Background The purpose of this study is to explore laypersons' attitudes toward the use of archived (existing) materials such as medical records and biological samples and to compare them with the attitudes of physicians who are involved in medical research. Methods Three focus group interviews were conducted, in which seven Japanese male members of the general public, seven female members of the general public and seven physicians participated. Results It was revealed that the lay public expressed diverse attitudes towards the (...) use of archived information and samples without informed consent. Protecting a subject's privacy, maintaining confidentiality, and communicating the outcomes of studies to research subjects were regarded as essential preconditions if researchers were to have access to archived information and samples used for research without the specific informed consent of the subjects who provided the material. Although participating physicians thought that some kind of prior permission from subjects was desirable, they pointed out the difficulties involved in obtaining individual informed consent in each case. Conclusions The present preliminary study indicates that the lay public and medical professionals may have different attitudes towards the use of archived information and samples without specific informed consent. This hypothesis, however, is derived from our focus groups interviews, and requires validation through research using a larger sample. (shrink)

Variation in decision-making about end-of-life care among ethnic groups creates clinical conflicts. In order to understand changes in preferences for end-of-life care among Japanese who immigrate to the United States, we conducted 18 focus groups with 122 participants: 65 English-speaking Japanese Americans, 29 Japanese-speaking Japanese Americans and 28 Japanese living in Japan.Negative feelings toward living in adverse health states and receiving life-sustaining treatment in such states permeated all three groups. Fear of being meiwaku, a physical, psychological or financial caregiving burden (...) on loved ones, was a prominent concern. They preferred to die pokkuri (popping off) before they become end stage or physically frail. All groups preferred group-oriented decision-making with family. Although advance directives were generally accepted, Japanese participants saw written directives as intrusive whereas Japanese Americans viewed them mainly as tools to reduce conflict created by dying person's wishes and a family's kazoku no jo– responsibility to sustain the dying patient. These findings suggest that in the United States Japanese cultural values concerning end-of-life care and decision-making process are largely preserved. (shrink)

ABSTRACT Objectives: the purpose of this study is to explore laypersons’ attitudes towards and experiences of medical research, and to compare them with those of physicians in Japan. Designs and Participants: fourteen Japanese adults from the general public and seven physicians participated in one of three focus interviews. Setting: Osaka, Japan. Results: trust and distrust in the physician by whom the participants were invited to participate in research played a considerable role in their decisions about participation. That the participants felt (...) an obligation to participate was also expressed. The lay participants perceived medical research as something entirely outside of their world. A greater willingness to volunteer for research was expressed if there were direct benefits to themselves or their families. Research methods such as use of placebos, double blinds, and randomisations seemed to cause negative attitudes to medical research. All physicians were convinced of the need for medical research, including double‐blinded randomised control trials, and its significant role in medical progress. Most physicians thought that the greater awareness of the need for medical research in the community and a better understanding of the psychology of potential research participants were necessary and urgent. Conclusions: there is a good possibility that the lay public and medical professionals have sharply different beliefs about and attitudes towards every aspect of medical research. Building up a better and equal patient‐doctor relationship based on trust is a key issue in medical research, and it is mandatory to fill the gap in perception regarding medical research between them through fully informed debates. (shrink)

This volume brings together essays that explore the intersections between Nietzsche and Wittgenstein from various perspectives. While some chapters focus on the philological and biographical connections of Wittgenstein's reading of Nietzsche, others reflect on the ideas that are implicitly shared by the two thinkers. For Nietzsche and Wittgenstein, philosophy is inextricably connected to ethics and the arts and therefore takes a peculiar method that differs from the sciences. Nevertheless, their thinking strives for knowledge and truth by means of discursive text (...) forms, however unconventional they may be. The first group of chapters contextualize explicit references to Nietzsche in Wittgenstein's writings and clarify their philosophical function. In Part II, the contributors take a philosophical problem as their starting point and show how it can be illuminated by comparing or contrasting Wittgensteinian and Nietzschean arguments and methods. Together the chapters trace Nietzsche's influence on Wittgenstein's thought concerning the critique of language, ethics, aesthetics, religion, and philosophical method. Wittgenstein and Nietzsche will be of interest to scholars and advanced students working in the history of philosophy and intellectual history. (shrink)

A system for analyzing concerns of people from Weblog articles is proposed. The system called KANSHIN analyzes concerns of people by collecting Japanese, Chinese, and Korean Weblog articles. Users can find concerns of people in each language. Users can also compare differences of concerns between Japanese, Chinese, and Korean language communities. We describe several analysis results: (1) patterns of social concerns, (2) change of focuses on a problem along with the time, (3) differences of concerns on a problem between Japanese, (...) Chinese, and Korean Weblog sites, and (4) relation between words in Weblog articles and real world natural phenomenon. (shrink)

