Harmony is one of the most fundamental Japanese values. It is derived from Confucianism and encompasses a state of mind, an action process and outcomes of the action. This article draws on research data and discusses Japanese nurses’ perceptions of harmony as reflected in their everyday practice. The most important virtues for these nurses were reported as politeness and respect for other persons. The outcome from the nurses’ harmonious practice, it is claimed, benefited patients and created peaceful, harmonious relationships for (...) all. Because of the unique link between harmony and the location of interaction, the ideal ‘workplace harmony’ threatened some nurses’ professional decision making. These nurses confused harmony with conformity by superficial agreement. The Japanese seniority system could be a major factor contributing to this problem. Ethics education that includes traditional values and concepts in Japanese culture is strongly urged. (shrink)

End-of-life issues have become an urgent problem in Japan, where people are among the longest lived in the world and most of them die while connected to high-technology medical equipment. This study examines a sensitive end-of-life ethical issue that concerns patients, families and nurses: the withdrawal of artificial food and fluid from terminally ill patients. A sample of 160 Japanese nurses, who completed a questionnaire that included forced-choice and open-ended questions, supported this act under only two specific conditions: if the (...) patient requested it, and if it relieved the patient’s suffering. They considered that the doctor’s orders, the family’s request, or the patient’s advanced age did not ethically justify this act. A small number of people who had recently lost a relative took part in semistructured interviews focusing on their experiences of their terminally ill relatives being given artificial food and fluid. Ethical, social and cultural factors surrounding this issue are discussed. (shrink)

This article explores the potent force of material objects in testimional culture by enacting an encounter with the ‘debris’ of a World War Two internment camp for Japanese Canadians. Pushing beyond the limits of the repetition of linear history, the article moves instead towards a phenomenological analysis of how yielding to remains of the past might allow us to reconnect with the destroyed worlds from which they were removed. Using Michel Taussig's notion of mimesis and Peggy Phelan's work on mimicry, (...) alongside Merleau‐Ponty's work on the habit‐body, this article brings into relief the neglected place of material objects collected by archives and brought to memorials in testimonial culture. (shrink)

Internet services, such as review sites, FAQ sites, online auction sites, online flea markets, and social networking services, are essential to our daily lives. Each Internet service aims to promote information exchange among people who share common interests, activities, or goods. Internet service providers aim to have users of their services actively communicate through their services. Without active interaction, the service falls into disuse. In this study, we consider that an Internet service has a network externality as its main feature, (...) and we model user behavior in the Internet service with network externality as a dynamic game. In particular, we model the diffusion process of users of an ISNE as an infinite-horizon extensive-form game of complete information in which: each user can choose whether or not to use the ISNE in her/his turn and the network effect of the ISNE depends on the history of each player’s actions. We then apply Markov perfect equilibrium to analyze how to increase the number of active users. We derive the necessary and sufficient condition under which the state in which every player is an active user is the unique Markov perfect equilibrium outcome. Moreover, we propose an incentive mechanism that enables the number of active users to increase steadily. (shrink)

This pilot study had two purposes: (1) to review recent Japanese nursing literature on nursing advocacy; and (2) to obtain data from nurses on advocacy. For the second purpose, 24 nurses at a nursing college in Japan responded to a questionnaire. The concept of advocacy, taken from the West, has become an ethical ideal for Japanese nurses but one that they do not always understand, or, if they do, they find it difficult to fulfil. They cite nursing leadership support as (...) necessary to enacting this role. Discussion on the meaning of and the rationale for advocacy in a society where goodness or badness is relative to social situations and its impact may reveal two parallel but overlapping views of morality. Such a situation would not only influence notions of advocacy but also possibly render them more complex. (shrink)

This article, written from research data, focuses on the possible meaning of the data rather than on detailed statistical reporting. It defines whistleblowing as an act of the international nursing ethical ideal of advocacy, and places it in the larger context of professional responsibility. The experiences, actions, and ethical positions of 24 Japanese nurses regarding whistleblowing or reporting a colleague for wrongdoing provide the data. Of these respondents, similar in age, educational level and clinical experience, 10 had previously reported another (...) nurse and 12 had reported a physician for a wrongful act. These data raise questions about overt actions to expose a colleague in a culture that values group loyalty and saving face. Additional research is needed for an in-depth understanding of whistleblowing, patient advocacy and professional responsibility across cultures, especially those that value group loyalty, saving face and similar concepts to the Japanese Ishin Denshin, where the value is on implicit understanding requiring indirect communication. Usually, being direct and openly discussing sensitive topics is not valued in Japan because such behavior disrupts the most fundamental value, harmony (wa). (shrink)

The purpose of this article is to initiate a philosophical discussion about the ethical component of professional competence in nursing from the perspective of Brazilian nurses. Specifically, this article discusses professional competence in nursing practice in the Brazilian health context, based on two different conceptual frameworks. The first framework is derived from the idealistic and traditional approach while the second views professional competence through the lens of historical and dialectical materialism theory. The philosophical analyses show that the idealistic view of (...) professional competence differs greatly from practice. Combining nursing professional competence with philosophical perspectives becomes a challenge when ideals are opposed by the reality and implications of everyday nursing practice. (shrink)

