Background Japanese people have become increasingly interested in the expression and enhancement of their individual autonomy in medical decisions made regarding medical treatment at and toward the end of life. However, while many Western countries have implemented legislation that deals with patient autonomy in the case of terminal illness, no such legislation exists in Japan. The rationale for this research is based on the need to investigate patient's preferences regarding treatment at the end of life in order to re-evaluate advance (...) directives policy and practice. Methods We conducted a cross-sectional survey with 418 members of the general middle-aged and senior adults (aged between 40 and 65) in Tokyo, Japan. Respondents were asked about their attitudes toward advance directives, and preferences toward treatment options. Results Over 60% of respondents agreed that it is better to express their wishes regarding advance directives (treatment preferences in writing, appointment of proxy for care decision making, appointment of legal administrator of property, stating preferences regarding disposal of one's property and funeral arrangements) but less than 10% of them had already done so. About 60% of respondents in this study preferred to indicate treatment preferences in broad rather than concrete terms. Over 80% would like to decide treatment preferences in consultation with others (22.2% with their proxy, 11.0% with the doctor, and 47.8% with both their proxy and the doctor). Conclusion This study revealed that many Japanese people indicate an interest in undertaking advance directives. This study found that there is a range of preferences regarding how advance directives are undertaken, thus it is important to recognize that any processes put into place should allow flexibility in order to best respect patients' wishes and autonomy. (shrink)
This study aimed to: (1) develop and evaluate the Moral Distress Scale for Psychiatric nurses (MDS-P); (2) use the MDS-P to examine the moral distress experienced by Japanese psychiatric nurses; and (3) explore the correlation between moral distress and burnout. A questionnaire on the intensity and frequency of moral distress items (the MDS-P: 15 items grouped into three factors), a burnout scale (Maslach Burnout Inventory — General Survey) and demographic questions were administered to 391 Japanese psychiatric nurses in 2007—2008. These (...) nurses experienced relatively low levels of moral distress despite the fact that they were commonly confronted by morally distressing situations. All the circumstances in which the participants experienced moral distress were included in the ‘low staffing’ factor, which reflects the characteristics of Japanese psychiatric care. The frequency score of the low staffing factor was a significant predictor of burnout. (shrink)
Perceptual grouping has traditionally been thought to be governed by innate, universal principles. However, recent work has found differences in Japanese and English speakers' non-linguistic perceptual grouping, implicating language in non-linguistic perceptual processes (Iversen, Patel, & Ohgushi, 2008). Two experiments test Japanese- and English-learning infants of 5-6 and 7-8 months of age to explore the development of grouping preferences. At 5-6 months, neither the Japanese nor the English infants revealed any systematic perceptual biases. However, by 7-8 months, the same age (...) as when linguistic phrasal grouping develops, infants developed non-linguistic grouping preferences consistent with their language's structure (and the grouping biases found in adulthood). These results reveal an early difference in non-linguistic perception between infants growing up in different language environments. The possibility that infants' linguistic phrasal grouping is bootstrapped by abstract perceptual principles is discussed. (shrink)
In studies publishing identifying personal information, obtaining consent is regarded as necessary, as it is impossible to ensure complete anonymity. However, current journal practices around specific points to consider when obtaining consent, the contents of consent forms and how consent forms are managed have not yet been fully examined. This study was conducted to identify potential issues surrounding consent to publish identifying personal information.
The word sautrāntika is known to designate one of the philosophical schools in later documents, but its earlier phase remains uncertain. The discovery of this term in the Mahāparinirvāṇa-mahāsūtra thus brings forward new evidence essential for solving the problem of sautrāntika. In this paper, I will attempt to establish the interpretation of the context, in which the phrase vinayadharaḥ sautrāntikaḥ appears.
This case examines management underpinnings of conducting socially purposeful business in contexts where the labor conditions and ethics are questionable. Shiraishi Garments Company was a Japanese entrepreneurial venture in the clothing industry that evolved into a highlysuccesssful multinational company. After its supply chain had extended into China, some ethical labor issues emerged. The decision point is focused squarely on the company’s CEO, who must deal with conflicting forces stemming from his personal values and professional responsibilities. In exploring the issues, (...) the case illustrates business risks of superficial standards auditing of international operations. The case also describes how multinational firms are often part of the problem and the solution when it comes to ethical labor issues. On these grounds, the case study reveals some alternative approaches to the audit model based on more meaningful partnerships. Implications pertain to successful and ethical supply chain relationships between foreign entrepreneurial firms and the developing economic systems they enter. (shrink)
A challenge in human genome research is how to describe the populations being studied. The use of improper and/or imprecise terms has the potential to both generate and reinforce prejudices and to diminish the clinical value of the research. The issue of population descriptors has not attracted enough academic attention outside North America and Europe. In January 2012, we held a two-day workshop, the first of its kind in Japan, to engage in interdisciplinary dialogue between scholars in the humanities, social (...) sciences, medical sciences, and genetics to begin an ongoing discussion of the social and ethical issues associated with population descriptors. (shrink)
I first heard about renshi from Hiromi Itō, a remarkable and justifiably celebrated Japanese poet and writer, who has also been our neighbor in Encinitas, California, for most of the last two decades. Her presence among us goes back to 1991 and to my first visit to Japan, a contact I hadn’t had before but have been able to repeat six times since then.