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)

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
前田 義郎
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.32, pp.1-10, 2014 (Released:2018-02-01)

In this paper, I discuss the significance of informed consent( IC) at the time of its origin in the United States. There are two settings wherein IC is applied ― human research and clinical medicine. In clinical medicine, two legal principles ― battery and negligence ― are relevant in lawsuits. I show that the core of IC comprises the principle of “negligence,” whose significance is clarified in this paper in detail. This principle means “an enlargement of the scope of doctors’ responsibility”, which urges us to redefine the relationship between doctors and patients. Finally, on these grounds, I consider the ethical implications of “self-determination of patients.” The essence of IC is that it changes the order of priority, from the previous relation, “the benefit of the patient > the will of the patient,” to the current relation “the will of the patient > the benefit of the patient”. In other words, the essence of IC is to respect the will of patients and provide medical benefits by assisting them.
著者
佐藤 拓司
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.23, pp.97-105, 2005-10-26 (Released:2018-02-01)

This paper analyzes the notion of sexual perversion from a philosophical stance. Sexual perversion is difficult to analyze because the notion of sex is itself ambiguous and unclear. Alan Soble identifies five central distinctions within the conceptual philosophy of sex that define the concept of the sexual act as 1) involving contact with a sex organ, 2) serving a procreative function, 3) producing sexual pleasure, 4) relying on intention or purpose, 5) being defined in terms of sexual desire. However, none of these definitions is sufficient. The philosopher Thomas Nagel set out a psychological standard that remains useful today. He defined the purpose of sexual desire as one of communication among the participants. According to Nagel, sex has an overlapping system of sexual perceptions and interactions: it involves a desire that one's partner be aroused by the recognition of one's desire that he or she be aroused. Nagel's theory, known as the "communication model", proposes a purpose for the sexual act and attempts to explain the essence of perversion. It proposes that the act of blocking off the communication results in the perversion. This model has a number of problems, however. For example, it implies that sexual relations between regular partners are inferior to novel encounters because less remains to be communicated sexually. Why is such a conclusion derived? Because the communication model is built up with equivocal and ambiguous structure, it involves both external and internal moral criteria. The coexistence of both types of criteria is the source of the model's problems.
著者
江口 聡
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.19-28, 2010-09-24 (Released:2018-02-01)

After briefly reviewing the philosophical controversy on abortion, I will introduce Don Marquis' "future-like-ours" argument and its various critiques. Marquis insists that (1) it is seriously immoral to kill us because killing deprives us of our valuable futures, and (2) a human fetus has a future like ours, therefore (3) it is seriously immoral to kill a human fetus. His argument is very simple but plausible, and not easy to rebut. Possible objections to his argument are (1) an objection from negligence of the women's viewpoint, (2) a ruductio ad absurdum objection from contraception, (3) an objection from metaethical analysis of "loss" and "deprivation", (4) an objection from personal identity and non-similarity of a fetus and us, and (5) a metaethical objection from relation of value and desire. I argue that objection (5), which relies on the desire account of value, is most powerful, if we are to account for modifications and qualifications of "desire", such that desire should be interpreted as "dispositional desire" and desires should be "rational and well-informed". But these objections also have a significant burden of philosophical justification.
著者
関 修
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.15, pp.33-47, 1997

1. Medical Philosophy, Ethics and Problems of Homosexuality. The various concepts of sexuality were invented by psychopathology in the late 19th Century. In the DSM-III-R of 1987, homosexuality suddenly became normal from abnormal. However transgender remains an illness, as it was before. It is only a political problem. Another important problem is about AIDS. In Japan, there is discrimination between AIDS caused by medicine and AIDS caused by other factors. 2. Homosexuality as Thought : Situation of modern French Thought. In France, The "May Revolution" of 1968 caused the foundation of a new university : Paris 8th (Vancennes). One of its founders, Rene Scherer began his first lecture on sexuality in the faculty of Philosophy. His partner, Guy Hocquenghem, founded FHAR. Recently, Red and Black-Homosexuals in France after 1968 by F.Martel was published. However, Prof. Scherer has told me it is a defective book. 3. Thought of G. Hocquenghem : concerning homosexual desire. The originality of Hocquenghem's thought seems to lie in his idea of forming "a group of subjects" through the anus. The creation of relations among others by anality stands against ideas of couples. Being homosexual is not a means to attain self-identification, but a means to be out of self, to become a foreigner. It is also an escape to an infinite drifting from a stiff identity. 4. The Voice of M. Foucault : Homosexuality as a form of existence. Foucault's thought about homosexuality summarizes two points. First, to be homosexual is not correct ; to become homosexual is correct. He takes "gay" to create a new form of existence. Therefore, he does not think coming-out to be inevitable. Secondly, his problem is to begin to love among individuals. It means that "I" is more essential than sexuality. Here there seems to be fascination for passivity. 5. Conclusion : In Japan, they say "gay" is already out of fashion : now "queer" replaces it. However, such nomenclature is only a matter of fashion. To my regret, regular studies on gayness or queerness are not carried out in Japan. Now, it is necessary to study homosexuality as thought. That means to meet various thoughts not only to introduce and imitate them but to get involved in them : to have a mind of "hospitality". That is a critically needed task in Japan.
著者
金谷 光子 尾曽 直美
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.22, pp.93-102, 2004

