著者

水田 信

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.25-32, 1995-10-01 (Released:2018-02-01)

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S. Kierkegaard pointed out that "despair" is a spiritual sickness, defining the human being-which is a synthesis of soul and body-as spirit in "Sickness unto Death". He said the possibility of this sickness is the human advantage over animal, and yet it is a drawback. V.E. Frankl, who was influenced in his thoughts and work by Kierkegaard, said that sickness is only in the sphere of psychophysical organization, not in the spiritual-personal sphere. Even neurosis is not a spiritual desease nor sickness in human spirituality. He also said that despair is human, and is not morbid. Frankl's "disease" has doubtlessly a narrower meaning than Kierkegaard's. However, can we acknowledge that "despair" is normal or sound in the human state ? As a matter of fact, there is a correspondence between some of Frankl's statements about "collective neurosis" and Kierkegaard's descriptions of forms of despair. So, we can expect that Kierkegaard's thought is useful to understanding Frankl's "logotherapy" or "existential analysis". Looking at it the other way around, it means that we can interpret Kierkegaard's ideas through knowledge of modern psychopathology. From this point of view, I would like to inquire into the essence of mental illness and to seak the key to recuperation from it.

著者

中里 巧

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.44-51, 1995-10-01 (Released:2018-02-01)

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I. The Concept of the Diakonia It is important that we research the hospice care from the viewpoint of the deaconess movements, when we think of the care especially. The origin of the concept "care" can be found in the old Greek word "diakonein" in The New Testament. The etymology of "diakonein" is "to serve at table". i. Table The table symbolizes openheartness and a hospitality just as the Latin word "hospitium". This elemental idea is the open-minded dialogue with the place. ii. Meal The meal symbolizes life and the death. The eating means to sacrifice another living for oneself. The meal points to the unity of life and death symbolically. One life should be dependent upon another death and one death should support another life. iii. Obedience "To serve" symbolizes Obedience. The carer obeys the cared-for one according to the life which the former gives to the latter. And the carer learns from the cared-for one and receive the wisdom from that person who die. iv. The Principle of the Diakonia The concept of the diakonia is built of the following elements: the open-minded dialogue with the place, the unity of the life and death and giving life and receving wisdom. The ideas of the diakonia are concentrated upon the practice of Jesus Christ. Jesus said by himself that he was a deacon. The practice of diakonia in imitatio Christ is in The New Testament. The New Testament the be cared one should be the poor. II. The Deaconess Societies and their Care The practices of The deakoness are found from the ancient age to the recent times. But the first official society is founded by Theodor Fliedner in Kaiserswerth 1836. The most difficult problem of them has been the conflict between the religiose idea and the technics of the care. III. The Separation of the Deaconess Movements and the social Welfare The deaconess movements spreaded rapidly and widely to the Northern Europe. The ideas of the diakonia spreded also upon The church voluntary works in Denmark. And the elemental thoughts of the diakonia has been developed to the social welfare.

著者

岡田 渥美

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.13, pp.61-69, 1995-10-01 (Released:2018-02-01)

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Scientific knowledge based on the modern European concept has achieved an emphatic success in promoting advanced technology, particularly since the middle of the 20th Century, and has blessed us with enormous benefits and convenience. On the other hand the pervasion of belief in 'science as a panacea' without realizing its robotic nature, led human to the confrontation with the danger of 'geo-catastrophe.' Moreover it exerted such a profound influence on every corner of our social life and even permeates the human 'psyche' (way of thinking, emotion, will, or value-consciousness of individuals) that it precipitated the crisis of 'psycho-catastrophe.' It is no exaggeration, in this sense, that "we nowadays are struggling for lives in quest of meaninglessness." (L.Mumford) A recent controversial issue of "Organ Transplantation from Brain-Death Donors" typically reflects the dilemma of human beings. If we reflect upon our onus for the whole humankind in the past, present and future, along with a hope of ensuring their welfare in the coming Centuries, we need to reexamine and redefine the true quality of "the 'life' which belongs exclusively to humans."

