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
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
no.15, pp.33-47, 1997-09-20

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
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
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

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
長田 蔵人
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.27, pp.60-68, 2009-10-01 (Released:2018-02-01)

We usually recognize instinctively that it is unreasonable to be blamed for something beyond our control or expectations, and that we should be morally evaluated in terms of motives or intensions, which are insusceptible to luck. On the other hand, however, we admit in many cases that luck exerts some influence on agents' moral evaluations. This inconsistency has long been discussed as the problem of 'moral luck'. This paper shows that the same inconsistency can be found in our attitude toward medical malpractice, and considers how to deal with it. According to D. Dickenson, who introduced the concept of moral luck into discussions of medical ethics, bad luck in medical accidents means doctors' misfortune of being blamed for inevitable accidents that occur beyond their control. Medical malpractice, which is caused by negligence and therefore can be prevented, is thus excluded from her consideration. Contrary to this, this paper argues that even regarding cases of negligence, if there are structural, technical factors that can induce such negligence, anybody could make medical errors, and it is in this sense that there exists moral luck in the cases of malpractice. This consideration leads us to the following conclusions; (1) even in the cases of negligence, it may be unreasonable to inflict criminal punishment on doctors, for we cannot clearly distinguish according to criminal law between cases of vicious negligence and those of mere moral luck; (2) a criminal suit is not a proper means to investigate what really occurs in medical malpractice.
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
伊藤 幸郎
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.22, pp.69-75, 2004-10-18 (Released:2018-02-01)

What is meant when a doctor says, "You are healthy" after the health examination? Is it possible to diagnose a person to be healthy? In fact, this question comes from a confusion between science and values. Health is not a scientific term but a value-laden, normative concept. So your doctor can only say "I couldn't find any disease," not "You are healthy." Clinical medicine textbooks describe many diseases, but they never give a working definition of "health". There are many diseases to be diagnosed but only one "health." "Health" is unique for each person and stands outside any medical investigations. When one tries to define health he will tend to fall into a circular discussion: Health is an absence of diseases and disease is a lack of health. One typical definition of health has been given by the WHO (1946). The WHO defined health as a state of complete physical, mental and social well-being. Some critics say that the WHO definition merely replaced the word "health" with "well-being." Many philosophers have proposed non-circular, positive definitions of health. However, like the WHO, they eventually fall into theories of happiness, which are very important, but cannot be applied to medicine as science. In contrast to clinical, the textbooks of public health education have rich descriptions of health. Public health officers also stress the importance of health. As shown in the slogan "health promotion," the health and disease of a population is recognized as a quantitative concept which may increase or decrease. In conclusion, health examinations don't diagnose a person as being healthy. All we can do is a massscreening of diseases. The true meaning of health depends on each person's view of happiness and as such, it is not a pure medical problem.
著者
菅原 潤
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.24, pp.21-30, 2006-10-24 (Released:2018-02-01)

The German philosopher Juergen Habermas, who emphasizes the significance of communicative rationality in constructing social theories, has recently made active proposals in bioethics. To the extent that he insists on duties analogous to moral ones with regard to the moral status of animals, he remains in step with the opinions of some English-speaking ethical theorists. Indeed his acceptance of communications between men and other animals is consistent in part with the position of Peter Singer, who represents such opinions and objects to differentiating between humans and animals with reference to moral duties. However, Habermas fears that valuing various lives only for their sensible capacities, regardless of special differences, might result in assignment of priority to the lives of healthy higher animals over those of handicapped babies, and therefore maintains that we are after all different from the other animals in moral status. This conclusion by Habermas is built on the philosophical edifice of Max Horkheimer and Theodor W. Adorno, the author of the Dialectic of enlightenment, in accordance with the idea that we should not instrumentalize the living activities of humen beings. This is why he insists that research in reproductive medicine should be carefully considered. Accordingly, his attitude toward bioethics results in a kind of anthropocentrism, though we must not overlook the need for expansion of communicative relasions between humans and other animal species. The opinions of Habermas on bioethics have affected the ethics of nature, as outlined by Angelika Krebs and Martin Seel under the influence of Frankfurt School in the contemporary Germany.
著者
田村 京子
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
no.17, pp.123-132, 1999-10-01