This research explored the ethical issues that nurses reported in the process of elaboration and further disclosure after an initial diagnosis of a terminal illness had been given. One hundred and six hospice nurses in Norway and Denmark completed a questionnaire containing 45 items of forced-choice and open-ended questions. This questionnaire was tested and used in three countries prior to this study; for this research it was tested on Danish and Norwegian nurses. All respondents supported the ethics of ongoing disclosure (...) to terminally ill patients based on ethical principles embedded in their country’s Patients’ Rights Acts. Truth, as an intrinsic value, proved foundational to patient autonomy, the most frequent ethical principle these nurses reported to justify their ethical position on information disclosure to terminally ill people. Telling the truth about a diagnosis was not the end of ethics in hospice care, but rather the beginning because what occurs ethically in dealing with prognosis issues became central to these hospice nurses, the patients and their families. Coupled with truth-telling, compassionate interaction and care become extensions of patients’ rights. (shrink)

This study examines public health nurses’ perceptions and concerns about the implications of Japan’s new long-term care insurance law concerning care provision for elderly people and their families. Respondents voiced their primary concern about this law as access to services for all elderly people needing care, and defined their major responsibility as strengthening health promotion and illness prevention programmes. Although wanting to expand their roles to meet the health care, social and public policy advocacy needs of elderly persons and their (...) families, respondents also stated their concern for the possible lack of enough resources for this expansion to support family caregivers adequately. They viewed their first function as developing collaborative relationships with local government officials to help to assure sufficient resources to provide the necessary foundation for long-term care programmes to deliver services to all those in need. These concerns fall within the larger ethical issue of distributive justice in a society based on the obligations of the state to citizens and the family to its members, especially elderly relatives, who, according to traditional Japanese values, retain respect. (shrink)

Objectives: This study aimed to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to improve subjective well-being (SWB), including evaluative, hedonic, and eudemonic well-being, and the mental component of quality of life (QOL) of working population. Methods: A literature search was conducted, using PubMed, Embase, PsycINFO, and PsycARTICLES. Eligible studies included those that were RCTs of any intervention, conducted among healthy workers, measured SWB as a primary outcome, and original articles in English. Study characteristics, intervention, outcomes, and (...) results on SWB outcomes were extracted by the investigators independently. After a brief narrative summarizing and classifying the contents of the interventions, the included outcomes were categorized into each aspect of SWB (evaluative, hedonic, and eudemonic well-being, and the mental component of QOL). Finally, the characteristics of the effective interventions for increasing each aspect were summarized, and the pooled effect of interventions on SWB was investigated by a meta-analysis. Publication bias was investigated by drawing a funnel plot and conducting Egger's test. Results: From the 5,450 articles found, 39 met the inclusion criteria for the systematic review. The interventions included in this review were classified into six categories (physical activity, ergonomics, psychological, environmental, multicomponent intervention, and others). The meta-analysis from 31 studies showed that the pooled effect of included interventions on SWB was significantly positive (standardized mean difference (SMD) = 0.51; standard error (SE) = 0.10). A funnel plot showed there were extremely large or small SMDs, and Egger's test was significant. Thus, we conducted sensitivity analysis, excluding these extreme SMDs, and confirmed that the estimated pooled effect was also significantly positive. Subgroup analyses for separate types of interventions showed the effects of psychological interventions (e.g., mindfulness, cognitive behavioral based approach, and other psychological interventions) were also significantly positive. Conclusion: The current study revealed the effectiveness of interventions for increasing SWB. Specifically, psychological interventions (e.g., mindfulness, cognitive behavioral based approach, and other psychological interventions) may be useful for improving SWB. (shrink)

This article reports a survey of nurses in different cultural settings to reveal their perceptions of ethical role responsibilities relevant to nursing practice. Drawing on the Confucian theory of ethics, the first section attempts to understand nursing ethics in the context of multiple role relationships. The second section reports the administration of the Role Responsibilities Questionnaire (RRQ) to a sample of nurses in China (n = 413), the USA (n = 163), and Japan (n = 667). Multidimensional preference analysis revealed (...) the patterns of rankings given by the nurses to the statements they considered as important ethical responsibilities. The Chinese nurses were more virtue based in their perception of ethical responsibilities, the American nurses were more principle based, and the Japanese nurses were more care based. The findings indicate that the RRQ is a sensitive instrument for outlining the embedded sociocultural factors that influence nurses’ perceptions of ethical responsibilities in the realities of nursing practice. This study could be important in the fostering of partnerships in international nursing ethics. (shrink)

Although applauding Pickering & Garrod's (P&G's) attempt to ground language use in the ideomotor perception-action link, which provides an of embodied social interaction, we suggest that it needs to be complemented by an additional control mechanism that modulates its operation in the service of the language users' communicative intentions. Implications for intergroup relationships and intercultural communication are discussed.

