This paper examines the ethical aspects of organ transplant surgery in which a donor heart is transplanted from a first recipient, following determination of death by neurologic criteria, to a second recipient. Retransplantation in this sense differs from that in which one recipient undergoes repeat heart transplantation of a newly donated organ, and is thus referred to here as “reuse cardiac organ transplantation.” Medical, legal, and ethical analysis, with a main focus on ethical analysis. From the medical perspective, it is (...) critical to ensure the quality and safety of reused organs, but we lack sufficient empirical data pertaining to medical risk. From the legal perspective, a comparative examination of laws in the United States and Japan affirms no illegality, but legal scholars disagree on the appropriate analysis of the issues, including whether or not property rights apply to transplanted organs. Ethical arguments supporting the reuse of organs include the analogous nature of donation to gifts, the value of donations as inheritance property, and the public property theory as it pertains to organs. Meanwhile, ethical arguments such as those that address organ recycling and identity issues challenge organ reuse. We conclude that organ reuse is not only ethically permissible, but even ethically desirable. Furthermore, we suggest changes to be implemented in the informed consent process prior to organ transplantation. The organ transplant community worldwide should engage in wider and deeper discussions, in hopes that such efforts will lead to the timely preparation of guidelines to implement reuse cardiac organ transplantation as well as reuse transplantation of other organs such as kidney and liver. (shrink)

Interventions performed on a pregnant woman's body can affect the fetus in multiple ways. Such effects can be harmful to beneficial to the fetus. Unfortunately, the effects of new drugs and compoun...

In their comprehensive review article, De Bie et al., using some references, discreetly point out that pregnant women’s decision in Domain III to undergo fetal extraction via C-section should conti...

BackgroundWhether and how to disclose genomic findings obtained in the course of genomic clinical practice and medical research has been a controversial global bioethical issue over the past two decades. Although several recommendations and judgment tools for the disclosure of genomic findings have been proposed, none are sufficiently systematic or inclusive or even consistent with each other. In order to approach the disclosure/non-disclosure practice in an ethical manner, optimal and easy-to-use tools for supporting the judgment of physicians/researchers in genomic medicine (...) are necessary.MethodsThe bioethics literature on this topic was analyzed to parse and deconstruct the somewhat overlapping and therefore ill-defined key concepts of genomic findings, such as incidental, primary, secondary, and other findings. Based on the deconstruction and conceptual analyses of these findings, we then defined key parameters from which to identify the strength of duty to disclose (SDD) for a genomic finding. These analyses were then applied to develop a framework with the SDD matrix and systematic decision-making pathways for the disclosure of genomic findings.ResultsThe following six major parameters (axes), along with sub-axes, were identified: Axis 1 (settings and institutions where findings emerge); Axis 2 (presence or absence of intention and anticipatability in discovery); Axis 3 (maximal actionability at the time of discovery); Axis 4 (net medical importance); Axis 5 (expertise of treating physician/researcher); and Axis 6 (preferences of individual patients/research subjects for disclosure). For Axes 1 to 4, a colored SDD matrix for genomic findings was developed in which levels of obligation for disclosing a finding can be categorized. For Axes 5 and 6, systematic decision-making pathways were developed via the SDD matrix.ConclusionWe analyzed the SDD of genomic findings and developed subsequent systematic decision-making pathways of whether and how to disclose genomic findings to patients/research subjects and their relatives in an ethical manner. Our comprehensive framework may help physicians and researchers in genomic medicine make consistent ethical judgments regarding the disclosure of genomic findings. (shrink)

In this article, we perform a thought experiment about living donor kidney transplantation. If a living kidney donor becomes in need of renal replacement treatment due to dysfunction of the remaining kidney after donation, can the donor ask the recipient to give back the kidney that had been donated? We call this problem organ restitution and discussed it from the ethical viewpoint. Living organ transplantation is a kind of ‘designated donation’ and subsequently has a contract-like character. First, assuming a case (...) in which original donor wishes the return of the organ which had been transplanted into B, and the original recipient agrees, organ restitution will be permissible based on contract-like agreement. However, careful and detailed consideration is necessary to determine whether this leaves no room to question the authenticity of B’s consent. Second, if B offers to give back the organ to A, then B’s act is a supererogatory act, and is praiseworthy and meritorious. Such an offer is a matter of virtue, not obligation. Third, if A wishes B to return the organ, but B does not wish/allow this to happen, it is likely difficult to justify returning the organ to A by violating B’s right to bodily integrity. But B’s refusal to return the donated organ cannot be deemed praiseworthy, because B forgets the great kindness once received from A. Rather than calling this an obligation, we encourage B to consider such virtuous conduct. (shrink)

