This symposium on the relation of medical sociology to publich health was an attempt to generate a new framework of the public health in Japan, comparing the existing public health as a part of medical science to the public health as an interdisciplinary science. We set forth several questions to facilitate discussions in the symposium. 1) What are the historical and cultural factors that the public health science in Japan has been developed as a part of the medical science but an interdisciplinary science? 2) Which direction will the public health in Japan be facing toward after the amendments of the rural public health system and the law? 3) If the Japanese public health science would develop as an interdisciplinary science in the near future, which sciences in social sciences and sciences of humanities should we expect to take significant roles? 4) Should we consider more seriously about the extent of the authority of medical doctors in public health? 5) We need to identify and examine the difference between the public health as a part of the medical science like in Japan and the public health as an interdisciplinary science such as in USA. Concerning to these propositions, the opinions and idea of both sides were presented in the symposium.
In this paper, we review the reform of the National Health Service and its evaluation; we also examine the purpose of the reform from the viewpoint of the "Patient First". According to the White Paper "Working for Patients" and some other papers, the status of the General Physicians and the Patients has been improved compared with the one before the reform. As a result of the NHS reform, the gap of the health has been widened among the socioeconomic groups and the aged of both sexes. In the future, this kind of reform and the activity will be widely accepted in Japan with the efforts of the specialists in this field. We will also be able to expect not a small contribution to a reform from the families of the patients, supported by the help of the municipalities, who spare no effort to make their situation better. In order to promote these mission programs for the people, we cannot ignore the most important three process: to set up a health personnel system, to set up medical facilities, and to set up an evaluation planning. The real purpose is to improve the health of many people, not just to promote the implementation program itself. We should make efforts to improve the level of the health section among the other sectors of the local government. Everyone should also be given a greater opportunity to take part in the process of planning based on the concept of the "Informed Choice" and the "Patient First".
Modern/Postmodern scheme is significant in making us conscious that our age and our society is only one of those which can exist. But at the same time, this scheme has made us stop thinking further. We should think what system we choose and why we choose it and how we can make it.
Medicine is said to have been in a state of great transition these days. In what sense and to what degree is this statement valid? Referring the concept of "modern medicine" and the debates concerning "modernity-postmodernity", this paper try to explicate the present state of medicine.
The purpose of this paper is to describe interaction process of 13 demented elders and their family caregivers that use home help service, from the viewpoint of social construction of "The Demented Elderly" and "The Family". As the method, I adopted the non directive (in-depth) interview method centering around the retrospective questions, analyzed family caregivers' "care stories". This qualitative study examine (1) how interaction process of the aged with dementia and their family caregivers transform, (2) how family caregivers interpret their dementing family members and own situation with meaning.
The delivery processes has undergone extensive modification over the past three decades. In particular, the place of delivery changed from home to hospital. So, medical doctor and staffs tend to follow their own convenience in some medical treatments and positions of delivery, and as a result, they limit the delivering women's choices and the expression of their own wills. Although the woman may suspect their instincts are natural, they may also suspect their instincts are not normal. We will argue the meaning of the natural child birth. This paper examines the significance of the decision-making process for delivering women. Furthemore, we analyze historical midwifery, and compare it with medical delivery since a midwife helps in the delivery and care of a pregnant woman.
The social movement of nursing professionalizaion has been related to the criticism of modern curing-centered medicine and has demanded the medicine of "for patients" caring. However the relationship between both of the suggestions has been not so clear. In this paper, I try to make it clear from the research of B hospital where the nurses have improved nursing duties since about 8 years ago. The 'medicine' in B hospital is called as 'patient-centered medicine' and the purpose of it is that patients control their health by themselves. Then the nurses in B hospital have regarded their duties as accomplishment of the patients' 'independent life' with patients themselves.
This paper examines and criticizes medicalization theories with particular attention to P. Conrad's work. Medicalization theories are devided into two groups- critical and descriptive theories. Conrad's theory includes elements of both perspectives. Medicalization theories have a tacit assumption, namely, the [medical/non-medical] dualism. This dualism is not always relevant when people encounter medical affairs. According to Conrad's own research of 'compliance', epilespy patients decide whether or not they should comply to doctors' prescriptions in terms of their efficiency-'a ticket to normality'. People who do comply do not have the assumption of the [medical/non-medical] dualism. Therefore medicalization theories which assume the dualism fail to describe a variety of medical activities.