著者

佐藤 純一

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.70-78, 1995-10-01 (Released:2018-02-01)

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This paper attempts to reconsider the etiology of modern medicine (or bio-medicine) from the view points of medical anthropology and medical sociology. The discussion of causality in modern medicine fundmentally depends upon biological factors and theories, and seems to neglects socio-cultural factors and theories. At first in this article, the another criticizes the origin of modern medicne, emphasizing the importance of the viewpoint of socio-cultural contexts. Next, based on historical-theoretical-anthropological studies of modern medicine and non-western medicine ("traditional medicine"), it is strongly proposed that the origins of both traditional medicine, and also modern medicne, derive from theories bound with the respective culture. Therefore we can think the modern medicine as a kind of traditional medicine. A tentative theoretical model of origins in order to inquire into all origins is proposed. In the kind part of this article, after describing the new concept of the origins of modern medicne, which depends upon probability and epidemiology, the new concept is examined with this tentative thoretical model.

著者

霜山 徳爾

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.79-87, 1995-10-01 (Released:2018-02-01)

著者

杉田 勇

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.88-104, 1995-10-01 (Released:2018-02-01)

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In 1990 The Japan Medical Association translated the Englisch concept "informed consent" as "explain and consent" into Japanes and made a report on informed consent. In the report it is said that informed consent will make an opportunity to reconstruct a new human relationship between physicians and patients in our country. But how is informed consent possible ? The aim of this paper is to consider informed consent from three aspects, i.1. legal, ethical and philosophycal theory and to establish the theoretical foundation for informed consent. The consideration of the paper is as follows. 1. Concept of informed consent. 2. Informed consent. for whom ? 3. Can we introduce informed consent directly into our country ? 4. Acceptance and modification of the informed consent concept. 5. Never treat a person simply as a means, but always as a goal. 6. The meaning of informed consent. -From consent to agreement.- 7. Conclusion. -Metaphysical meaning of informed consent.-

著者

澤田 愛子

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.13, pp.105-114, 1995-10-01 (Released:2018-02-01)

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When we consider the ethical and social responsibility of nursing, we should note the concept of nursing advocacy, which is often used as a key word in nursing ethics in U. S. Nursing advocacy holds the view that nurses are responsible for advocacy of patients rights and interests. We can find out different model theories on nursing advocacy in many literature on bioetics and nursing ethics. For example, there is the legal rights model of G. J. Annas, the values-based model of Kohnke, the respect forpersons model by C. P. Murphy and the social advocacy model of Freeman. However, we do not have yet have a conclusive theory on it. We can draw some points on nurses' roles in informed consent between physicians and patients by using the concept of nursing advocacy, For example, nurses can give more explanations to patients to make up for a lack of medical informations by doctors. Moreover, they can help patients to understand information better by asking doctors in place of the patients, In this way, nurses can help patients to make decisions according to their own values. Nurses should do their best to keep best interests of patients, However, to enable nursing advocacy, nurses' rights as patients' advocates should be respected by physicians and other health care personnel.

著者

奈倉 道隆 大倉 民江

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.115-122, 1995-10-01 (Released:2018-02-01)

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In Japan, informed consent (IC) is not carried out satisfactorily in order to improve the situation, medical social work (MSW) is essential. While the need for MSW is increasing, it is yet recognized in the medial world of japan in four of the reasons for this fact are as follow (1) Medical doctors take the initiative in the field of medicine and patients become more passive. As a result publish do not try to ask for MSW support. (2) In Japan, medicine only means diagnosis, treatment or nursing of diseases. Solution psychological or social problems of a patient are not considered medical matters, even though they may be related to disease or treatment. (3) Right now, medicine is not administered through team work, and MSW, activities which received patient asking and coordination of medical activities do not operate smoothly yet. (4) In Japan people tend to think that maintaining a good relationship is much more important than realizing their own will or desire. These four factors hinder IC. Now it is necessary to solve these problems. The solution of this problem would also bring the proper situation to make progress IC and establish MSW concretely, which would contribute to IC.

