インフォームド・コンセント、脳死と臓器移植、生体肝移植、終末医療と尊厳死、体外受精...。これら医療の新しい問題をどう考えたらいいのか。バイオエシックスが生まれ育った北米で二十年を過ごし、日本の医療倫 理の確立のために活躍してきた著者が、患者中心の医療の倫理とは何か、わが国になじむ倫理とは何かを、情熱をこめて語る。.

Crucial problems exist in understanding Japanese traditional customs with regard to autonomous decision making by patients in Japan. These problems are difficult to comprehend because they seem, by western standards, to defy logic. Questions that baffle those outside the Japanese tradition, include: Why do many Japanese patients hesitate to make medical treatment and care decisions for themselves without consulting family, close friends, or someone viewed as being in a superior position? Why do many Japanese physicians fail to disclose the truth (...) directly to the patient, instead customarily conveying information to family members, despite the doctors' awareness of their legal obligation to protect the patient's privacy? Why do many Japanese physicians continue to question whether patients should be told the truth at all? What perpetuates Japan's widespread, but often unnoticed, neglect of the individual's right to self-determination in healthcare decision making? (shrink)

Approximately 30 years ago, a son prepared a cup of milk mixed with insecticide and arranged for his mother to unknowingly administer the poison to his father, who had been suffering severe pain after a cerebral apoplectic attack and demanding that his son assist him. in dying. After drinking the mixture, the father died, and the son was charged with homicide.

The Japanese government took significant steps in making decisions about a newly developing clinical application of gene therapy when, on April 15, 1993, the Government officially accepted the Guidelines for Clinical Research on Gene Therapy submitted by the Health Science Council of the Ministry of Health and Welfare of Japan to the Minister.

A historical investigation of the exclusion of Africa and Asia from modern histories of philosophy.

Is there only one bioethics? Is a global bioethics possible? Or, instead, does one encounter a plurality of bioethical approaches shaped by local cultural and national traditions? Some thirty years ago a field of applied ethics emerged under the rubric `bioethics'. Little thought was given at the time to the possibility that this field bore the imprint of a particular American set of moral commitments. This volume explores the plurality of moral perspectives shaping bioethics. It is inspired by Kazumasa (...) class='Hi'>Hoshino's critical reflections on the differences in moral perspectives separating Japanese and American bioethics. The essays include contributions from Hong Kong, China, Japan, Texas, the United States, Germany, Switzerland, and Italy. The volume offers a rich perspective of the range of approaches to bioethics. It brings into question whether there is unambiguously one ethics for bioethics to apply. (shrink)

Putative counterexamples to the Principle of Identity of Indiscernibles (PII) are notoriously inconclusive. I establish ground rules for debate in this area, offer a new response to such counterexamples for friends of the PII, but then argue that no response is entirely satisfactory. Finally, I undermine some positive arguments for PII.

Mental health research and care in the twenty first century faces a series of conceptual and ethical challenges arising from unprecedented advances in the neurosciences, combined with radical cultural and organisational change. The Oxford Textbook of Philosophy of Psychiatry is aimed at all those responding to these challenges, from professionals in health and social care, managers, lawyers and policy makers; service users, informal carers and others in the voluntary sector; through to philosophers, neuroscientists and clinical researchers. Organised around a series (...) of case studies in five key topic areas - concepts of disorder, the philosophical history of psychopathology, philosophy of science, ethics and philosophical value theory, and philosophy of mind - the book provides a detailed introduction to the field and a framework for study and skill development. Each case study is supported by selected readings from both philosophy and mental health, thinking skills exercises, self-test questions, key learning points and detailed guides to further reading. There is an introduction for philosophers to classification and descriptive psychopathology, and for practitioners to philosophical methods (including logic). The philosophical topics covered include philosophical methods (analytic and Continental); phenomenology, hermeneutics and existentialism, logical empiricism and its successors; idealism and realism; reasons and causes; and modern theories of mind and brain, free will and personal identity. Topics from mental health include psychiatry and 'anti-psychiatry'; Jaspers' psychopathology and the new neurosciences; the future of psychiatric classifications; strengths-based approaches, recovery practice, social inclusion and diversity; and key topics in psychopathology, such as delusion, autism, disorders of volition, thought insertion and other experiences in schizophrenia. The Oxford Textbook of Philosophy of Psychiatry aims to secure the skills-base of the discipline by bringing philosophers closer to the realities of practice in mental health, and mental health practitioners closer to the resources of philosophy as a partner to the sciences in responding to the challenges of twenty-first century mental health and social care. (shrink)

