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.8, pp.35-51, 1990

Today's marvellous medical advances confront us with a verysevere problem, namely the criteria for establishing death, such as brain death. Technical advances in medicine now permit maintenance of cardiac and respiratory functions in human beings for a few days after massive or total destruction of the brain. This fact has presented us with delicate and difficult problems, especially in relation to organ transplantation. Namely, when a human being's brain functions are lost irreversibly and yet his cardiac and respiratory functions are maintained by an artificial life-support system, does he live or not? Up to now the signs of life have been seen as vital signs (body temperature, pulse, respiratory rate and blood pressure etc.). But if these signs are maintained by artificial methods, are they truly vital signs? Physicians say that even if a life-support system works, cardiac function will stop in a few days or a few weeks. But this short term is quite important for organ transplantation. At that time each organ except the brain is maintained through artificial circulation of blood. Therefore physicians who agree to organ transplantation stress that brain death is the true death of human beings, for the purpose of legal removal of organs. But many ordinary people have complex feelings about it. They don't easily admit a family member's brain death because of their warm pink bodies. Here we have a severe problem. In this article I have focussed on these problems and have tried to think of the redefinition of death in modern society from different perspectives, that is, philosophically, psychologically, medically, culturally and legally. And finally in conclusion my thoughts are presented.
著者
村岡 潔
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.52-58, 2015-09-30 (Released:2018-02-01)

Recently, a modern medical strategy has been proposed in Japan. It is called "Preemptive Medicine." This paper described the main features of "Preemptive Medicine" and its theoretical framework from the medical philosophy viewpoint. First, I examined a definition and concept of "Preemptive Medicine." This medical strategy presents a preemptive intervention for persons at risk to become ill in the near future. Risk prediction depends on presymptomatic tests like genetic testing that could reveal hereditary characteristics and other possible biomarkers. This predictive medical intervention prior to onset might be a new fashion in preventive medicine. Second, I reviewed the definition and characteristics of existing preventive medicine in comparison with those of "Preemptive Medicine." I then noted that "Preemptive Medicine" was the primary type of preventive medicine, so-called primary prevention. Third, I surveyed a typical single book on "Preemptive Medicine" in Japan edited by Hiroo Imura. It depicted the present state of and some problems for realization of the new approach. Fourth, I considered the meaning of intervention for "potential patients" or persons without illness at present but with some risk of becoming ill. They could be distressed over their predicted future disease. Furthermore, the efficacy of the prevention is not sufficiently proven from the viewpoint of Evidence Based Medicine. Finally, I concluded that the characteristics of "Preemptive Medicine" are, as follows: (1) "Preemptive Medicine" is a new form of preventive medicine; (2) its goal is personalized primary prevention; (3) it might have some psychological and social implications for harm to "potential patients"; and (4) it needs to show validity in early predictive intervention.