70 found
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  1.  46
    Voluntary Active Euthanasia and the Nurse: A Comparison of Japanese and Australian Nurses.Noritoshi Tanida, Atsushi Asai, Motoki Ohnishi, Shizuko K. Nagata, Tsuguya Fukui, Yasuji Yamazaki & Helga Kuhse - 2002 - Nursing Ethics 9 (3):313-322.
    Although euthanasia has been a pressing ethical and public issue, empirical data are lacking in Japan. We aimed to explore Japanese nurses’ attitudes to patients’ requests for euthanasia and to estimate the proportion of nurses who have taken active steps to hasten death. A postal survey was conducted between October and December 1999 among all nurse members of the Japanese Association of Palliative Medicine, using a self-administered questionnaire based on the one used in a previous survey with Australian nurses in (...)
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  2.  48
    Doctors' and Nurses' Attitudes Towards and Experiences of Voluntary Euthanasia: Survey of Members of the Japanese Association of Palliative Medicine.Atsushi Asai, Motoki Ohnishi, Shizuko K. Nagata, Noritoshi Tanida & Yasuji Yamazaki - 2001 - Journal of Medical Ethics 27 (5):324-330.
    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% (...)
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  3.  98
    Arguments Against Promoting Organ Transplants From Brain-Dead Donors, and Views of Contemporary Japanese on Life and Death.Atsushi Asai, Yasuhiro Kadooka & Kuniko Aizawa - 2012 - Bioethics 26 (4):215-223.
    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 (...)
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  4.  46
    Can Physicians' Judgments of Futility Be Accepted by Patients?: A Comparative Survey of Japanese Physicians and Laypeople.Yasuhiro Kadooka, Atsushi Asai & Seiji Bito - 2012 - BMC Medical Ethics 13 (1):7.
    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 (...)
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  5.  83
    Experts' Attitudes Towards Medical Futility: An Empirical Survey From Japan. [REVIEW]Alireza Bagheri, Atsushi Asai & Ryuichi Ida - 2006 - BMC Medical Ethics 7 (1):1-7.
    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 (...)
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  6.  26
    Contemporary Issues Concerning Informed Consent in Japan Based on a Review of Court Decisions and Characteristics of Japanese Culture.Sakiko Masaki, Hiroko Ishimoto & Atsushi Asai - 2014 - BMC Medical Ethics 15 (1):8.
    Since Japan adopted the concept of informed consent from the West, its inappropriate acquisition from patients in the Japanese clinical setting has continued, due in part to cultural aspects. Here, we discuss the current status of and contemporary issues surrounding informed consent in Japan, and how these are influenced by Japanese culture.
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  7.  18
    Matters to Address Prior to Introducing New Life Support Technology in Japan: Three Serious Ethical Concerns Related to the Use of Left Ventricular Assist Devices as Destination Therapy and Suggested Policies to Deal with Them.Atsushi Asai, Sakiko Masaki, Taketoshi Okita, Aya Enzo & Yasuhiro Kadooka - 2018 - BMC Medical Ethics 19 (1):1-8.
    Background Destination therapy is the permanent implantation of a left ventricular assist device in patients with end-stage, severe heart failure who are ineligible for heart transplantation. DT improves both the quality of life and prognosis of patients with end-stage heart failure. However, there are also downsides to DT such as life-threatening complications and the potential for the patient to live beyond their desired length of life following such major complications. Because of deeply ingrained cultural and religious beliefs regarding death and (...)
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  8.  12
    Matters to address prior to introducing new life support technology in Japan: three serious ethical concerns related to the use of left ventricular assist devices as destination therapy and suggested policies to deal with them.Atsushi Asai, Sakiko Masaki, Taketoshi Okita, Aya Enzo & Yasuhiro Kadooka - 2018 - BMC Medical Ethics 19 (1):12.
    Destination therapy is the permanent implantation of a left ventricular assist device in patients with end-stage, severe heart failure who are ineligible for heart transplantation. DT improves both the quality of life and prognosis of patients with end-stage heart failure. However, there are also downsides to DT such as life-threatening complications and the potential for the patient to live beyond their desired length of life following such major complications. Because of deeply ingrained cultural and religious beliefs regarding death and the (...)
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  9.  3
    The Ethics of the Reuse of Disposable Medical Supplies.Anjan Kumar Das, Taketoshi Okita, Aya Enzo & Atsushi Asai - 2020 - Asian Bioethics Review 12 (2):103-116.
    The use of single-use items is now ubiquitous in medical practice. Because of the high costs of these items, the practice of reusing them after sterilisation is also widespread especially in resource-poor economies. However, the ethics of reusing disposable items remain unclear. There are several analogous conditions, which could shed light on the ethics of reuse of disposables. These include the use of restored kidney transplantation and the use of generic drugs etc. The ethical issues include the question of patient (...)
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  10.  44
    Focus Group Interviews Examining Attitudes Towards Medical Research Among the Japanese: A Qualitative Study.Atsushi Asai, Motoki Ohnishi, Etsuyo Nishigaki, Miho Sekimoto, Shunichi Fukuhara & Tsuguya Fukui - 2004 - Bioethics 18 (5):448–470.
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  11.  24
    The Process of Whistleblowing in a Japanese Psychiatric Hospital.Kayoko Ohnishi, Yumiko Hayama, Atsushi Asai & Shinji Kosugi - 2008 - Nursing Ethics 15 (5):631-642.