著者

土屋 健三郎

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.12, pp.75-89, 1994-10-01 (Released:2018-02-01)

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The President's Address which I gave at the first entrance ceremony of the University of Occupational Environmental Health held in 1978 was entitled "The Mission of the University." The first article stated: "This university should educate students to become doctors who philosophize for themselves throughout their lives." The verb "philosophize" means to reflect seriously on great matters such as life and death,mind and body, etc. A philosophizing doctor integrates science and humanism with his or her person. In modern industrialized society, technology-oriented scientists and physicians tend to view nature as a set of external objects free for artificial intervention. This tendency presents many hazardous problems of bioethics. Modern Western rationalism is responsible for much of excessive dominance of science and technology. In contrast Oriental thinking views human life as being harmoniously incorporated in nature. In order to survive, the world must find a way to unify Oriental humanism with Western humanism. Although modern scientific technology has elevated the standard of living, it has also caused the destruction of nature. Here another controversial problem emerges; that is, whether or not satisfying human desires takes precedence over the sanctity of life and nature. This problem requires us to establish new environmental ethics. If we merely stand on either the biological view of life or the person-centered view of life, we understand life in utilitarian terms and do not realize the intrinsic meaning of life. To establish both the new bioethics and environmental ethics, we should regard the standpoint which sees life as a matter of quality and the nature-centered view as important. If human beings do something because they have the technique to do it, it may lead them to a self-destructive end. I believe that human beings should have a modest attitude toward life and nature.

著者

山下 博

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.12, pp.90-98, 1994-10-01 (Released:2018-02-01)

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The basic standards for education in universities or colleges were revised on March 7th, 1991.The purpose of the revision is to simplify the basic standards and to show the fundamental principles of education in universities and colleges. After the Second World War, the Japanese Ministry of Education introduced a new education system for the purpose of establishing a more humanistic system. For the past 50 years, this system has been in effect also in higher education. The principle of this system is ideal and works very well in primary and secondary school education. However, in higher education, the time allotted for major subjects has been decreased from four years to two years resulting in a lower quality of professional education in Japan. Now, the Japanese Ministry of Education has started to feel anxiety regarding the future of Japanese higher education and has decided to improve this system. this revision will be the second one since the Meiji restoration. By this revision, Japanese universities and colleges will be able to draw up their own curricula. In return, they are asked to establish a self-evaluation system, which is necessary for accreditation. In many medical schools in Japan, the faculty for general education is being abolished and medical subjects are taught even in the first year. On the other hand, since medical ethics is very important today,medical doctors must be trained in this field. In this unsettled situation, lecturers of general education subjects must also be fully dedicated to the purpose of their medical colleges and strive to improve their teaching methods accordingly. I explained the situation of general education in medical schools in Japan and the principle of our medical college.

著者

品川 信良

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.12, pp.99-105, 1994-10-01 (Released:2018-02-01)

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Since the 19th century, the more that medicine has advanced, the more the distance between medicine and other specialties such as philosophy, ethics, and law has increased. When science and technology are subspecialized, the number of subspecialists with narrow views is very likely to increase. Medicine is not an exception. To narrow this distance between medicine and philosophy, ethics and law, many attempts and trials are in progress almost throughout the world, especially in advanced countries. Probably the most interesting among them is in the United States of America (USA). In the USA, with regard to clinical ethics and medicolegal problems, the development of a new srecialty or of a new job, independent both from patients and physicians, is in progress, and the number of new specialists has been increasing since the 1980s. One new specialty of this kind is called "ethics consultation", and its specialists are called "ethics consultants" or "clinical ethicists". An attempt toward in progress has been made in Hirosaki, Aomori Prefecture in Northern Japan, since 1991. An association named "Seminar Medicine and Community" was founded. The numbers was 300 in October, 1993. Of them, 174(58.0%) and 89(29.7%) consisted of physicians and comedical staff, respectively. The remaining 37(12.3%) are specialists in philosophy, ethics, law and so on. Meeting are held once every three months, for discussions on selected controversial topics and traditional basic problems relating to health care and medicine from interdisciplinary viewpoints. In addition we publish a journal (Journal of Health Care, Medicine and Community) every six months. Papers are published in Japanese with English abstracts. Papers either from inside or outside Japan by any author who does not belong to our association will be accepted if judged by the editorial board to be "distinguished"