Le présent essai soutient une position qui s’inscrit dans le courant dit « libertarien » tout en explorant les implications de la politique qui prône un revenu de base et suscite présentement un débat vivace à travers le monde, y compris au Japon. Il existe diverses formes d’éthique libertarienne. Ici, dans la lignée de Nozick, la « propriété de soi » et la clause lockéenne sont reconnus comme deux rouages essentiels de l’argumentation qui conduit à leur ajustement en vue d’une (...) éthique spécifique. Nous examinons comment Nozick défend la « propriété de soi » : son argumentation respecte la séparabilité des personnalités et elle accorde une grande importance à l’élaboration libre par chacun d’un mode de vie lui convenant. Une fois révisées la nature du droit dit « d’appropriation » et de la clause dite « lockéenne », nous réinterprétons cette position centrale des libertariens en considérant la position fondamentale de Nozick comme prenant appui sur une conception égalitariste de la notion de dispositions suffisantes. Les avantages de cette position sont dus non seulement à l’adéquation entre la théorie et un principe de distribution, mais encore à l’image de l’individu doté d’une propriété de soi réaffirmée, dans la vision libertarienne que Nozick déploie. Cette approche fournit les bases de la morale d’une activité libre exercée sur les marchés : ce point est essentiel pour les auteurs libertariens, qui refusent toute aliénation de la propriété privée et toute redistribution. Une version simplifiée du revenu de base une fois définie en l’adaptant à des cadres variés, dont le cadre japonais nous mène à conclure que le revenu de base, quoique séduisant, est partiellement conforme aux thèses libertariennes et qu’une version minimale serait à retenir. (shrink)

OBJECTIVES: Life-sustaining treatment at the end of life gives rise to many ethical problems in Japan. Recent surveys of Japanese physicians suggested that they tend to treat terminally ill patients aggressively. We studied why Japanese physicians were reluctant to withhold or withdraw life-support from terminally ill patients and what affected their decisions. DESIGN AND PARTICIPANTS: A qualitative study design was employed, using a focus group interview with seven physicians, to gain an in-depth understanding of attitudes and rationales in Japan regarding (...) medical care at the end of life. RESULTS: Analysis revealed that physicians and patients' family members usually make decisions about life-sustaining treatment, while the patients' wishes are unavailable or not taken into account. Both physicians and family members tend to consider withholding or withdrawing life-sustaining treatment as abandonment or even killing. The strongest reason to start cardiopulmonary resuscitation- and to continue it until patients' family members arrive-seems to be the family members' desire to be at the bedside at the time of death. All physicians participating in our study regarded advance directives that provide information as to patients' wishes about life-sustaining treatment desirable. All expressed concern, however, that it would be difficult to forego or discontinue life-support based on a patient's advance directive, particularly when the patient's family opposed the directive. CONCLUSION: Our group interview suggested several possible barriers to death with dignity and the appropriate use of advance directives in Japan. Further qualitative and quantitative research in this regard is needed. (shrink)

Replication forks inevitably stall at damaged DNA in every cell cycle. The ability to overcome DNA lesions is an essential feature of the replication machinery. A variety of specialized polymerases have recently been discovered, which enable cells to replicate past various forms of damage by a process termed translesion synthesis. Alternatively, homologous recombination can be used to restart DNA replication across the lesion. Genetic and biochemical studies have shed light on the impact of these two post‐replication repair pathways in bacteria (...) and yeast. In vertebrates, however, a genetic approach to study post‐replication repair has been compromised because many of the genes involved appear to be essential for embryonic development. We have taken advantage of the chicken cell line DT40 to perform a genetic analysis of translesion synthesis and homologous recombination and to characterize genetic interactions between these two pathways in vertebrates. In this article, we aim to summarize our current understanding of post‐replication repair in DT40 in the perspective of bacterial, yeast and mammalian genetics. BioEssays 26:151–158, 2004. © 2004 Wiley Periodicals, Inc. (shrink)

The objective of this study was to reveal the problems related to interpersonal relationships which patients with obstinate diseases face, and consider the behavior, attitude and medical intervention that healthcare and healthcare-related professions should take in regards to these problems. Semi-structured individual interviews were conducted with patients with obstinate neurological diseases and observation of outpatient care was also conducted. Data were analyzed by qualitative content analysis. Patient diseases included Parkinson Disease , Amyotrophic Lateral Sclerosis , myasthenia gravis, spinocerebellar ataxia , (...) and progressive supranuclear palsy . Findings highlighted that patients’ disease and suffering was not understood fully by patients’ families, that patients feel a lack of family support and cooperation, and that society’s level of understanding of their disease was also insufficient. Again, findings revealed that patients recognized their inability to perform personal activities and to behave competently within the contexts of family and society. This lowered their self evaluation. These findings highlight three needs: “the need for empathy,” “the need for self the “the need for empathy” and “the need for self esteem.”This study was supported by a great-in-aid by Ministry of Health, Labor and Welfare in Japan, “Outcomes Research of Specific Diseases”（PI:S.Fukuhara）（Grand no: H14-44）. (shrink)