Because there may be limitations in the scientific method of discovering and treating patients' "problems," the narrative approach has become increasingly important. These limitations have been pointed out by scholars from various fields. Hermeneutic view point has it that clinical knowledge is mostly based on the doctor's assumption and differs greatly from the world in which the patients live their lives. What should those in the nursing profession choose as a means of understanding patients? There is a Social Constructionist view that understanding is obtained through "language." When the sick patient tells about the world in which he/she lives in certain words, he/she has decided not to tell in other words. Then the patient's world appears before us as he/she tells. The patient organizes his/her world through telling as well. After over three years of interviewing with Ms. K, who was stuck with her mal-treating mother, we verified what telling brought to her, and how it was connected with understanding herself. Listening to Ms. K's narrative was linked to understanding her world in which she lived her life. It also brought a certain order to her confused history. As a result, her regrettable past came to have possibility for the future, altering her mentality so much as to make it possible for her to say "I have done my best" and "I have been living so well."
著者
杉岡 良彦
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.25, pp.61-70, 2007-10-18 (Released:2018-02-01)

Dr. Makoto Kondo, a radiologist at Keio University, has suggested that one should not fight against cancer. His arguable claims are that (1) cancer screening is ineffective and that (2) cancer is divided into two categories: true cancer and pseudo-cancer ("gan-modoki" in Japanese). The former has a strong potential to be invasive and has already reached the invasive state on detection by screening. The latter is noninvasive and therefore the affected patients need not undergo medical treatment unless they exhibit some symptoms. Kondo highlights the evidence provided by medicine and informs us of how poor its basis is. It should be noted that he reached this conclusion through in-depth reflection on findings regarding cancer, without submitting to the opinions of the authorities. From the perspective of philosophy of medicine, we may state that his attitude is that of a philosopher. However, he also discourages patients who believe that cancer screening and treatment are effective. On the other hand, Dr. Toru Abo, an immunologist and a professor at Niigata University, has developed a theory regarding the close relationship between the autonomic nervous system and the immune system, and maintains that cancer can be cured by activation of the latter. In contrast to the claims of Kondo, many of Abo's claims lack medical evidence, but he offers hope to patients. Kondo's theory is based on positivism, and he does not raise the hope of patients. Kondo's position is very effective in revealing the insubstantial basis of medical science, but he confronts patients with nihilism, while Abo offers hope without considering the fact humans are mortal. Based on the opinions of these two doctors, we can reflect on the limits of application of positivism in medicine and the importance of the optimism that patients display and their individual initiative.
著者
竹内 章郎
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.17, pp.211-218, 1999-10-01 (Released:2018-02-01)

In this article, I will chiefly demonstrate the assertion that the right to die cannot yet be justified. And I will carry out this demonstration from the following five aspects. First of all, the way of society and culture should not be ignored, for the right to live and the right to die are also dependent upon the way of society and culture. Particularly noteworthy is the horizontal development of society and culture. In the long run, if this development is enough to preserve all the lives of people sufficiently, people may not claim the right to die. Secondly, I notice the problem of the method of the ethical question itself, which academic practices have often overlooked. Because this problem has effected the justification of the right to die as I will show later. Third, we must clearly distinguish the right to die from inevitable death by reason of historical limitations. This argument, of which many sholars often have forgotten, should be unavoidable. Fourthly, we may be informed of some problems about the right of self-determination. Because even if the authentic right to death is guessed on the basis of the right of genuine self-determination, that case cannot often be brought into materialization. Fifthly, we should direct our attention to self-preservation of life itself and to social intensification of a disposition to this self-preservation. I have confidence that the evidence of demonstration which can be acquired from those aspects mentioned above in this article may be sufficiently strong to override the justification of the right to die.
著者
加藤 太喜子
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.31, pp.33-41, 2013 (Released:2018-02-01)