The purpose of this article is to initiate a philosophical discussion about the ethical component of professional competence in nursing from the perspective of Brazilian nurses. Specifically, this article discusses professional competence in nursing practice in the Brazilian health context, based on two different conceptual frameworks. The first framework is derived from the idealistic and traditional approach while the second views professional competence through the lens of historical and dialectical materialism theory. The philosophical analyses show that the idealistic view of (...) professional competence differs greatly from practice. Combining nursing professional competence with philosophical perspectives becomes a challenge when ideals are opposed by the reality and implications of everyday nursing practice. (shrink)

The primary question this article deals with is one of ontology. In a dystopian world populated with genetically engineered windups and hybrids, what constitutes ‘the human’? This article looks at how the posthuman body in a dystopian novel like The Windup Girl, set in a world where geographical, political, social, economic and religious norms and boundaries are erased and reconfigured, can in no way simply remain a mere body, but transmutes into a highly complex political and social site from whence (...) multiple relations of power originate, travel and culminate in. The titular character in the novel, Emiko, is a genetically engineered windup created in a laboratory, with obedience and the need to please etched right into her DNA. This makes her a prized possession for a brothel owner in Bangkok, once her Japanese master abandons her. She is both desirable and revolting to her customers at the same time – her perfect body is too perfect, her genetic urge to please at any cost draws them in, but her involuntary shaking and robot-like jerking disgusts them. The windup can thus be seen as both the Lacanian object cause of desire and Kristeva’s abject body. (shrink)

A review of Annette Kuhn and Kirsten Emiko McAllister, _Locating Memory: Photographic Acts_.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:kamikaze, Cherry Blossoms, and Nationalisms: The Militarization of Aesthetics in Japanese HistoryGary L. Ebersolekamikaze, Cherry Blossoms, and Nationalisms: The Militarization of Aesthetics in Japanese History. By Emiko Ohnuki-Tierney. Chicago: University of Chicago Press, 2002. Pp. xvii + 411.In the 2004 American presidential campaign, a film clip of a young John Kerry testifying against the Vietnam War before a congressional committee hearing received significant television air time. In (...) the clip, Kerry poignantly asks: "How do you ask a young man in his twenties to be the last to die in the Vietnam War?" In kamikaze, Cherry Blossoms, and Nationalisms: The Militarization of Aesthetics in Japanese History, anthropologist Emiko Ohnuki-Tierney attempts to answer a similar set of questions regarding the best and the brightest young Japanese men sent to their deaths as kamikaze pilots in the closing days of the Pacific War. "How and why," she asks, "do individuals sacrifice themselves for the[ir] country?" "When a soldier 'volunteers' to die for his country, does he do so both in thought and in action? Or does he sacrifice himself only in action without espousing the ideology of state nationalism in toto?" (p. 1).Ohnuki-Tierney suggests that in recent years, as a reaction against structuralism, many anthropologists have shifted their attention to issues of praxis (what social actors and agents do). This shift is certainly evident, but I wonder if her next characterization is accurate: "Thus we now seldom differentiate between reproduction of behavior and that of an ideology or thought structure" (p. 186). She is certainly correct [End Page 607] to answer two of her own additional questions in the negative: "Is identifying reproduction in behavior enough for us to understand historical continuity and discontinuity? Is our quest satisfied if we find that a perfect reproduction takes place in action, even in the absence of reproduction in the thoughts and feelings of social agents?" (ibid.). She is wrong, though, to suggest that few other scholars have recognized and addressed this issue. If anything, the issues surrounding structure and change or cultural reproduction and change have been at the center of the work of Marshall Sahlins, James Fernandez, and Talal Asad, to name only three such scholars of note in anthropology. Moreover, generations of sociologists and historians of religion have also grappled with the issues of continuity and change.In this study, Ohnuki-Tierney has made an important contribution to our understanding of the kamikaze pilots by focusing on the lives and writings of a handful of university conscripts. Specifically, she has culled the limited number of published writings in Japanese by these former students, as well as more numerous unpublished diaries, letters, and other documents. Additionally, in an appendix (pp. 307-340) she has compiled a startling list of the works read by four of the kamikaze pilots that can help us to understand their interests and the possible influences on their thoughts. They were extremely well read in theology, philosophy, literature, and political thought—and they read widely in European languages, as well as Japanese. Through these sources, Ohnuki-Tierney attempts to understand why these young men went off to certain death, even when they did not ascribe to the emperor-centered ideology of the Japanese militarist state. In part, she seeks to counter the prevalent image that these patriotic young men worshipped the emperor and died for him. In doing so, she argues for the necessity to distinguish between patriotism and state nationalism, or, to put it another way, between dying for one's country and dying for the emperor.Much of Ohnuki-Tierney's earlier work has dealt with the roles of specific symbols in Japanese society. The Monkey as Mirror: Symbolic Transformations in Japanese History and Ritual (Princeton University Press, 1987) traced the changing uses of the monkey as a symbol of identity and otherness throughout Japanese history, while Rice as Self: Japanese Identities through Time (Princeton University Press, 1993) focused on rice as an important multivalent symbol of Japanese identity. The present study apparently began innocently enough as a study of the symbolic complex surrounding cherry blossoms in Japanese cultural history. Only in the course of her research did Ohnuki... (shrink)