    This study aims to unveil the process of whistleblowing. Two nursing staff members who worked in a psychiatric hospital convicted of large-scale wrongdoing were interviewed. Data were analyzed using a modified grounded theory approach. Analysis of the interviews demonstrated that they did not decide to whistleblow when they were suspicious or had an awareness of wrongdoing. They continued to work, driven by appreciation, affection, and a sense of duty. Their decision to whistleblow was ultimately motivated by firm conviction. Shortly after (...)
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  12.  18
    A Critical Discussion of Arguments Against the Introduction of a Two-Tier Healthcare System in Japan.Atsushi Asai, Taketoshi Okita, Masashi Tanaka & Yasuhiro Kadooka - 2017 - Asian Bioethics Review 9 (3):171-181.
    In medical ethics, an appropriate national healthcare system that meets the requirements of justice in healthcare resource allocation is a major concern. Japan is no exception to this trend, and the pros and cons of introducing a two-tier healthcare system, which permits insured medical care services to be provided along with services not covered by social health insurance, have been the subject of debate for many years. The Supreme Court ruled in 2011 that it was valid for the government to (...)
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  13.  26
    Reexamination of the Concept of ‘Health Promotion’ Through a Critique of the Japanese Health Promotion Policy.Taketoshi Okita, Aya Enzo & Atsushi Asai - 2017 - Public Health Ethics 10 (3):267-275.
    This article presents a critique of the health promotion policy of Japan, which is based on an examination of the social importance of and justification for health promotion. This is done to suggest the proper direction that the future Japanese policy could take, and to question the adequacy of the term of ‘health promotion’. We find the ‘social progress’ characterization of the ‘Second Term of National Health Promotion Movement in the Twenty-First Century - Health Japan 21 ’ to be problematic. (...)
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  14.  28
    Ethical Obligations in the Face of Dilemmas Concerning Patient Privacy and Public Interests: The Sasebo Schoolgirl Murder Case.Yasuhiro Kadooka, Taketoshi Okita & Atsushi Asai - 2016 - Bioethics 30 (7):520-527.
    A murder case that had some features in common with the Tarasoff case occurred in Sasebo City, Japan, in 2014. A 15-year-old high school girl was murdered and her 16-year-old classmate was arrested on suspicion of homicide. One and a half months before the murder, a psychiatrist who had been examining the girl called a prefectural child consultation centre to warn that she might commit murder, but he did not reveal her name, considering it his professional duty to keep it (...)
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  15. Reexamination of the Ethics of Placebo Use in Clinical Practice.Atsushi Asai & Yasuhiro Kadooka - 2013 - Bioethics 27 (4):186-193.
    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 (...)
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  16.  24
    Tsunami-Tendenkoand Morality in Disasters.Atsushi Asai - 2015 - Journal of Medical Ethics 41 (5):365-366.
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  17.  32
    Comparison of Ethical Judgments Exhibited by Clients and Ethics Consultants in Japan.Noriko Nagao, Yasuhiro Kadooka & Atsushi Asai - 2014 - BMC Medical Ethics 15 (1):19.
    Healthcare professionals must make decisions for patients based on ethical considerations. However, they rely on clinical ethics consultations (CEC) to review ethical justifications of their decisions. CEC consultants support the cases reviewed and guide medical care. When both healthcare professionals and CEC consultants face ethical problems in medical care, how is their judgment derived? How do medical judgments differ from the ethical considerations of CECs? This study examines CECs in Japan to identify differences in the ethical judgment of clients and (...)
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  18.  33
    Defining Futile Life-Prolonging Treatments Through Neo-Socratic Dialogue.Kuniko Aizawa, Atsushi Asai & Seiji Bito - 2013 - BMC Medical Ethics 14 (1):51.
    In Japan, people are negative towards life-prolonging treatments. Laws that regulate withholding or discontinuing life-prolonging treatments and advance directives do not exist. Physicians, however, view discontinuing life-prolonging treatments negatively due to fears of police investigations. Although ministerial guidelines were announced regarding the decision process for end-of-life care in 2007, a consensus could not be reached on the definition of end-of-life and conditions for withholding treatment. We established a forum for extended discussions and consensus building on this topic.
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  19.  9
    A Valuable Up-to-Date Compendium of Bioethical Knowledge.Atsushi Asai & Sachi Oe - 2005 - Developing World Bioethics 5 (3):216-219.
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  20.  40
    Attitudes and Behaviors of Japanese Physicians Concerning Withholding and Withdrawal of Life-Sustaining Treatment for End-of-Life Patients: Results From an Internet Survey.Seiji Bito & Atsushi Asai - 2007 - BMC Medical Ethics 8 (1):1-9.
    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 (...)
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  21.  37
    Choices of Japanese Patients in the Face of Disagreement.Atsushi Asai, Minako Kishino, Tsuguya Fukui, Masahiko Sakai, Masako Yokota, Kazumi Nakata, Sumiko Sasakabe, Kiyomi Sawada & Fumie Kaiji - 1998 - Bioethics 12 (2):162–172.
  22. An Ethical and Social Examination of the Death Penalty as Depicted in Two Current Films Made in a ―Pro-Death Penalty Society‖.Atsushi Asai & Sakiko Maki - 2011 - Eubios Journal of Asian and International Bioethics 21 (3):95-98.
    In Japan, although various arguments exist regarding the appropriateness of the death penalty, nationwide public opinion polls regarding the death penalty revealed that 85.6% of respondents supported maintaining the death penalty in 2009. Under these circumstances, it is worthwhile to deliberate the ethical and social issues surrounding the death penalty as depicted in Japanese films from medical humanities perspectives. In the present paper, we discuss two recent films concerning the death penalty, 13 kaidan directed by Masahiro Nagasawa, 2005 and Kyuka (...)
     