Regulation for use of tissue of aborted human fetuses for research is enforced in countries and international organizations such as World Medical Association and the Council of Europe. For these parties, the use of fetal tissue is permissible when conditions prescribed by the guidelines are met. Common requirements for permissible use are ① approval by the Ethics Committee; ② determination of provision of fetal tissue after the decision of abortion; and ③ consent of the provider. Some guidelines require that the man is not rejecting, but there is also one guideline that accepts only the consent of the woman. In any guidance, the consent by woman is essential. From the perspective of systems of providing information, this paper presents a literature survey of the use of fetal tissue. It was found that ① daily, open exchange of views about provision of fetal tissue is not possible for women; ② women hope and want to know the intended use of the fetal tissue and the overall description of the research; ③ although information needed to grasp the overall idea of the research is sorely lacking, women may make decisions under pressure. On the basis of the results, people who are requested to provide information later are required to provide information that is satisfactory for decision making, instead of unsatisfactory information such as those labeled as“ being offered to know/not being offered to know”. For this reason, the current“ sufficient” explanation should be re-examined as to whether it is truly a satisfactory explanation.
著者
石川 洋子
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.1-9, 2010-09-24 (Released:2018-02-01)

Advocacy in nursing, is a central concept in terms of protecting the interests and rights of patients as well as establishing and improving the expertise and social status of nurses. In fact, advocacy is a role played not only by nurses, but by all medical professionals. Advocacy is an important concept for nursing with extensive meaning and contents. Consequently, confusion can occur due to the uncertainty advocacy poses for nursing practice. Moreover, advocacy is accompanied by risk and difficulty, and there are no clear guidelines on how to implement it. It is necessary to enhance education and improve the workplace environment to practice advocacy effectively. It is also essential that nurses reconsider their values and how they support patients while collaborating with other medical professionals.
著者
有馬 斉
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.25, pp.71-80, 2007-10-18 (Released:2018-02-01)

In moral discourse, people often appeal to emotion as opposed to reason. This is particularly true when they discuss the moral status of the use of new biomedical technology. Sometimes we may be unable to articulate an argument against organ transplantation from a brain-dead person, host surrogacy, human embryonic stem cell research, etc; we may then only say that "these acts are disgusting." What exactly do we mean when we say that someone's act is "disgusting"? In the first half of this paper, I shall distinguish three cases: (1) a person who seeks to reach a "reflective equilibrium;" (2) a communitarianist; and (3) a moral realist, each of whom may appeal to emotions in his or her own way. The purpose of the latter half of the paper is to examine and refute the manner in which moral realists appeal to emotion. Consider, for example, incest, cannibalism, rape and murder. It may seem that these acts are objectively evil, and that they provoke a negative emotional reaction. These facts might lead one to believe a realistic idea that human beings are biologically equipped with a special kind of emotion whose function is to detect objectively existing moral evilness. In order to show a fallacy involved in this inference, I shall point to a fact that has been reported in the literature of empirical psychology.
著者
吉田 一史美
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.29, pp.53-62, 2011-09-30 (Released:2018-02-01)

This paper studies a movement in Japan in the 1970s and 1980s for a new adoption system to give women reproductive freedom by providing an alternative to abortion. The study examines why the adoption movement resulted in failure and reveals how concurrent campaigns to restrain abortion influenced this failure. In 1973, Dr. Noboru Kikuta publicly confessed to arranging 100 illegal adoptions using false birth certificates in cases of unwanted pregnancy to protect the mothers and save their fetuses. Subsequently, he started a movement to deny abortion to any woman past her seventh month of pregnancy, when a fetus can survive outside of the womb, and to establish a new adoption system protecting women's privacy in records of childbirth and adoption to provide an alternative to abortion. However, jurists did not embrace the protection of unmarried mothers from stigma and the Special Adoption Law established in 1987 did not reflect Kikuta's proposal. In the 1970s and 1980s, while Kikuta developed his movement, some religious groups and politicians criticized the Eugenic Protection Act, which was enacted in 1948 and allowed abortion within the seventh month. They campaigned to amend the act to prohibit most abortions and include disabled fetuses in eugenic policies instead. However, feminist and disabled people's groups protested against and frustrated the campaigns. As a side effect of this controversy, Kikuta's movement for a new adoption system was seen as being radically pro-life or anti-feminist. Moreover, obstetricians making a living by performing abortion and feminists did not actively support him. Kikuta's new adoption system was a simple proposal to protect fetuses' lives and add to women's choices, but the concurrent anti-abortion campaigns made Kikuta's beliefs and actions seem overly political. Kikuta's failure and the present situation of adoption in Japan are representative of the limitations of women's reproductive freedom in Japan.