Semantic studies on diagrammatic notations (Barwise & Etchemendy, ; Shimojima, ; Stenning & Lemon, ) have revealed that the “non-deductive,” “emergent,” or “perceptual” effects of diagrams (Chandrasekaran, Kurup, Banerjee, Josephson, & Winkler, ; Kulpa, ; Larkin & Simon, ; Lindsay, ) are all rooted in the exploitation of spatial constraints on graphical structures. Thus, theoretically, this process is a key factor in inference with diagrams, explaining the frequently observed reduction of inferential load. The purpose of this study was to (...) examine the empirical basis for this theoretical suggestion, focusing on the reality of the constraint-exploitation strategy in actual practices of diagrammatic reasoning. Eye movements were recorded while participants used simple position diagrams to solve three- or four-term transitive inference problems. Our experiments revealed that the participants could exploit spatial constraints on graphical structures even when (a) they were not in the position of actually manipulating diagrams, (b) the semantic rule for the provided diagrams did not match their preferences, and (c) the constraint-exploitation strategy invited a partly adverse effect. These findings indicate that the hypothesized process is in fact robust, with the potential to broadly account for the inferential advantage of diagrams. (shrink)
As of 2009, the number of donors in Japan is the lowest among developed countries. On July 13, 2009, Japan's Organ Transplant Law was revised for the first time in 12 years. The revised and old laws differ greatly on four primary points: the definition of death, age requirements for donors, requirements for brain-death determination and organ extraction, and the appropriateness of priority transplants for relatives.In the four months of deliberations in the National Diet before the new law was established, (...) various arguments regarding brain death and organ transplantation were offered. An amazing variety of opinions continue to be offered, even after more than 40 years have elapsed since the first heart organ transplant in Japan. Some are of the opinion that with the passage of the revised law, Japan will finally become capable of performing transplants according to global standards. Contrarily, there are assertions that organ transplants from brain-dead donors are unacceptable because they result in organs being taken from living human beings.Considering the current conditions, we will organize and introduce the arguments for and against organ transplants from brain-dead donors in contemporary Japan. Subsequently, we will discuss the primary arguments against organ transplants from brain-dead donors from the perspective of contemporary Japanese views on life and death. After introducing the recent view that brain death should not be regarded as equivalent to the death of a human being, we would like to probe the deeply-rooted views on life and death upon which it is based. (shrink)
A placebo is a substance or intervention believed to be inactive, but is administered by the healthcare professional as if it was an active medication. Unlike standard treatments, clinical use of placebo usually involves deception and is therefore ethically problematic. Our attitudes toward the clinical use of placebo, which inevitably includes deception or withholding information, have a tremendous effect on our practice regarding truth-telling and informed consent. A casual attitude towards it weakens the current practice based on shared decision-making and (...) mutual trust between patients and healthcare professionals. Issues concerning the clinical use of placebo are thus intimately related to patient-provider relationships, the public's trust in medicine, and medical education. A review of recent survey studies suggests that the clinical use of placebo appears to be fairly well accepted among healthcare professionals and is common in clinical settings in various countries. However, we think that an ethical discussion is urgently needed because of its controversial nature. If judged to be ethically wrong, the practice should end. In the present paper, we discuss the ethicality of the clinical use of placebo with deception and argue against it, concluding that it is unethical and should be banned. We will show that most arguments in favor of the clinical use of placebo can be refuted and are therefore incorrect or weak. These arguments will be presented and examined individually. Finally, we will briefly consider issues relevant to the clinical use of placebo without deception. (shrink)