著者

岡田 雅勝

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.12, pp.106-110, 1994-10-01 (Released:2018-02-01)

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In medical education,as in general education,it may be asked whether those subjects included in natural sciences, humanities,foreign languages and sports are really necessary. The essential task of philosophy is to think deeply about the most fundamental problems of our world and life, and to critically judge them. It is, therefore necessary to teach philosophy as part of medical education. However,in recent years, the presentation of philosophy to students has become far from simple. Younger generations are less inclined to think seriously and deeply about life and merely wish to spend their youth pleasantly. When considering such tendencies,teachers of philosophy, such as ourselves, must seriously reflect on what we do and how we can change our own attitudes about the role of philosophy in education. The points of my speech are as follows. 1) The aim in teaching philosophy is to cultivate, to nourish and to develop the intellect of students through lectures on philosophy. We should therefore lecture not only on Western Philosophy but also our own Japanese traditional spiritual culture. 2) Contemporary topics such as bioethics and medical technology should also be covered in philosophy. Knowledge of these topics will deepen student's understanding of what a human being is and will eventually help create the image of an ideal doctor. 3) We must attempt to provide students with the critical faculties to consider and judge, and live their own lives.

著者

岡本 天晴

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.12, pp.111-117, 1994-10-01 (Released:2018-02-01)

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The distinction between general education classes and specialized classes has been discarded in the amendment of regulations for university curriculum (July 1,1991). As a result, universities can now draw up their own curricula. However, the amendment also stipulates that universities "must give specialized education to the students as well as to take appropriate measures to enhance broad knowledge and comprehensive ability to make decisions and to enrich the humanity of the students." Philosophy classes, as a part of the curriculum, should also be given at medical schools in line with the ministry's policy on curriculum compilation. Generally speaking, students take philosophy classes merely as one of the liberal arts classes (history of philosophy, introduction to philosophy etc.). The goal of the classes is to show students the various issues concerning philosophy. But it is also, if not more,important for medical students to acquire "broad knowledge" as is stipulated above: That is to say, to be familiar with the philosophical ways of thinking and to appreciate the world of philosophy, in itself, so that students develop the ability to see problems and to solve them on their own. Science, medical science included, has developed remarkably and has benefited people in many aspects. On the other hand,however, it has also over-defined and over-simplified the human existence to a point where science how endangers the very existence of human beings. We have become suspicious of the optimistic view that one day science and technology will solve all the contradictions of modern civilization. It is philosophy, based on liberal ideas, spirit and above all, human love that would enable people to evaluate modern civilization for what it is and to question the raison d'etre of human existence. I would like to discuss the role of philosophy taught in medical schools as an important part of general knowledge, and also to illustrate what the students might face in taking such classes.

著者

平山 正実

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.12, pp.118-124, 1994-10-01 (Released:2018-02-01)

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The paper discusses the image of an ideal physician, and also mentions how such physicians may be nurtured. Ideal physicians are expected not only to listen carefully to what patients and their family members have to tell them but to give them hope, to pray for them and to face them with integrity. Further, they need to have deep insight about themselves, know their own limitations well, and at the same time should be able to maintain reason and conscience in their approach to patients. The above has to do with ones' attitude as physicians, or a character question visa-vis their becoming ideal physicians. Naturally, any good physician must be one who is knowledgeable and equipped with good technical skills in the field concerned. In rearing ideal physicians, the following points need to be taken into account: 1) Physicians are expected to treasure even 'negative events' they have had in their own personal history such as their own experience of becoming sick, similar cases, including the deaths, of family members, the days of disappointment / frustration and to remember them as they face patients; 2) During their freshman and sophomore years at medical college, they should be exposed to opportunities of directly meeting the sick and the disabled; 3) It is recommended that they take part in rope playing featuring moot ethics committee, medical courts, and others.