This book is a defense of modal realism; the thesis that our world is but one of a plurality of worlds, and that the individuals that inhabit our world are only a few out of all the inhabitants of all the worlds. Lewis argues that the philosophical utility of modal realism is a good reason for believing that it is true.

This article studies the treatment effect models in which individuals are classified into unobserved groups based on heterogeneous treatment rules. By using a finite mixture approach, we propose a marginal treatment effect framework in which the treatment choice and outcome equations can be heterogeneous across groups. Under the availability of instrumental variables specific to each group, we show that the MTE for each group can be separately identified. On the basis of our identification result, we propose a two-step semiparametric procedure (...) for estimating the group-wise MTE. We illustrate the usefulness of the proposed method with an application to economic returns to college education. (shrink)

Annual and cumulative incidences of HIV + and AIDS in patients reported by the AIDS Surveillance Committee of the Ministry of Health and Welfare are cited to illustrate some characteristics in Japan: nearly 59% of either HIV + or AIDS patients were infected through injection of blood products or by blood transfusion. A number of plaintiffs have sued the Japanese government and pharmaceutical companies since 1989, but no judicial decisions have yet been made. The incidence of HIV decreases for each (...) of the following routes of infection: the second highest route of transmission being heterosexual, followed by bisexual and unconfirmed or unknown cases, and less frequently homosexual, drug use and lastly via vertical transmission. The most serious bioethical problems with HIV + and AIDs patients in Japan is the social segregation of these patients. There are many emotional fears among the general public and medical personnel about AIDS because of their inadequate scientific knowledge of this disease. The Japan Hospital Association is doing The Stop AIDS Campaign and made several surveys. Japan has become increasingly aware of the importance of AIDS education and a great deal of effort is being made to enhance bioethical considerations. (shrink)

Annual and cumulative incidences of HIV+ and AIDS in patients reported by the AIDS Surveillance Committee of the Ministry of Health and Welfare are cited to illustrate some characteristics in Japan: nearly 59% of either HIV+ or AIDS patients were infected through injection of blood products or by blood transfusion. A number of plaintiffs have sued the Japanese government and pharmaceutical companies since 1989, but no judicial decisions have yet been made. The incidence of HIV decreases for each of the (...) following routes of infection: the second highest route of transmission being heterosexual, followed by bisexual and unconfirmed or unknown cases, and less frequently homosexual, drug use and lastly via vertical transmission. The most serious bioethical problems with HIV+ and AIDS patients in Japan is the social segregation of these patients. There are many emotional fears among the general public and medical personnel about AIDS because of their inadequate scientific knowledge of this disease. The Japan Hospital Association is doing The Stop AIDS Campaign and made several surveys. Japan has become increasingly aware of the importance of AIDS education and a great deal of effort is being made to enhance bioethical consideration. (shrink)

Annual and cumulative incidences of HIV + and AIDS in patients reported by the AIDS Surveillance Committee of the Ministry of Health and Welfare are cited to illustrate some characteristics in Japan: nearly 59% of either HIV + or AIDS patients were infected through injection of blood products or by blood transfusion. A number of plaintiffs have sued the Japanese government and pharmaceutical companies since 1989, but no judicial decisions have yet been made. The incidence of HIV decreases for each (...) of the following routes of infection: the second highest route of transmission being heterosexual, followed by bisexual and unconfirmed or unknown cases, and less frequently homosexual, drug use and lastly via vertical transmission. The most serious bioethical problems with HIV + and AIDs patients in Japan is the social segregation of these patients. There are many emotional fears among the general public and medical personnel about AIDS because of their inadequate scientific knowledge of this disease. The Japan Hospital Association is doing The Stop AIDS Campaign and made several surveys. Japan has become increasingly aware of the importance of AIDS education and a great deal of effort is being made to enhance bioethical considerations. (shrink)

