著者

加藤 穣

出版者

日本医学哲学・倫理学会

雑誌

医学哲学 医学倫理 (ISSN:02896427)

巻号頁・発行日

vol.33, pp.41-51, 2015-09-30 (Released:2018-02-01)

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The objective of this paper is to discuss the reasons that some individuals in the United States refuse to be vaccinated, focusing on those reasons usually described as "conscientious." This paper discusses current compulsory vaccination practices and the most common categories of reasons objectors in the United States give for refusing vaccinations (on medical, religious, or philosophical grounds, the latter two of which are often described as conscientious reasons). Possible ways to handle refusals are examined from the perspectives of the three categories of refusals mentioned above, the particularities of vaccination within biomedical ethics, and public health ethics discussions. Although refusals based on divergent perceptions of risk are commonly classified as refusals for philosophical (personal) reasons, objectors in this category are trying to present medical reasons, which do not convince experts. Even if experts try to persuade the public by presenting scientific evidence, there remain fundamental difficulties in convincing objectors. Refusals for religious reasons are to a certain extent established historically, but few major religious groups nowadays explicitly refuse vaccinations per se. Refusals in this category are not necessarily plainly "religious." Certain refusals on religious grounds, including those based on repugnance for the use of components derived from aborted fetuses, can be avoided by technological advances in the medical field. Refusals based on philosophical reasons should be handled in more sensitive, individualized ways than they are now. The inquiry ventured in this paper is important for Japanese society in that it deals with general questions surrounding the contradictions between the autonomy principle, which is paramount in biomedical ethics, and the compulsory schema of public health policy, and asks whether and how the different qualities or characters of decisions regarding health care and public health should be translated into practice.

著者

加藤 穣

出版者

日本医学哲学・倫理学会

雑誌

医学哲学 医学倫理 (ISSN:02896427)

巻号頁・発行日

vol.33, pp.41-51, 2015

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The objective of this paper is to discuss the reasons that some individuals in the United States refuse to be vaccinated, focusing on those reasons usually described as "conscientious." This paper discusses current compulsory vaccination practices and the most common categories of reasons objectors in the United States give for refusing vaccinations (on medical, religious, or philosophical grounds, the latter two of which are often described as conscientious reasons). Possible ways to handle refusals are examined from the perspectives of the three categories of refusals mentioned above, the particularities of vaccination within biomedical ethics, and public health ethics discussions. Although refusals based on divergent perceptions of risk are commonly classified as refusals for philosophical (personal) reasons, objectors in this category are trying to present medical reasons, which do not convince experts. Even if experts try to persuade the public by presenting scientific evidence, there remain fundamental difficulties in convincing objectors. Refusals for religious reasons are to a certain extent established historically, but few major religious groups nowadays explicitly refuse vaccinations per se. Refusals in this category are not necessarily plainly "religious." Certain refusals on religious grounds, including those based on repugnance for the use of components derived from aborted fetuses, can be avoided by technological advances in the medical field. Refusals based on philosophical reasons should be handled in more sensitive, individualized ways than they are now. The inquiry ventured in this paper is important for Japanese society in that it deals with general questions surrounding the contradictions between the autonomy principle, which is paramount in biomedical ethics, and the compulsory schema of public health policy, and asks whether and how the different qualities or characters of decisions regarding health care and public health should be translated into practice.

著者

加藤 穣

出版者

日本医学哲学・倫理学会

雑誌

医学哲学 医学倫理 (ISSN:02896427)

巻号頁・発行日

vol.30, pp.63-67, 2012-09-30 (Released:2018-02-01)

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Members of the Watchtower Bible and Tract Society, also known as Jehovah's Witnesses, refuse blood transfusions based on their religious principles. In Japan, their refusal has posed challenges since the 1980s. The only court ruling on this matter by the Supreme Court was made in 2001, which ruled that the refusal of blood transfusion based on religious reasons should be respected as a personal right. The Supreme Court apparently chose the words cautiously and addressed exclusively the refusal of blood transfusion based on religious principles, as the Japanese judicial system has a way of judging exclusively the contested issue. Nevertheless, the ruling has mostly been regarded as a celebrated case of recognizing the superiority of an autonomous decision by a patient over other values or obligations. Although typical blood transfusion refusal in an operation planned in advance by competent adult Jehovah's Witnesses has been established since the court ruling, it has been understood in an expansive way without justification. That is, the religiosity of blood transfusion refusal by Jehovah's Witnesses has been ignored for the most part, with their religious refusal understood as merely an autonomous decision or self-determination. I argue against rapid expansive interpretation of the said court decision, citing court rulings and related cases in other countries, especially the United States. In doing so, I show the need to revisit the implications of the religious aspects of refusals in potentially controversial cases.