BackgroundSolitary death (kodokushi) has recently become recognized as a social issue in Japan. The social isolation of older people leads to death without dignity. With the outbreak of COVID-19, efforts to eliminate solitary death need to be adjusted in line with changes in lifestyle and accompanying changes in social structure. Health monitoring services that utilize wearable devices may contribute to this end. Our goals are to outline how wearable devices might be used to (1) detect emergency situations involving solitary older (...) people and swiftly connect them with medical treatment, to (2) reduce the frequency of deaths that remain undiscovered and (3) to reduce social isolation by promoting social interaction. MethodsTheoretical and philosophical approaches were adopted to examine ethical issues surrounding the application of wearable devices and cloud-based information processing systems to prevent solitary death in the world with/after COVID-19.Main body(1) Technology cannot replace social connections; without social support necessary to foster understanding of the benefits of health management through wearable devices among older adults, such devices may remain unused, or not used properly. (2) Maturity of the technology; systems face the difficult task of detecting and responding to a wide range of health conditions and life-threatening events in time to avert avoidable morbidity and mortality. (3) Autonomy and personhood; promoting the voluntary use of wearable devices that are a part of larger efforts to connect isolated individuals to a community or social services might be effective. Legal force should be avoided if possible. There is some concern that landlords may require an older person to sign a contract agreeing to wear a device. The autonomy of solitary older people should be respected. (4) Governance: policies must be developed to limit access to data from wearables and the purposes for which data can be used.ConclusionIf thoughtfully deployed under proper policy constraints, wearable devices offer a way to connect solitary older people to health services and could reduce cases of solitary death while respecting the personhood of the user. (shrink)

Death in the life of the samurai -- An introduction to Yamamoto Tunetomo's Hagakure -- The Hagakure -- A leisurely chat in the evening shadows -- A samurai must devote his heart firmly to bushidō -- Hardship is a beneficial experience -- There is nothing as deep as giri -- Close your eyes and think of your lord -- Death is a punishment not meted out lightly -- Even if it contains poison, what's the big deal? -- Naritomi Hyōgo's (...) words about achieving victory -- The quarrel (kenka) of Araki Kuzaemon -- You are weaker than you look -- "Victory or defeat is a trivial matter" -- Military strategies. (shrink)

Death in the life of the samurai -- An introduction to Yamamoto Tunetomo's Hagakure -- The Hagakure -- A leisurely chat in the evening shadows -- A samurai must devote his heart firmly to bushidō -- Hardship is a beneficial experience -- There is nothing as deep as giri -- Close your eyes and think of your lord -- Death is a punishment not meted out lightly -- Even if it contains poison, what's the big deal? -- Naritomi Hyōgo's (...) words about achieving victory -- The quarrel (kenka) of Araki Kuzaemon -- You are weaker than you look -- "Victory or defeat is a trivial matter" -- Military strategies. (shrink)

The definitive translation of the seminal treatise on the code of the samurai. Living and dying with bravery and honor is at the heart of Hagakure, a series of over 1,300 short texts written by eighteenth-century samurai Yamamoto Tsunetomo. These texts illuminate the classic Japanese concept of bushido (the Way of the Warrior), which dictated how samurai were expected to behave, conduct themselves, live, and die. Acclaimed translator William Scott Wilson has selected and translated here three hundred of those (...) texts to create an accessible distillation of this guide, making it one of the most thorough and astonishing windows into the captivating world of the samurai available. This edition includes an introduction that delves into the Zen concept of muga, or “death” of the ego, giving an in-depth historical and philosophical background for the more metaphorical reading of Hagakure that is based on Tsunetomo’s reference to bushido as “the Way of death.” Through this lens, which has held a morbid fascination for readers through the years, the classic takes on a fresh and nuanced appeal. This book was previously published under the title Hagakure. This book is part of the Shambhala Pocket Library series. The Shambhala Pocket Library is a collection of short, portable teachings from notable figures across religious traditions and classic texts. The covers in this series are rendered by Colorado artist Robert Spellman. The books in this collection distill the wisdom and heart of the work Shambhala Publications has published over 50 years into a compact format that is collectible, reader-friendly, and applicable to everyday life. (shrink)

国家への関心と憂戚から「国家理性」の正体を明らかにする。多くの具体的事象を元にさまざまな国難に処してきた過去の日本人のこころに迫る。比較文化の視点から後世に誇れる日本の精神文化を鋭く分析。.

