- 著者
- 棚橋 實
- 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.16, pp.149-150, 1998-10-01 (Released:2018-02-01)
Studies on liberalism in medicine, as theoretical foundations for patients' self-decision-making, have not been fully explored. This is because liberalism itself consists of historical and ambiguious areas where less attention has been directed to its intent and debates. Renewing the definition of liberalism is among the most important duties that we must now (achieve?) pursue. "Withholding of life sustaining-treatment" as a role of the physician has been actively debated in the United States, but in Japan we have not discussed in detail about the role of the physician over the relationship with patients and families. The meaning of "futile" as a concept for terminally ill patients encounters many difficulties such as informed consent and patients' self-control. But the emphasis on finding a common ground between patients and physicians wishes remains unanswered in Japan. Concerning rejection of blood transfusions by Jehovah's Witnesses, the situation about patients' self-decision making in Japan has been at stake, since the religious and precautious problems have surrounded the concerns. But in February 1998 the Tokyo High-Court of Justice held that blood transfusions without consent are illegal and implied that we are going to get the mutual understanding of real self-decisionmaking. Recognizing the increased interest in liberalism, recent developments in health care policy have drawn sharp distinctions between medical treatmen for patients who are competent to make decisions and those who are not. While traditional liberalism favors competent patients, medical liberalism includes areas to which incompetent patients, such as embryos and patients in vegetative states belong, In these cases, liberalism itself can not be principally realized. A discussion about liberalism in medicine raises questions not easily answerd without consideration of one's own values and the values of society.
- 著者
- 棚橋 實
- 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.13, pp.146-149, 1995-10-01 (Released:2018-02-01)
Many problems emanate from the modern science and technology that laid the foundation for modern medicine. They generally tend to lose whole system or balances compared with previous period. Even in the most advanced sphere of medicine we encounter the limits of modern science in two directions which we will examine as follows. First, we should restore the real definition of illness which appears to have been lost in modern medicine, second, to retrieve the wholeness of mankind from the dualism of humans having separate dimensions of mind and body. When we talk about the idea of illness, we ought to presume simultaneously what health is, or what health means, and not be allowed to illness as an exceptional issue with regared to health. For we have a gift for spontaneous recovery as Hippocrates once commented. Moreover, we must clarify the biological and philosophical structure of life itself and flou mind effort in the area of preventive medicine. All human illness must be based on the idea of "mind-body interaction" only on which healing could be realized. Particularly we must appreciate the patient as a real individual to whom philosopher since Descartes could not attain in proper meaning, because even the same disease appears with different symptoms in different patients. In order to closely new aspects of real individuals, we should evaluate the ethical relationship between patient and physician in which dialogue plays an important role, and narrative contexts or temporal axis for this purpose are very valuable J. Dewy mentioned that morality is a continuing process not a fixed achievement.