BackgroundThe current debate about medical futility is mostly driven by theoretical and personal perspectives and there is a lack of empirical data to document experts and public attitudes towards medical futility.MethodsTo examine the attitudes of the Japanese experts in the fields relevant to medical futility a questionnaire survey was conducted among the members of the Japan Association for Bioethics. A total number of 108 questionnaires returned filled in, giving a response rate of 50.9%. Among the respondents 62% were healthcare professionals (...) (HCPs) and 37% were non-healthcare professionals (Non-HCPs).ResultsThe majority of respondents (67.6 %) believed that a physician's refusal to provide or continue a treatment on the ground of futility judgment could never be morally justified but 22.2% approved such refusal with conditions. In the case of physiologically futile care, three-quarters believed that a physician should inform the patient/family of his futility judgment and it would be the patient who could decide what should be done next, based on his/her value judgment. However more than 10% said that a physician should ask about a patient's value and goals, but the final decision was left to the doctor not the patient. There was no statistically significant difference between HCPs and Non-HCPs (p = 0.676). Of respondents 67.6% believed that practical guidelines set up by the health authority would be helpful in futility judgment.ConclusionThe results show that there is no support for the physicians' unilateral decision- making on futile care. This survey highlights medical futility as an emerging issue in Japanese healthcare and emphasizes on the need for public discussion and policy development. (shrink)
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)
BackgroundA baby hatch called the “Stork’s Cradle” has been in place at Jikei Hospital in Kumamoto City, Japan, since May 10, 2007. Babyklappes were first established in Germany in 2000, and there are currently more than 90 locations. Attitudes regarding baby hatches are divided in Japan and neither opinions for nor against baby hatches have thus far been overwhelming. To consider the appropriateness of baby hatches, we present and examine the validity of each major objection to establishing baby hatches.DiscussionThere are (...) various objections to baby hatches as follows: It violates a child’s right to know the identity of his or her biological parents by allowing anonymous birth; it neglects fulfillment of the biological parents’ basic obligation to raise their child and its very availability induces abandonment of infants; some people abuse it for very selfish reasons; it cannot save babies’ lives; the rights of one parent can be ignored if the other surrenders a child without his or her consent; it puts a baby in medical jeopardy; and it has no clear legal basis. The authors would argue that there are many plausible refutations for each objection mainly based on priority of child’s right to life, pregnant women’s vulnerability and necessity of anonymity, social responsibility to protect and raise children, differences between dropping a child off at a baby hatch and child neglect, limited function of social childcare center, inevitability of abuse by a minority of people, necessary distinction between outcomes that occur only because baby hatches exist and those that occur regardless of their existence, important local direct and upmost measures for women in trouble, and difference between ambiguous legality and illegality.SummaryWe argue that a certain number of baby hatches should continue to be established as a last resort, in a form that can maintain anonymity if the parent dropping the child off so desires. It should be supported if it is initiated with good intentions; if the maximum possible effort is made at said facility to protect the interests, rights, and safety of the child; and if no clear evidence of harm exists. (shrink)
Background Evidence concerning how Japanese physicians think and behave in specific clinical situations that involve withholding or withdrawal of medical interventions for end-of-life or frail elderly patients is yet insufficient. Methods To analyze decisions and actions concerning the withholding/withdrawal of life-support care by Japanese physicians, we conducted cross-sectional web-based internet survey presenting three scenarios involving an elderly comatose patient following a severe stroke. Volunteer physicians were recruited for the survey through mailing lists and medical journals. The respondents answered questions concerning (...) attitudes and behaviors regarding decision-making for the withholding/withdrawal of life-support care, namely, the initiation/withdrawal of tube feeding and respirator attachment. Results Of the 304 responses analyzed, a majority felt that tube feeding should be initiated in these scenarios. Only 18% felt that a respirator should be attached when the patient had severe pneumonia and respiratory failure. Over half the respondents felt that tube feeding should not be withdrawn when the coma extended beyond 6 months. Only 11% responded that they actually withdrew tube feeding. Half the respondents perceived tube feeding in such a patient as a "life-sustaining treatment," whereas the other half disagreed. Physicians seeking clinical ethics consultation supported the withdrawal of tube feeding (OR, 6.4; 95% CI, 2.5–16.3; P < 0.001). Conclusion Physicians tend to harbor greater negative attitudes toward the withdrawal of life-support care than its withholding. On the other hand, they favor withholding invasive life-sustaining treatments such as the attachment of a respirator over less invasive and long-term treatments such as tube feeding. Discrepancies were demonstrated between attitudes and actual behaviors. Physicians may need systematic support for appropriate decision-making for end-of-life care. (shrink)
