This study aims to clarify the ethical dilemmas faced by Medical Social Workers (MSW) during rationing of short-term admission for Severe Motor and Intellectual Disabilities (SMID). I participated in this affair for one year as MSW. I show that MSW can fall into an ethical dilemma between＜justice＞and＜care＞through this affair. MSW confront problems aiming at increase of well-being of each client rooted in the human rights and the social justice. The sympathy, which is the core of clinical ethics, is necessary to a client. The basis of sympathy to a client is compassion/Mitleid to vulnerability. MSW will build a relationship to each client on the basis of mutual trust. However, it is hard to make＜care＞compatible with＜justice＞. Then MSW fall into an ethical dilemma. Care conferences and case consideration can inspect the standard of the justice and the individual validity of care. This process contributes to procedure-like justice.

  This study aimed to evaluate the validity and reliability of scales that measure the ethical concerns and problems of nurses. This study was conducted on nurses and collected data using anonymous self-administered questionnaire sheets. Structural equation modeling was used to examine the construct validity, validity of external-aspect based on the relationship with the Hospital Ethical Climate Survey and the convergent validity based on the correlation with the Assessment of Belief Conflict in Relationship-14. To evaluate the reliability, the reliability coefficient omega was calculated. A total of 519 nurses were included, and the construct validity, validity of external-aspect, and convergent validity of the scales could be confirmed. The reliability coefficient omega was 0.902. We describe the measures for resolving the ethical concerns and problems of nurses, including the fostering of a favorable ethical climate and the need to prepare a process for examining the most favorable ethical actions and behaviors.

  Conflicts of interest between mothers and fetuses sometimes manifest in obstetric practice. Bioethics usually involves the issue of artificial abortion. However, if survival of the fetus is the basic premise, from the point of view of the fetus, prolongation of its growth in the womb would typically be seen as more desirable than its expulsion, even if continuation of the pregnancy would endanger the life of the mother. Since there is a general, implicit principle in medicine that the mother’s life is given priority, it is rare for this to be called into question from the medical point of view. However, if the benefit to the mother derives from her preference, then the conflict of interest between the mother and the fetus is difficult for the obstetrician to resolve.

  This research dealt with a nullipara who wanted multiple children but refused cesarean section aimed at saving the life of her first child. We investigated this case from the legal, ethical and women’s studies standpoints to determine whether, in accomodating the mother’s wish to maximize maintenance of her fertility, the medical cargivers could accept the possibility of stillbirth.

  In Japan, outside of the provisions in the Penal Code that define the crime of abortion, there is no law that aggressively protects the fetus. In some states in the United States, there is still doubt regarding forcing someone to undergo treatments, including cesarean section. For medical workers, the risk to a fetus during vaginal birth can be estimated only stochastically, and deciding at what degree of risk cesarean section should be forced on the mother is a difficult technical and ethical problem. Ethically, limiting the point of view to the final number of children might be acceptable from the classical utilitarian perspective, but it is difficult to accept from current utilitarian perspectives, such as rule utilitarianism. On the other hand, adding the women’s studies point of view to the discussion would raise the problem of, “Should a mother have to be sacrificed by undergoing invasive treatments such as cesarean section for her fetus?” This might result in controversy.

  The authors, who work in perinatal care, consider that in the present situation priority must be placed on the mother’s decision. However, that cannot be adequately justified, even at a later time when abortion has become impossible, based only on a perinatal medical staff’s implicit principle that the life of a fetus is inferior to the life of its mother. It will be necessary to also debate the question/principle of whether the value of fetal life should take precendence over the mother’s will.

  This study aimed to clarify nursing college students’ awareness of physical restraints of elderly patients. Data were collected by conducting semi-structured interviews with five first-year and five final-year students. The collected data were analyzed using the KJ Method. The comparison between first- and final-year students revealed similarities in the way they responded to “The present condition requires physical restraint” with “Negative recognition” of physical restraint. Simultaneously, they required “Inventive ideas before applying a physical restraint” and “Alleviation of suffering during physical restraint.” On the other hand, as a unique feature, first-year students have been trying to “Learn from the nurses” and develop an “Ethical attitude while facing patients” to explore the use of physical restraints, though they responded, “I do not know because I have no experience.” However, final-year students have a “Critical view against nurse’s ethics view” because the “Interpretation of physical restraint has individual differences.” They also recognized the necessity of “Final judgment and correspondence by medical team” and “Ethical consideration.”

  In the nursing records of one acute care hospital, Juntendo University Hospital, the Japanese expression “mi-no-okidokoro-ga-nai” is often used to refer to patient-specific-distress at the end of life in the nursing records. It literally means feeling out of place, being so embarrassed one wants to disappear, or having a sense of restlessness. However, medical nurses at J Hospital seem to use this expression when patients have terminal restlessness.

  In this paper, I report from the electronic medical records of patients nursed during their final moments of life at the hospital, and examine the circumstances of “mi-no-okidokoro-ga-nai”. The results show that whenever the nurses judged that the distress symptoms in terminally ill patients was not sufficiently alleviated, this Japanese expression was used to imply that the medical team should quickly diagnose the cause of the pain and expand the range of treatments. In such a context, we consider ways to broaden the treatment range of patients, with consideration of various ethical issues.

  The purpose of this study was to clarify the virtues of an occupational therapist. It is important for occupational therapists to build and continue relationships with clients.

  The author performed a focus group interview at the conference room of a university with author’s office in the beginning of November 2016. Two male and two female occupational therapists, with experience as clinical educators, participated in this focus group interview and held the discussion for approximately 60 minutes. The theme of the interview was “What virtues should occupational therapists have?” The author acted as the moderator for the focus group interview. The author analyzed the recorded interview using qualitative content analysis.

  The author extracted 14 cords from the voice record of the interview. Next, the author extracted 5 subcategories from the cords. Finally, the author extracted 2 categories from the subcategories. One category was one’s own normative attitude as a professional. The other category was building and deepening relationships with clients.

  The author considered that one’s own normative attitude as a professional requires reflection for clinical practice, and building and deepening relationships with clients requires the element of caring.

  Cancer genomic medicine is being installed in Japan. It will not only lead to paradigm shift of cancer chemotherapy, but also raise ethical concerns that include 1) accurate response to secondarily found germ line mutations, 2) dilemma between data sharing and privacy protection, 3) access to new drugs not covered by public insurance, and 4) elimination of information gaps between patients and physicians and among physicians.