著者

平野 武

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.12, pp.125-131, 1994-10-01 (Released:2018-02-01)

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Law school and medical school in the USA are what we call professional schools where graduate students work. These two professional schools have similarities in both their educational systems and problems. Generally speaking, undergraduate students in the USA study general education courses in colleges or universities and then select a major which is specialized but not professional. General education in the USA is rather different from "ippan kyoiku" in Japan. Students in Japan study "ippan kyoiku" without reference to their own Majous, less of them,so students have no motivation to accomplish it. they are not very interested in "ippan kyoiku", including philosophy. Philosophy education is now in crisis. We are facing the reformation of college education. Medical schools are not free from the changes. I propose that this Symposium should suggest a new model of the education of philosophy in the new curriculum of Medical schools in Japan. That suggestion should have some effects on the reformation going on.

著者

五十嵐 靖彦

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.12, pp.132-136, 1994-10-01 (Released:2018-02-01)

著者

勢川 瑠美子

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.11, pp.118-122, 1993-10-01 (Released:2018-02-01)

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今日に至るまでの看護は、時代の変化に伴い、社会が求めるニーズ並びに働く看護婦たちのニーズ等から多岐にわたり、その役割は拡大されてきました。平成3年に「看護の日」及び看護週間が認められ看護の本質や意味を国民的レベルで考えることが提唱され、看護の問題を国民一人一人の課題として考えようとするところに至ったことは、看護者の望むところではありますが、医療の中の検査、処置、薬剤や機器の高度化は看護婦の診療介助業務をますます増加し、患者のケアに十分な時間をとることが難しくなってきています。このような中で家族や患者の期待する看護ケアを提供するためには、共に働く医療チーム(特に医師)の協力は不可欠であります。これらに関わる現状と問題を具体的に挙げる中から「医療と看護」を再考していく機会にしたいと考えています。

著者

永田 勝太郎

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.11, pp.123-132, 1993-10-01 (Released:2018-02-01)

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The need of terminal care has been pointed out for a long time, but its practice has not come to be common in clinical work. This is mainly because of the lack of philosophy and methodology of terminal care. To practice terminal care it is indispensable to have a philosophy and methodology of comprehensive medicine based on whole person medicine (Balint, M.), which pursues the possibility of humanistic medical care. In the context of whole-person medicine, the bio-psycho-socio-existential medical model is the basic viewpoint to understand a patient. Furthermore, to perform comprehensive medicine, mutual respect between the current occidental medicine and the traditional oriental medicine with an interface with psychosomatic medicine is essential. Especially to care for a cancer pain patient, this viewpoint is indispensable. The core of psychosomatic medicine is Balint's medical interview, in which a patient is accepted, supported, and assured by a medical professional. In this interview, the medical professional works as a medicine (Balint, M.), that is to say, it is "therapeutic self (Watkins, J. G.). Logotherapy (Frankl, E. V.) is one method of the psychotherapy the main approach of which is to seek after a patient's meaning of life. "Life review interview" (Butler, R.) is one of the concrete methods of logotherapy. Through logotherapy, some cancer patients could gain awareness of their own meaning of life, then overcame cancer, and created their own new life. That is to say, they could live with cancer. The common attitude of such patients is "gentleness and toughness", through the experience of cancer. A nurse always takes care of a patient who is a human being with some disease. In the practice of nursing, a nurse meets many patients and observes many lives, which are living and dying. Nursing is one of the most humanistic occupations.

著者

杜 治政 品川 信良

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.11, pp.133-146, 1993-10-01 (Released:2018-02-01)

著者

欒 栄生 王 暁艶 品川 信良

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.11, pp.147-148, 1993-10-01 (Released:2018-02-01)