1. Tetsugaku jiban no ten'i : hi bunri jutsugosei basho hi jiko --.

The Hagakure is one of the most influential of all Japanese texts--written nearly 300 years ago by Tsunetomo Yamamoto to summarize the very essence of the Japanese Samurai bushido ("warrior") spirit. Its influence has been felt throughout the world and yet its existence is scarcely known to many Westerners. This is the first translation to include the complete first two books of the Hagakure and the most reliable and authentic passages contained within the third book; all other English translations (...) published previously have been extremely fragmentary and incomplete. The principal pillars of Bushido are loyalty, filial piety, bravery and mercy. Yamamoto lived his life based on these principles and was willing to sacrifice his own life to bring them to ultimate fruition once his lord died. However, Shogunate law forbade Samurai retainers from taking their lives after their liege and master died, so Yamamoto became a monk instead--spending the last years of life in seclusion recording his wisdom and insights in the Hagakure for the edification and training of future Samurai warriors in the essence of bushido. Alex Bennett's completely new and highly readable translation of this essential work is the only full version of the Hagakure published to date. Its extensive footnotes fill in many cultural and historical gaps found in previous translations. This unique combination of readability and scholarship gives Bennett's translation a distinct advantage over all other English editions of this work. Reading this compendium of tales of a faithful and devoted samurai provides a unique insight into the nature of samurai service and its role in Japanese history and society until today. (shrink)

武士道とは何か。武士はいかに生き、死すべきなのか―。戦乱の世が生み出した軍学書『甲陽軍鑑』『五輪書』から、泰平の時代の倫理書『山鹿語類』『葉隠』へ。そして、幕末維新期の吉田松陰、西郷隆盛へと連なるサム ライの思想水脈を経て、武士道を世界に知らしめた新渡戸稲造まで。日本人必読の名著12冊で知る、高潔にして強靱な武士の倫理と美学。章末には、各書から選りすぐった人生指南の「名言」を付す。.

「人と天地との一体化」とは何か。儒学の「天人合一」説を独自の立論を通して再定義した伊藤仁斎の思想に焦点を当て、その思想的意義を問い直す。仁斎学の思想体系を平易明白に解説した入門書。.

近代仏教の確立者と称される清沢満之の思想を解明するだけでなく、その思想が夏目漱石、正岡子規などをはじめとする同時代の人々や、後世の社会に与えた影響にも着目することで、今後の清沢研究にまったく新しい視座 を提供する刺激的な入門書!

明治期に、はじめて宗教的伝統に基づく他力の発想と西洋から学んだ論理とを結びつけて語ることを試みた清沢満之。これまで清沢が残した思想を高く評価する人物は何度か現れたものの、いまだ忘れられた宗教人・哲学者 である。夏目漱石や正岡子規らとの関係、そして西田幾多郎ら京都学派に与えた影響を辿り、彼の思想が日本思想史に残した大きな影響とその可能性に光を当てる。.

明治の近代化のなかで、日本人が初めて海外に向けて、自国の文化の全体像を示した書である『武士道』。義、勇、仁、礼、信、そして名誉、忠義...。桜花にたとえられた武士の精神と、日本人の依って立つ思考や道徳 意識は、いかにして生まれたか。グローバル・スタンダードの荒波が押し寄せ、寄る辺ない風潮の漂う今だからこそ、本書を通して考える―日本とは、日本人とは何なのか、と。.

商品の魅惑と横暴さによって見えなくされている“資本”、それは「利子生み資本」とは異なる「つつましやかな資本」の可能条件である。「利潤」を生む資本と「剰余価値」を生む資本とを区分し、原発危機・経済危機を 産みだしている悪しき「ふとどきな資本」に分水嶺を設定し、物象化の構造化された諸構造を超えていく自己技術と資本パワーを示す、画期的な書。場所資本、環境資本、文化資本の理論場を切削する。.

西周の私塾での講義「百学連環」の講義録を現代の言葉に置き換え精読することで、文化の大転換期に学術全体をどう見ていたかに迫る。.