Hospital ethics committees (HECs) are expected to play extremely broad and pivotal roles such as case consultation, education of staffs on healthcare ethics, and institutional policy formation. Despite the growing importance of HECs, there are no standards for setup and operation of HECs, and composition and activities of HECs at each institution are rarely disclosed in Japan. In addition, there is also a lack of information sharing and collaboration among HECs. Therefore, the authors established the Consortium of Hospital Ethics Committees (...) (CHEC) in October 2020, which has been regularly hosting a couple of core activities. One is the Healthcare Ethics Forum, held monthly online for CHEC members to freely discuss HECs and healthcare ethics consultation. The other is the Collaboration Conference of Hospital Ethics Committees, intended to provide a place for HEC members and administrative officers from across Japan to exchange information of their HECs, learn from each other, and cooperate to operate HECs appropriately. In this paper, the authors introduced CHEC as well as reported the results of a questionnaire survey conducted at the first conference among participating facilities, suggesting the diverse structures and activities of HECs in Japan. (shrink)

This study aimed to identify the ethical issues faced by home care physicians and nurses, and the support they require. It was conducted in collaboration with the Japanese Association for Home Care Medicine from November to December 2020. An e-mail was sent to 2785 physicians and 582 nurses who are members of the society, requesting their participation in a web-based survey targeting physicians and nurses with practical experience in home care; 152 physicians and 53 nurses responded. Home care physicians and (...) nurses face ethical issues, some of which are that “the patient’s wishes cannot be reliably understood owing to their impaired decision-making capacity” and “there is disagreement between the patient and their family members over the necessary healthcare.” The respondents sought “experience with, and insight into, healthcare ethics” and “home care” from people with whom they would consult on ethical issues, but at the time of the actual consultation, those individuals were the main healthcare professionals involved with the patient. In addition, the respondents desired to have “multidisciplinary discussions in the community,” “participation of healthcare ethics experts at meetings,” and “meetings held by healthcare ethics experts” to discuss specific cases. Given these results and the history of healthcare ethics education in Japan—which has been implemented mostly for healthcare providers—we conclude that it is important for academic societies that offer healthcare ethics education to healthcare providers and regional core hospitals with ethics support resources to collaborate to provide ethics consultation services in the community. (shrink)

The storage and access of genetic testing results have unique considerations for medical records. Initially, genetic testing was limited to patients with single gene diseases. Genetic medicine and testing have expanded, as have concerns about appropriately handling genetic information. In this study, we surveyed the management of genetic information in general hospitals in Japan using a questionnaire on access restrictions. Our questions included whether any other medical information was managed in a unique way. We identified 1037 hospitals designated for clinical (...) training located throughout Japan and received responses from 258 hospitals, and 191 reported that they handle genetic information and results of genetic tests. Of the 191 hospitals that handle genetic information, 112 hospitals implement access restrictions to genetic information. Seventy-one hospitals, one of which uses paper medical records rather than electrical medical records, do not enforce access restrictions. For eight hospitals, it was not known whether access restrictions were enforced or not. The responses from these hospitals indicated that access restrictions and storage methods varied across institution type (e.g., general vs. university hospitals), institution size, and the presence of a clinical genetics department. Other information, such as infectious disease diagnosis, psychological counseling records, abuse, and criminal history, was also subject to access restriction in 42 hospitals. The disparity in how medical facilities handle sensitive genetic information demonstrates a need for discussion between medical professionals and the general public on the storage of sensitive records, including genetic information. (shrink)

This paper presents the first dataset for Japanese Legal Judgment Prediction (LJP), the Japanese Tort-case Dataset (JTD), which features two tasks: tort prediction and its rationale extraction. The rationale extraction task identifies the court’s accepting arguments from alleged arguments by plaintiffs and defendants, which is a novel task in the field. JTD is constructed based on annotated 3477 Japanese Civil Code judgments by 41 legal experts, resulting in 7978 instances with 59,697 of their alleged arguments from the involved parties. Our (...) baseline experiments show the feasibility of the proposed two tasks, and our error analysis by legal experts identifies sources of errors and suggests future directions of the LJP research. (shrink)