著者

于 麗玲 塩見 佳也 加藤 穣 宍戸 圭介 池澤 淳子 粟屋 剛

出版者

日本生命倫理学会

雑誌

生命倫理 (ISSN:13434063)

巻号頁・発行日

vol.23, no.1, pp.125-133, 2013-09-26

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中国「優生優育」政策は、「中華人民共和国母嬰保健法」(以下、母嬰法と称する)及びその下位法令(「母嬰保健法実施方法」、「出生前診断技術管理方法」、「新生児疾病検査管理方法」ほか)から看取される。「優生」に関して、母嬰法及びその下位法令は、婚姻予定のカップルや一定の医師に、以下のような義務を課している。すなわち、同法等は、まず婚姻予定のカップルに対して、(1)婚姻前の一定の時期に「婚前医学検査」を受ける義務、及び(2)婚姻登記機関へ「婚前医学検査証明」を提出する義務を課している。次に、一定の医師に対して、一定の場合に、(3)カップルに婚姻の時期を暫く延期するように勧告する義務、(4)カップルに「婚前医学検査証明」を発行しない義務、(5)カップルに長期間の避妊もしくは避妊手術を行うよう勧告する義務、(6)妊婦に出生前診断を実施する義務、(7)妊婦に人工妊娠中絶をするよう勧告する義務を課している。母嬰法及びその下位法令は「優生」に関する義務を課すのみではない。「妊産期医療サービス」(母嬰法第14条1項と2項、「母嬰実施方法」第26条)、「新生児保健」(母嬰法第14条4項、「母嬰実施方法」第26条)等をも規定している。これは、「優生優育」政策における「優育」の側面を表すものである。

著者

于 麗玲 塩見 佳也 加藤 穣 宍戸 圭介 池澤 淳子 粟屋 剛

出版者

日本生命倫理学会

雑誌

生命倫理 (ISSN:13434063)

巻号頁・発行日

vol.23, no.1, pp.125-133, 2013-09-26 (Released:2017-04-27)

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中国「優生優育」政策は、「中華人民共和国母嬰保健法」(以下、母嬰法と称する)及びその下位法令(「母嬰保健法実施方法」、「出生前診断技術管理方法」、「新生児疾病検査管理方法」ほか)から看取される。「優生」に関して、母嬰法及びその下位法令は、婚姻予定のカップルや一定の医師に、以下のような義務を課している。すなわち、同法等は、まず婚姻予定のカップルに対して、(1)婚姻前の一定の時期に「婚前医学検査」を受ける義務、及び(2)婚姻登記機関へ「婚前医学検査証明」を提出する義務を課している。次に、一定の医師に対して、一定の場合に、(3)カップルに婚姻の時期を暫く延期するように勧告する義務、(4)カップルに「婚前医学検査証明」を発行しない義務、(5)カップルに長期間の避妊もしくは避妊手術を行うよう勧告する義務、(6)妊婦に出生前診断を実施する義務、(7)妊婦に人工妊娠中絶をするよう勧告する義務を課している。母嬰法及びその下位法令は「優生」に関する義務を課すのみではない。「妊産期医療サービス」(母嬰法第14条1項と2項、「母嬰実施方法」第26条)、「新生児保健」(母嬰法第14条4項、「母嬰実施方法」第26条)等をも規定している。これは、「優生優育」政策における「優育」の側面を表すものである。

著者

加藤 穣

出版者

日本医学哲学・倫理学会

雑誌

医学哲学 医学倫理 (ISSN:02896427)

巻号頁・発行日

vol.28, pp.29-37, 2010-09-24 (Released:2018-02-01)

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In several areas in the world, including New York State and the State of New Jersey, one can virtually be diagnosed dead based on cardiac death criteria even if brain death occurs. In New York and New Jersey, such exemption from brain death determination is often a consequence of the accommodation of religious and moral objection to neurological death criteria. This paper aims to shed some light on the implications and problems of conscientious objection to the determination of death based on brain death. In the first place, the paper describes the background that led to the enactment of such objections in New York and New Jersey, including the initiative by some religious group. Then, the efficacy of the frequentlymentioned parallelism between conscientious objection to brain death and military service is called into question. After distinguishing between the positive and negative effects of conscientious objection to brain death, the paper argues that conscientious objection to brain death differs from objection to conventional conscription understood as a strong obligation in that the "object" of the objection is not obligation but the default death definition or the alleged singularity of human death, considering that the New York guidelines, for example, prescribe no obligation for patients or their families. In so doing, the paper questions the understanding that the essence of accommodation of conscientious objection to brain death is sincerity in limiting the free choice or self-determination in death declaration. The possible ramifications of the above conscience clause are also discussed.