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  23. Application of Takahashi’s Three-Level Structure Analysis to Biomedical Ethics in End-of-Life Care in East Asia in Consideration of Future Normative Ethical Directions: A Brief Report.Atsushi Asai - 2014 - Eubios Journal of Asian and International Bioethics 24 (3):76-80.
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  24. A Question In End-of-Life Medicine In Japan: Three Levels Structure Analysis Of The Ethics Of Provision Of Permanent And Active Artificial Nutrition And Hydration For Elderly Who Cannot Eat.Atsushi Asai - 2011 - Eubios Journal of Asian and International Bioethics 21 (1-2):37-40.
    This article will focus on issues concerning the provision of artificial nutrition and hydration to patients who are extremely old, completely bedridden, and totally dependent on others. These patients have no advance directives, no malignancy, suffer from persistent but unstable disturbance of consciousness as well as severe cognitive impairment, and cannot eat sufficient amounts of food to maintain their lives. Should ANH be provided? Some would agree while others would maintain otherwise. The underlying values and normative theory behind each argument (...)
     
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  25.  16
    A Valuable Up-to-Date Compendium of Bioethical Knowledge.Atsushi Asai & O. E. Sachi - 2005 - Developing World Bioethics 5 (3):216–219.
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  26. Barriers To Informed Consent In Japan.Atsushi Asai - 1996 - Eubios Journal of Asian and International Bioethics 6 (4):91-93.
    In the Japanese clinical setting, informed consent has not been well adopted although the idea is no longer novel and the bioethics movement is well known. There are several barriers to informed consent in Japan.It is possible that both patients and physicians do not know the idea or misunderstand it. Some may think that informed consent can be obtained from a patient who does not know his or her diagnosis or from family members of a competent patient. Because of no (...)
     
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  27. Commentary by Atsushi Asai & Takuro Shimbo.Atsushi Asai & Takuro Shimbo - 1998 - Eubios Journal of Asian and International Bioethics 8 (4):106-106.
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  28. Commentary by Atsushi Asai.Atsushi Asai - 2002 - Eubios Journal of Asian and International Bioethics 12 (1):23-24.
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  29. Commentary By Atsushi Asai.Atsushi Asai - 1997 - Eubios Journal of Asian and International Bioethics 7 (4):107-107.
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  30. Commentary. Can Clinical Ethics Deal With Some "Real" Problems?Atsushi Asai - 1998 - Eubios Journal of Asian and International Bioethics 8 (1):16-17.
     