Recent social theory has identified various institutional forces operating at a global level promoting novel trends towards “individualization”, “reflexive self-identity” and “new individualism” (Beck and Beck-Gernsheim, 2001; Giddens, 1991, 1992; Elliott and Lemert, 2009, 2009a). This article develops an exploratory overview of the theory of new individualism with reference to Japanese sociologies of self specifically and contemporary Japanese society more generally. Detailing the large-scale societal shift in Japan from traditional forms of identity-construction (based on a citizenship model of social order) (...) to post-traditional forms of identity-construction (promoted by globalization and neoliberal policies), the article distinguishes between four discourses of the self in post-war Japanese society: the age of the ideal; the age of the dream; the age of fiction; and, the age of fragmentation. Moreover, the article examines the Japanese employment system and the emergence of new individualist employment, as well as considering the emotional impacts of a rise in suicides in contemporary Japan. The argument is that the new individualist thesis can contribute to a sociological understanding of recent social transformations in Japan. However, situating new individualism in the context of Japan also highlights significant tensions in processes of new individualism, tensions between individual initiatives and institutional pressures. (shrink)
We investigate the effect of radiation reaction on the motion of a wave packet of a charged scalar particle linearly accelerated in quantum electrodynamics (QED). We give the details of the calculations for the case where the particle is accelerated by a static potential that were outlined in Higuchi and Martin Phys. Rev. D 70 (2004) 081701(R) and present similar results in the case of a time-dependent but space-independent potential. In particular, we calculate the expectation value of the position of (...) the charged particle after the acceleration, to first-order in the fine structure constant in the ℏ→ 0 limit, and find that the change in the expectation value of the position (the position shift) due to radiation reaction agrees exactly with the result obtained using the Lorentz-Dirac force in classical electrodynamics for both potentials. (shrink)
Objective—To demonstrate Japanese doctors' and nurses' attitudes towards and practices of voluntary euthanasia (VE) and to compare their attitudes and practices in this regard. Design—Postal survey, conducted between October and December 1999, using a self-administered questionnaire.Participants—All doctor members and nurse members of the Japanese Association of Palliative Medicine.Main outcome measure—Doctors' and nurses' attitude towards and practices of VE.Results—We received 366 completed questionnaires from 642 doctors surveyed (response rate, 58%) and 145 from 217 nurses surveyed (68%). A total of 54% (95% (...) confidence interval (CI): 49-59) of the responding doctors and 53% (CI: 45-61) of the responding nurses had been asked by patients to hasten death, of whom 5% (CI: 2-8) of the former and none of the latter had taken active steps to bring about death. Although 88% (CI: 83-92) of the doctors and 85% (CI: 77-93) of the nurses answered that a patient's request to hasten death can sometimes be rational, only 33% (CI: 28-38) and 23% (CI: 16-30) respectively regarded VE as ethically right and 22% (CI: 18-36) and 15% (CI: 8-20) respectively would practise VE if it were legal. Logistic regression model analysis showed that the respondents' profession was not a statistically independent factor predicting his or her response to any question regarding attitudes towards VE. Conclusions—A minority of responding doctors and nurses thought VE was ethically or legally acceptable. There seems no significant difference in attitudes towards VE between the doctors and nurses. However, only doctors had practised VE. (shrink)
We provide necessary and sufficient conditions for a dynamically consistent agent always to prefer more informative signals (in single-agent problems). These conditions do not imply recursivity, reduction or independence. We provide a simple definition of dynamically consistent behavior, and we discuss whether an intrinsic information lover (say, an anxious person) is likely to be dynamically consistent.
