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)

This paper will focus on bicorporates, the enigmatic composite animals with one head and two bodies which have been left rather outside of scholastic attention. The first known bicorporates appeared on Mesopotamian cylinder seals around the third millennium BCE. They subsequently appeared in Minoan, Greek, Etruscan and Roman art. In mediaeval Europe, they flourished in Romanesque churches, especially, Southern Europe and Scandinavia. Furthermore, they also emerged in India and Southeast Asia and China. Bicorporates exist across a remarkably wide geographical and (...) chronological range. Even though a small number of scholars carried out some research on them, most of their focus was trying to trace the migration route of the images. No previous study had focused on answering the most intriguing question, how these enigmatic images came about and the reason why they spread and recurred beyond geographical and chronological borders. Therefore, this paper will focus on the questions and seek to provide the answers, by applying neuropsychological reading and analytical psychology. The findings of this study suggest that Lewis‐Williams' neuropsychology and Jung's analytical psychology are intertwined and both offer explanations for the origin and widespread occurrence of bicorporate images. However, the contrast between these two theories lies in the fact that Lewis‐Williams' theory relies on the perspective of materialistic science, implying that these images are solely products of the human brain and nervous system. In contrast, Jung's theory allows for the possibility of exploring the invisible or esoteric realm, which cannot be disproven or proven by current materialistic science. (shrink)

Context Autopsy is a useful tool for understanding the cause and manner of unexpected patient death. However, the attitudes of the general public and physicians in Japan about clinical autopsy are limited. Objective To describe the beliefs of the general public about whether autopsy should be performed and ascertain if they would actually request one given specific clinical situations where patient death occurred with the additional variable of medical error. To compare these attitudes with previously obtained attitudes of physicians practising (...) at Japanese teaching hospitals. Design, setting and participants We conducted a cross-sectional study of the general public. We sent standardised questionnaires in 2010 to a randomly selected non-physician adult population using a survey company for participant selection. Respondents gave their opinions about the necessity of autopsy and how they might act given various clinical scenarios of patient death. We compared these results with those of a previous survey of Japanese physicians conducted in 2009. Results Of the 2300 eligible general adult population, 1575 (68.5%) responded. The majority of the general public indicated they believed an autopsy was necessary. However, in cases of unclear medical error or unclear cause and effect relationship of medical care and patient death, the general public were much less likely to indicate they would actually request an autopsy than were physicians (p<0.0001). Currently in Japan the debate about the role autopsy should play in the case of error related to death is underway. The results from this study will be important in informing related decisions. (shrink)

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)

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。.

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.

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)

This book departs from the premise that context represents a complex relational configuration which can no longer be conceived as an analytic prime but rather requires a parts-whole perspective to capture its inherent dynamism. The edited volume presents a collection of papers which examine the connectedness between context, contextualization and entextualization. They address the questions how meaning and speech acts are situated in context, how both are influenced by context, how context influences speech acts and meaning, how context is imported (...) into the discourse, and how context is entextualized in discourse. The papers cover institutional and non-institutional contexts, the language of Greek laws, political discourse, confrontational media discourse and task-oriented face-to-face and back-to-back interactions. They reflect current moves in pragmatics and discourse analysis to cross disciplinary and methodological boundaries by integrating relevant premises and insights, in particular cognition, adaptive action, negotiation of meaning, sequentiality, recipient design and genre. (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)

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)