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  31. Clinical Ethics Discussion 4: Urgent "Lifesaving" Clinical Research.Atsushi Asai & Koichiro Itai - 2004 - Eubios Journal of Asian and International Bioethics 14 (2):52-57.
    No matter how far medicine advances, incurable disease will inevitably exist; and the dying patient's last resort will likewise look to medical research. In this report, we examine a case concerning the use of experimental medical therapy on a critically ill child. We discuss the ethical argument pertaining to the recommending of experimental medical therapy to the family of a dying patient.Under the circumstances of having to face the impending death of one's own child, parents of a terminally ill child (...)
     
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  32.  14
    Conflicting Messages Concerning Current Strategies Against Research Misconduct in Japan: A Call for Ethical Spontaneity.Atsushi Asai, Taketoshi Okita & Aya Enzo - 2016 - Journal of Medical Ethics 42 (8):524-527.
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  33. Case Study 1: Hemodialysis For A Patient In Persistent Vegetative State.Atsushi Asai & Masashi Shirahama - 1997 - Eubios Journal of Asian and International Bioethics 7 (4):105-107.
     
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  34. Case Study 3: A Patient with HIV.Atsushi Asai - 1998 - Eubios Journal of Asian and International Bioethics 8 (1):15-16.
     
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  35. Case Study Concerning Privacy in the Care of Patients with HIV.Atsushi Asai & Kenji Miki - 2013 - Eubios Journal of Asian and International Bioethics 23 (1):13-16.
     
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  36.  1
    Doubt the Analects: An Educational Session Using the Analects in Medical Ethics in Japan.Atsushi Asai, Yasuhiro Kadooka & Sakiko Masaki - 2014 - Eubios Journal of Asian and International Bioethics 24 (5):138-141.
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  37.  11
    Euthanasia and the Family: An Analysis of Japanese Doctors’ Reactions to Demands for Voluntary Euthanasia.Atsushi Asai, Motoki Ohnishi, Akemi Kariya, Shizuko K. Nagata, Tsuguya Fukui, Noritoshi Tanida, Yasuji Yamazaki & Helga Kuhse - 2001 - Monash Bioethics Review 20 (3):21-37.
    What should Japanese doctors do when asked by a patient for active voluntary euthanasia, when the family wants aggressive treatment to continue? In this paper, we present the results of a questionnaire survey of 366 Japanese doctors, who were asked how they would act in a hypothetical situation of this kind, and how they would justify their decision, 23% of respondents said they would act on the patient’s wishes, and provided reasons for their view; 54% said they would not practice (...)
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  38.  2
    Ejaib & I.Atsushi Asai - 2016 - Eubios Journal of Asian and International Bioethics 26 (5):164-164.
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  39. Ethical Issues In Japanese Clinical Settings In 1990's: Attitudes And Experiences Of The Japanese.Atsushi Asai & Tsuguya Fukui - 1997 - Eubios Journal of Asian and International Bioethics 7 (2):39-43.
     
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  40. Ethics In Questionnaire-Based Research.Atsushi Asai, Takeo Nakayama & Mariko Naito - 2003 - Eubios Journal of Asian and International Bioethics 13 (4):147-151.
    This study is aimed to address the problems associated with questionnaire-based research. Twelve hypothetical cases are presented and checked for ethical validity. The problems are categorized under seven headings: Whether the participation of the subject is truly voluntary; whether consent to participate in the study has been obtained or proxy consent is required; whether consent to participate has been obtained from "authentic" participants and their privacy is protected; whether participants are fully informed before they consent to participate; whether the validity (...)
     