Back groundEmpirical surveys about medical futility are scarce relative to its theoretical assumptions. We aimed to evaluate the difference of attitudes between laypeople and physicians towards the issue.MethodsA questionnaire survey was designed. Japanese laypeople (via Internet) and physicians with various specialties (via paper-and-pencil questionnaire) were asked about whether they would provide potentially futile treatments for end-of-life patients in vignettes, important factors for judging a certain treatment futile, and threshold of quantitative futility which reflects the numerical probability that an act will (...) produce the desired physiological effect. Also, the physicians were asked about their practical frequency and important reasons for futile treatments.Results1134 laypeople and 401 (80%) physicians responded. In all vignettes, the laypeople were more affirmative in providing treatments in question significantly. As the factors for judging futility, medical information and quality of life (QOL) of the patient were rather stressed by the physicians. Treatment wish of the family of the patient and psychological impact on patient side due to the treatment were rather stressed by laypeople. There were wide variations in the threshold of judging quantitative futility in both groups. 88.3% of the physicians had practical experience of providing futile treatment. Important reasons for it were communication problem with patient side and lack of systems regarding futility or foregoing such treatment.ConclusionLaypeople are more supportive of providing potentially futile treatments than physicians. The difference is explained by the importance of medical information, the patient family’s influence to decision-making and QOL of the patient. The threshold of qualitative futility is suggested to be arbitrary. (shrink)
The effect of transition metal solutes on the lattice parameters of ?-TiAl and α2-Ti3Al were studied by first principles calculations to find suitable elements for controlling the α2/? interfacial misfit in lamellar Ti?Al alloys. Better agreement was found between the calculated and experimental phase and site preferences of impurity atoms than in a previous first principles study. The calculated lattice parameters suggest that elements in groups 6?11 of the 4th period (Cr, Mn, Fe, Co, Ni and Cu) are effective for (...) increasing the misfit, leading to increasing density of misfit dislocation and, in turn, higher yield strength and ductility. This effect is caused by the change in the lattice parameter of the ?-TiAl phase rather than those of α2-Ti3Al phase. This prediction agrees qualitatively with experimental data from a previous study although the effects of temperature are not taken into account. Further improvements should be possible by considering those effects. Nevertheless, the results highlight the effects of impurity addition on interfacial misfit at a level which cannot be achieved by classical concepts such as atomic size in a hard sphere model. The results will also be valuable in further more quantitative predictions and in understanding the effects of temperature, including off-stoichiometry, thermal expansion and vibration entropy. (shrink)
Eye contact plays a critical role in many aspects of face processing, including the processing of smiles. We propose that this is achieved by a subcortical route, which is activated by eye contact and modulates the cortical areas involve in social cognition, including the processing of facial expression. This mechanism could be impaired in individuals with autism spectrum disorders.
The export of arms belongs to the most contested issues in democracies. In this article, we examine the economic repercussions of the recent easing of the Japanese arms exports restrictions. We develop a rational expectations argument to understand why some political events increase the income of the arms manufacturers, while other ones reduce it or have no effect at all. Event studies suggest that investors closely observe relevant political developments since stock prices of the six arms manufacturers companies reacted consistently (...) to the announcements and leaks as to whether the arms export restrictions would be lifted or not. (shrink)
The present paper studies self-awareness and introduces some self-awareness related incidents. It then describes the relationship between self-awareness and consciousness and explains the MoNAD, a neural network circuit developed by the authors that capably describes the phenomena of self-awareness and consciousness. A model of self-awareness is then presented. This self-awareness model is a parallel network system in which multiple independent MoNADs communicate with one another. In experiments with robots, three test robots were used: (1) a self-image robot reflected in a (...) mirror, (2) another robot, and (3) a cable-connected robot behaving as commanded by the self-robot. The reactions of the three test robots to the self-robot were compared to investigate the self-awareness of the self-robot. The experiments have shown that the conditions required for the self-robot to interpret the test robot to be part of itself are: (1) the test robot must return a reaction within a certain period of time that is inte.. (shrink)