The basis of this symposium can be broken down into the following five main points: 1) Patient’s autonomy and degree of initiative; 2) Patient’s understanding of medical information and the implications; 3) Interaction between families and patients’ decision–making; 4) Need for change in health care providers and health communication skills; and 5) Thoughts on the development of medical settings and medical systems.

This paper deals with the assistant nurse system in Japan. This has been widely discussed for over 20 years, and has become quite controversial. The group of “nurses” wishes to abolish this system. This paper tries to analyse this argument using the professions’ theory.

Althought modern society is highly professionalized, some groups find it hard to be recognised as profession. Even if the nursing organization which tries to become more professionalized cuts off a less professionalized subgroup (assistant nurse), a new conflict will occur between the more specialized groups and the less specialized ones within the nursing organization. This paper tries to assess the position of the assistant nurse within the increasing specialization of the modern nursing profession.

In this paper, we evaluate R.M. Veatch’s new physician-patient model. The model was first introduced in Veatch’s paper titled “Abandoning Informed Consent” in 1995. The core idea of this model is that the patient chooses the physician which shares the same deep value. The main purpose of establishing this model is to restrain physicians’ paternalism and to respect for the patients’ decision making right more strictliy. This model has weak points. The main is that it costs high. Finally, we present our approach to improve the model.