Search

In everyday medical settings in Japan, physicians occasionally tell an elderly patient that their symptoms are "due to old age," and there is some concern that patient care might be negatively impacted as a result. That said, as this phrase can have multiple connotations and meanings, there are certain instances in which the use of this phrase may not necessarily be indicative of ageism, or prejudice against the elderly. One of the goals in medical care is to address pain and suffering that develops with age in elderly individuals, and whether or not aging is a disease is inconsequential. However, assuming that an individualized and thorough examination has been performed, there are some conditions that can be attributed only to age. Accordingly, physicians must acknowledge the merits and drawbacks of using the phrase "due to old age," and exercise caution when using it. Both physicians and their elderly patients must share a common awareness of the incomplete and limited nature of modern medicine and its scope, and physicians must help their elderly patients accept and live with the aging phenomenon. [ABSTRACT FROM AUTHOR]

In many countries, prenatal testing for certain fetal abnormalities is offered via publicly funded screening programs. The concept of reproductive autonomy is regarded as providing a justificatory basis for many such programs. The purpose of this study is to re‐examine the normative basis of public prenatal screening for fetal abnormalities by changing our perspective from that of autonomy to obligation. After clarifying the understanding of autonomy adopted in the justification for public prenatal screening programs, we identify two problems concerning this justification: first, the extent to which the government is obliged to meet this demand is not evident; and, second, it is not clear whether the provision of public screening is the most appropriate way to promote autonomy. Next, to tackle these problems, we focus on Onora O'Neill's argument of rights and obligations. Drawing on this argument, we show that, in addressing the problems above, it is important to change our normative perspective from rights or autonomy to obligation. Our argument will show that since the government does not have an incontrovertibly fundamental obligation to promote autonomy, this obligation needs to be constrained in terms of compatibility with other fundamental obligations. In addition, even if a government is obliged to promote autonomy to some degree, there could be more appropriate means to achieve it than providing public prenatal screening; therefore, it is not necessary for government obligations to extend to the provision of public prenatal screening. [ABSTRACT FROM AUTHOR]

Background: Medical care is obviously an important public service to ensure the health of a nation; however, medical resources are not always used appropriately. 'Convenience-store consultations' and inappropriate ambulance transportation represent instances of such improper use by contemporary Japanese citizens in recent years. This article illustrates two examples of misuse and discusses potential countermeasures by considering factors contributing to these behaviours.Main Body: From both public and medical perspectives, these patient behaviours are problematic, causing potential harm to others, negative consequences to such patients themselves, exhaustion of healthcare staff, and breakdown of emergency medical services. Although citizens need to recognize the public nature and scarcity of medical care, the more immediate need may be to identify and to remove personal and social causes inducing such misuse. In addition, healthcare professionals should become more trustworthy. To combat these issues, one-sided penalties such as accusations or sanctions for patients who misuse the system cannot be justified in principle. If measures taken to prevent misuse are ineffective, imposing surcharges or restricting consultations may be considered official policy, but these are not acceptable for several reasons.Conclusion: For now, we conclude that we must rely on the spontaneous motivation of patients who engage in 'convenience-store consultations' and ambulance transportation instead of taking a taxi. [ABSTRACT FROM AUTHOR]

The Japanese government has asserted that the purpose of scientific activities is to search for the truth about the world and contribute to public interest of the humanities and claimed that research misconduct should occur under no circumstances ever. The revealing of each new case of research misconduct leads to the establishment of investigation committees and research guidelines, as well as punishments for the transgressors. However, we wonder if Japanese researchers are receiving different messages that might undermine the purpose of the former messages. First, Japan's policies on science and technology have been created to comprise an integration of merit-based evaluations, principles of competition and a concentrated and unbalanced distribution of research funding, leading to decreases in ordinary research funding for the researchers and an increase in fierce research competition. Second, Japanese government and society as a whole continue to send the researchers messages such as 'Only results matter', 'Be No. 1 as a top priority' and 'All we need now is scientific progress'. Third, cultural peculiarities may explain some of the actions relevant to research misconducts currently noted in Japan. We argue that it is essential to re-examine and improve the governmental policies and evaluation methods for research achievements need to be more multifaceted. In order to have the researchers act according to ethics, it is essential for them to reaffirm their objectives for working in the fields of science and medicine and the importance of balancing their personal profit with the greater cause for entering into this field. [ABSTRACT FROM AUTHOR]

Introduction: To investigate the proportion of those having preferred place for end-of-life care among residents in a remote island and its association with family composition., Methods: Cross-sectional questionnaire survey was conducted in Ajishima, an island 23 km away from the coast of Ishinomaki City, northeast of Japan. Between October 2017 and February 2018, the questionnaire was distributed to 288 eligible residents and 113 valid responses were analyzed. Primary outcome was whether the subjects had preferred place for end-of-life care. The explanatory variable was family composition defined as whether having family members inside or outside the island [none (In-/Out-), only inside the island (In+/Out-), only outside the island (In-/Out+), and both inside and outside (In+/Out+)]. Poisson regression analysis was used to calculate the prevalence ratios (PRs) and 95% confidence intervals (CIs) of showing preferred place in each group., Results: The proportion of those having preferred place for end-of-life care was 72.6% in total. This rate significantly differed across family composition groups: 67.6%, 40.0%, and 82.9% for In+/Out+, In+/Out-, and In-/Out+ groups, respectively. The PR (95%CI) of having preferred place was 0.66 (0.33, 1.36) and 1.26 (1.01, 1.56) for In+/Out- and In-/Out+ groups, respectively, compared with In+/Out+ group., Conclusions: This study showed that significantly higher preference for place of end-of-life care was seen among residents who had family members only outside the island compared with those who had families both inside and outside. Health care professionals should consider family compositions when initiating end-of-life discussion to residents in remote areas., Competing Interests: None, (Copyright © Japan Medical Association.)