The three of clinical study on which I have worked up to now about a decision making to treatment of a patient in emergency medical care and the family, 1. After the back and that by which the family is a decision making for a doctor, it is not discussed, but after the family decides, feeling is shaken, 2. The family is anxious and decides about a surrogate, and by which the decision is heavy responsibility. 3. Though a nurse recognized that the care of a decision making was important, the contents which hold difficulty and discord were not made sufficiently, and became clear. However, it is based on various mental influence by a surrogate decision making, and the new question to which I say “Do a patient and the family wish for participation in a decision making really?” has formed. A Nudge-like decision making is also argued with the relation between decision capability and a stress and also the one of the good deed of a medical person as a new viewpoint to the research question.

Medical sociology is listed in the behavioural and social sciences section of WFME basic medical education curriculum. The MCAT (Medical College Admission Test) in USA has included sociology-related items since 2015. And the GMC undergraduate medical education guideline in UK has incorporated sociology since 2009. In response to these trends, a social science field related health care (mainly medical anthropology/medical sociology) has been added in the latest revision of MEMCC (Medical Education Model Core Curriculum) in Japan. I teach basic knowledge and ideas of health and medical sociology with reference to MEMCC and MCAT at a sociology class. It mainly focuses on liberal arts. In a small class seminar, students and I read English review papers and discuss on practical questions in order to acquire deeper knowledge on some themes of health and medical sociology.

The works of Italian ethnologist Ernesto de Martino (1908–1965) are read among Italian clinicians of mental health working with international migrants. He is well known for having applied the ethnology of Benedetto Croce’s (1866–1952) historicism, in which everything is interpreted according to its relations to historical processes, and having tried to reform the 40’s natural scientific viewpoint of social evolutionary ethnology to innovate Westerners’ selves. His concepts, presented through research on mental conditions of so-called “savages” or subalterns, serve as references for understanding international migrants as “Others” and suggests ways to rethink modern Western psychiatry. By reading de Martino, Italian clinicians may try to provide mental health services based on historicism.

Some diseases remain unclassifiable by standards of modern medicine—these are called rare and undiagnosed diseases (RUD). This paper analyzes proceedings of policy for rare diseases and intractable/rare diseases act to examine present status of public support for rare and undiagnosed diseases in Japan. Based on the analysis, currently there is no legalized support for patients with diseases without a name, and the situation is expected to remain unchanged. Namely, in proceedings of the intractable/rare diseases act it is stated that policy for rare diseases should support RUD patients, however closer analysis of the policy reveals it is impossible to provide support for patients with unnamed diseases. Thus, it is clear no real consideration was given to RUD patients in both documents. Here I aim to point out the most important issues that should be considered in the policy in order to improve it, so it will truly be inclusive of the needs of RUD patients.

This paper aims to consider self-management as one of the medical frameworks of patient understanding, based on the narratives of three chronic depressive patients. As analysis indicates, this paper introduces the concept of “the health-care system” by Arthur Kleinman. The results of analysis show that chronic depressive patients manage to survive by creating more than one place to receive care. It is necessary for medical professionals to recognize self-management in depressive patients as “creating various places to receive care”. Furthermore, it is important for medical professionals to be interested in private sector “health-care systems” which chronic patients create.

This paper describes how an eating disorder patient presents herself while using the expert/lay knowledge properly in an interview. The approach focusing on narratives treats expert/lay knowledge as the same status. It is because the lay knowledge has been seen as being inferior to the expert one by the medical power. However, in the practices of sick narrative or toujisya-kenkyu, people narrate own experiences or position his/her identity using the expert/lay knowledge properly. In other words, before the researcher sets the range of expert/lay knowledge, people do such distinction. This paper focuses on this point and describes how people use the expert/lay knowledge properly in the presenting him/herself. By doing so, this paper has shown a possibility of different understanding from the understanding that the previous research on suppression of experience knowledge by expertise has shown.