How (Not) to Be Secular is what Jamie Smith calls "your hitchhiker's guide to the present" -- it is both a reading guide to Charles Taylor's monumental work A Secular Age and philosophical guidance on how we might learn to live in our times. Taylor's landmark book A Secular Age (2007) provides a monumental, incisive analysis of what it means to live in the post-Christian present -- a pluralist world of competing beliefs and growing unbelief. Jamie Smith's book is a (...) compact field guide to Taylor's insightful study of the secular, making that very significant but daunting work accessible to a wide array of readers. Even more, though, Smith's How (Not) to Be Secular is a practical philosophical guidebook, a kind of how-to manual on how to live in our secular age. It ultimately offers us an adventure in self-understanding and maps out a way to get our bearings in today's secular culture, no matter who "we" are -- whether believers or skeptics, devout or doubting, self-assured or puzzled and confused. This is a book for any thinking person to chew on. (shrink)

Ethical views of the first-year to sixth-year medical students were studied during bioethics education via questionnaire in 2004. Questions included “would you treat a mentally ill man condemned to death to fit him for execution?”, “is a criminal law suit against a surgeon responsible for a patient's death reasonable?” and “should a surgeon responsible for a patient's death be prosecuted for manslaughter.” The number of students answered “yes, to treat a mentally ill man” tended to increase as they moved up (...) to the senior classes, although there was no statistical significance. A criminal law suit against the surgeon and the charge of manslaughter was responded with a wide variety among the classes, that is the second-year and fifth-year students showed less favorable attitudes to the law suit against the surgeon than the first-year, third-year and fourth-year students. There was no distinct relationship with age, gender or the past bioethics education. Thus, the attitudes of medical students agree on one, and differ on other ethical issues depending on their classes. Although the reason for the difference in ethical views among classes was not clear, these results suggested that ethics education was a sensitive subject for medical students hence the manner of ethics education by teachers was of critical importance. (shrink)

Philosophy has much to offer psychiatry, not least regarding ethical issues, but also issues regarding the mind, identity, values, and volition. This has become only more important as we have witnessed the growth and power of the pharmaceutical industry, accompanied by developments in the neurosciences. However, too few practising psychiatrists are familiar with the literature in this area. -/- The Oxford Handbook of Philosophy and Psychiatry offers the most comprehensive reference resource for this area ever published. It assembles challenging and (...) insightful contributions from key philosophers and others to the interactive fields of philosophy and psychiatry. Each contributions is original, stimulating, thorough, and clearly and engagingly written - with no potentially significant philosophical stone left unturned. Broad in scope, the book includes coverage of several areas of philosophy, including philosophy of mind, science, and ethics. For philosophers and psychiatrists, The Oxford Handbook of Philosophy and Psychiatry is a landmark publication in the field - one that will be of value to both students and researchers in this rapidly growing area. (shrink)

How can aesthetic enquiry contribute to the study of visual culture? There seems to be little doubt that aesthetic theory ought to be of interest to the study of visual culture. For one thing, aesthetic vocabulary has far from vanished from contemporary debates on the nature of our visual experiences and its various shapes, a fact especially pertinent where dissatisfaction with vulgar value relativism prevails. Besides, the very question ubiquitous in the debates on visual culture of what is natural and (...) what is acquired in our visual experiences has been a topic in aesthetics at least since the Enlightenment. And last but not least, despite attempts to study visual culture without employing the concept of art, there is no prospect of this central subject of aesthetic theory ebbing away from visual studies. The essays compiled in this volume show a variety of points of intersection and involvement between aesthetics and visual studies; some consider the future of visual art, some the conditions and characteristics of contemporary visual aesthetic experience, while others take on the difficult question of the relation between visual representation and reality. What unites them is their authors' willingness to think about contemporary visual culture in the conceptual frame of aesthetics. This book will be of great interest to students and scholars of philosophical aesthetics, art history, and cultural studies. (shrink)