of the concept of the QOL. However, due to the historical background, the word "hospice care" has a more symbolic sound, while "palliative care" indicates actual, concrete medical care. It should be emphasized that palliative care is medical care which places a high value on the QOL of patients and that it consists of academic activities based on the tenets of medical science and social science.

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A systematic-theoretical approach is necessary for teaching bioethical issues, which enables health professionals to cope with various thoughts and value judgements in clinical settings. The authors developed "Matrix of Nursing Ethics" and 8 steps for learning as an educational tool to foster ethical assessment abilities. A case of abortion in the third trimester of pregnancy (28wks5days) with fetal anomaly was analyzed using the matrix and the eight steps.

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This paper addresses the question : "Why should we value our life?", an issue so fundamental and yet to be addressed with clarity. The purpose of this inquiry is to develop a consensus of opinions on a host of complex bio-ethical issues that are emerging today, and thus to facilitate productive reseach activities. It should be noted that the etymological origin of "consensus" is "common sentiments", indicating the human tendency to reject rational and reasonable things if they seem unacceptable from an emotional point of view. Therefore, the fundamental issue, "Why should we value our life?", is investigated by examining the basis of commonly held views on the value of life, as indicated below : 1. the mysterious nature of life. 2. the uniqueness, singularity, and finiteness of life. 3. the interdependence of life systems. 4. the continuity of life. 5. fundamental human right. 6. the concept of humanity as an end in itself. 7. religious instructions. 8. instinct for self-preservation. 9. the wishes and expectations of the social group.

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Contemporary bioethics is primarily concerned with the question : How should we control medical practices by means of social norm like law and morality? This question has become increasingly serious, because, through the rapid progress of life sciences and medical technologies, various kinds of therapeutic procedures have been newly introduced into society and have given a great shock to our traditional view on life and death. These new technologies, highly developed as they are, don't necessarily meet the needs of society. For example, many of them can't provide us preventive measures, but only symptomatic treatments. Many of them are too expensive to be popularized. Some of them require the participation of other people, which causes new ethical difficulties. Hence another important problem for bioethics which will have to be solved by the consideration of social policy : How should we control the future development of medical technologies? Originally the study of both social norm and social policy belongs to social philosophy. So, in my view, making use of concepts, principles, and theories of social philosophy, bioethics as a discipline will be able to elaborate itself.

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In Buddhism there is no institute which establishes ethical code. On brain death and organ transplantation, we find various views in scholars and several doctrines in Buddhist sects, as they stress on special texts among Eighty-four thousand dharma-paryaya (Buddha's teachings). But philosophers or religious people today are, besides being absorbed in idea or dogma, expected to show realistic guiding principle on this problem. In this paper, after consulting the discussions in Japanese Association of Indian and Buddhist Studies (Committee Investigating the Organ-Transplant Problems) and movements in the traditional buddhist denomination, I tried to propose some concrete guide, such as "Ten Commandments for bio-ethics".

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From the ancient times in Japan "care of dying" has been taken into consideration. It is called RINJU-GYOUGI, which means last rites. RINJU-GYOUGI can be said as an idealized correspondence to death between a dying person and the attendant group around him, based on experience. This is not insistent on a strict way of performing the rites but a kind of a mental and active preparation in order to realize wish. It is fundamentally thought in Buddhist last rites that a space of "care of dying" is put by the intimate relatives of the dying person, taken into account that the dying person becomes never alone. Now the perparation is made beforehand and the flow from "care of dying" to the funeral and the successive participation by a group of people who takes "care of dying" had great significance. In that sense Buddhist last rites should not be restricted to the very moment of dying. Dealing with autonomous death is prompted and the will of the dying person is respected, where an aggressive attitude towards death as usual can be seen. Besides, those who are intimate and take "care of dying" never feel distinct bounds until the funeral. The relationship between "care of dying" and a funeral, as well as the view of sickness and the view of corpse, has got more complex structure through and attitude treasuring one's will before one's death and the fact that those who take "care of dying" deal with the dead person.

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Questionnaire was carried out to 46 medical professionals (Medical doctors and nurses) and 52 general adults (businessmen, public servants, etc.) and a comparative study was performed on their attitude and awareness on death and bioethics. Items compared were as follows. 1. Awareness and experiences about death (changes on views on life and death which was caused by close death experience, presence or absence of "strange experience" on death, close people's attitudes toward death). 2. Images toward death (color, associated words). 3. Issues on bioethics (informing one's cancer, brain death-organ transplantation, donating one's organs, cares for dying people and their families, necessity on death education). On this comparative study, differences of attitudes and awareness on bioethics of two groups were discussed, and further discussion was made on present "various issues concerning death".

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The question why all living things die has two aspects. One is to ask the causes of old age and death. The other is to ask the reason why all living things are destined to die. How biologists have historically answered these questions is the theme of my article. In regard to the first aspect of the question, it is useful to distinguish a natural death from a sudden death. Since the days of the ancient Greeks, natural philosophers and biologists have for the most part concentrated the problem of natural death and the process of ageing. Most of them have thought of the ageing process as something which is involved with loss. Aristotle thought the ageing process was a process in which innate heat was lost. Francis Bacon thought it was a process in which the power of repair was diminishing. In regard to the second aspect, the essays written by August Weismann are a very important inquery into the philosophical meaning of death. In his study for the first time death was viewed from the point of view of evolution, a point of view which stressed the positive evolutionary benefits of death as opposed to the old strictly negative view of death. He insisted that there was a big difference between unicellular and multicellular organismus in regard to their multiplication. Unicelluar organismus are potentially immortal and static. On the other hand, through evolution multicellular organismus acquired the process of sexual reproduction and its consequence, dynamic variety. Death is well explained as a secondarily acquired adaptation. Death is to be looked upon as an evolutionary strategy which is advantageous to the species as a concession to the injurious effect of the stressful operation of external forces.

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Legal medicine is a special branch of medicine, aiming to solve many different problems which occur in human social activities extending over medicine and law. It is trying to face and solve the problems concerning human death which is considered as an important, main research theme. Every person, who is engaging in forensic practice, now keenly feels that, in Japan, the public system for the inspection and autopsy of human bodies, of violent or unnatural death or sudden death of which the cause is unknown, by medical examiners is never throughout the country and never sufficient in order to certify human death correctly; including cause, mechanism and manner of death, and so on. From the insufficiency of medical examiner system, such a risk may be brought about as an inappropriate management of criminal or civil cases, which may spoil the honor of the dead and the rights of bereaved family, or may cause an unfairness between different regions in Japan. Although Japanese generally feel some doubt about and try to refuse autopsy of the dead who has lost the possibility of life, the correct and fair death certification and social recognition of the dead is indispensable in order to socially accomplish his life and make it meaningful. This attitude seems to make members of the society think over the meaning of their lives bioethically through the death of another member.

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