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  41.  98
    Ethical Reflections on the Thoughts and Lives of Kurosawa's Doctors.Atsushi Asai, Sakiko Maki & Yasuhiro Kadooka - 2012 - Medical Humanities 38 (1):38-43.
    The year 2010 marked the centenary of the birth of Akira Kurosawa (1910–1998), whose works have been reassessed favourably in the last couple of years in Japan. During his lifetime, Kurosawa directed and produced three films whose chief characters are medical doctors: Drunken Angel (1948), The Quiet Duel (1949) and Red Beard (1965). This paper discusses these three films and examines the thoughts and lives of the three protagonists from the perspective of modern medical ethics. The films depict contemporary ethical (...)
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  42.  1
    Grounds for Surrogate Decision-Making in Japanese Clinical Practice: A Qualitative Survey.Atsushi Asai, Taketoshi Okita, Aya Enzo, Kayoko Ohnishi & Masashi Tanaka - 2021 - BMC Medical Ethics 22 (1):1-12.
    BackgroundIn the coming years, surrogate decision-making is expected to become highly prevalent in Japanese clinical practice. Further, there has been a recent increase in activities promoting advance care planning, which potentially affects the manner in which judgements are made by surrogate decision-makers. This study aims to clarify the grounds on which surrogate decision-makers in Japan base their judgements.MethodsIn this qualitative study, semi-structured interviews were conducted to examine the judgement grounds in surrogate decision-making for critical life-sustaining treatment choices in acute care (...)
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  43.  1
    Letter to the Editor: The Challenges of Medical Ethics Educators at a Research University.Atsushi Asai, Taketoshi Okita & Aya Enzo - 2017 - Eubios Journal of Asian and International Bioethics 27 (1):22-22.
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  44. Perceptions of Interpersonal Relationships Held by Patients with Obstinate Disease.Atsushi Asai, Yugo Narita, Etsuyo Nishigaki, Seiji Bito & Taishu Masano - 2005 - Eubios Journal of Asian and International Bioethics 15 (1):32-34.
    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 , (...)
     
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  45. Reasons for Discontinuation of Treatments for Severely Demented Patients: A Japanese Physician’s View.Atsushi Asai & Motoki Onishi - 2001 - Eubios Journal of Asian and International Bioethics 11 (5):141-143.
    In the present paper, we evaluate the grounds on which therapeutic approaches are determined in elderly demented patients as a typical group of patients who are conscious but lack the ability to make competent judgments. It is argued that none of the factors that the patient as an individual being has at present and that are complete in that individual - the age of the patient, dementia, personhood, and the ability to feel pain - is likely to be a genuine (...)
     
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  46. Should a Patient in Persistent Vegetative State Live?Atsushi Asai - 1999 - Monash Bioethics Review 18 (2):25-39.
    Should a patient in a persistent vegetative state live? Is the life of a patient in a mere biological state worthwhile maintaining? I would argue that the life of a PVS patient is instrumentally valuable in so far as it can satisfy the family’s preference to keep it alive. A PVS patient should live if the patient’s family desires it Conversely, the PVS patient should be allowed to die or be actively killed if no one desires him or her to (...)
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  47. Some Fundamental Questions About Human Life: Ethicalcomments of Japanese Physicians in Terms of the Appropriate Care of Patients in Persistent Vegetative State.Atsushi Asai - 2001 - Eubios Journal of Asian and International Bioethics 11 (3):66-67.
     
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  48. Self-Determination of Death in Japan: A Review & Discussion.Atsushi Asai & Sayaka Sakamoto - 2007 - Eubios Journal of Asian and International Bioethics 17 (2):35-40.
    Self-determination is a central concept in the field of bioethics and the most critical decision among the myriad of decisions concerning medical care is the decision to choose to die; “self-determination of death.” The purpose of this paper is to clarify the basic positions on self-determination of death held by present Japanese people and we tentatively sorted these positions into 10 arguments. We discuss the problems and implications of these positions revealed within our present review and conclude that a society (...)
     
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  49. Should Physicians Make Value Judgments Regarding Medical Futility?Atsushi Asai - 1998 - Eubios Journal of Asian and International Bioethics 8 (5):141-143.
    Medical futility is one of the most controversial concepts in biomedical ethics. Different people have proposed diverse definitions. Nevertheless, decisions about medical futility have tremendous impacts on clinical practice and physician-patient relationships. The most fundamental dispute about medical futility is whether or not value-laden judgments regarding medical futility are acceptable.In this essay, I argue that value-laden judgments of medical futility are necessary in clinical settings because a majority of "futility " debates have focused on medical problems requiring value-laden judgments. Value (...)
     
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  50.  4
    Should We Aim to Create a Perfect Healthy Utopia? Discussions of Ethical Issues Surrounding the World of Project Itoh’s Harmony.Atsushi Asai, Taketoshi Okita, Motoki Ohnishi & Seiji Bito - 2020 - Science and Engineering Ethics 26 (6):3249-3270.
    To consider whether or not we should aim to create a perfect healthy utopia on Earth, we focus on the SF novel Harmony, written by Japanese writer Project Ito, and analyze various issues in the world established in the novel from a bioethical standpoint. In the world depicted in Harmony, preserving health and life is a top priority. Super-medicine is realized through highly advanced medical technologies. Citizens in Harmony are required to strictly control themselves to achieve perfect health and must (...)
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