With regard to the social welfare of disabled persons, I will consider the relationship between feelings of pity for them and discrimination against them. In Japan, most people today who have not been in close contact with disabled persons feel pity for them. Is this feeling of pity an expression of discrimination against them? In this paper, I will describe and analyze the nature of this feeling and make the following points: 1) A feeling is experienced passively, so we cannot modify it at the same time that we are feeling it. Therfore, feelings of pity for disabled persons are not in themselves equivalent to discrimination against them. It is possible to interpret them as such, but this interpretation only presents discrimination as a problem without a solution. 2) Referring to Arbert Memmi's definition of discrimination in context of racism, I will consider the way in which discrimination is the result of a relationship between individuals and society. Discrimination shuld be understood at the social level, namely in its relationship to social structure and social organization. Only then can we find measures to resolve it. 3) Pity for persons with disabilities is no more than a groundless conviction held by non-disabled persons, and is a reflection of the lack of communication between these two groups. 4) We should start from the fact that people, both with and without disabilities live in the same world at the same time, and thus learn to naturally accept heterogeneuty and variety in people.
著者
丸橋 裕
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
no.30, pp.40-51, 2012-09-30

Viktor von Weizsacker's significance as an originator of "anthropological medicine" and as a critic of medicine oriented solely to the scientific-biological standpoint encourages us in the present critical situation caused in connection with many problems in medical ethics to seek an adequate paradigm of medical ethics in his works. True, he wrote no systematic ethics of anthropological medicine as such. But his 'Euthanasia' and Experiments on Human Beings (1947) was a salient contribution to the foundation of that field, since in it he asserts that the real, though invisible, defendant on the Nuremberg bench was no particular doctor, but the general spirit of scientific-biological medicine, and declares his guiding principle that the solidarity and mutuality of doctor and patient should guide medical practice. Therefore, in this article I intend to describe the origin of the medical ethics inherent in Weizsacker's "Medical Anthropology" (Medizinische Anthropologie) where he formulates the concepts of solidarity and mutuality. First I try to show clearly how he proves, with the help of the principle of solidarity, that there was no "as such justification" for the 'euthanasia' and human experiments Nazi doctors had put into practice, and further how he tested, in every morally doubtful case, whether it complied with the law of mutuality. Secondly I will clarify in what kind of context medical practice must occur under the law of solidarity, if one is taking the law of mutuality seriously in the association between doctor and patient. And thirdly after showing that the concept of "the solidarity of death" tends to reduce various aspects of the personal and social structure of death to an abstract common denominator, I will consider the meaning of Weizsacker's utterance that the order of life is a fusion of "the solidarity of death" and "the mutuality of life."
著者
田野尻 哲郎
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
no.27, pp.1-12, 2009-10-01

Modern Japanese traditional medicine established in the mid-18th century suffered devastating damage due to the execution of the Medical Law (established in 1873) as an integral part Japan's modernization policies. Today, Japanese traditional medicine is a counterculture community on the periphery of modern mainstream medicine, whose practice changes in accordance with social changes. As a traditional medical movement, it has unique ethics that are constantly evolving. The traditional medical movement of a physical technique, which is known as "Noguchi-Seitai" and whose system and theory were established in 1927, passed through two transformation stages, one in 1956 and the other one in 1968. The movement become a community emerging concomitantly with medical techniques continuously alternating between a host and a guest, and the medical practice based on the psychosomatic transformations arose from self-training by the medical practitioner and the patient. Those transformations and generations are revealed from the conceptual viewpoint of "Education as Transformation" (Richard Katz, 1981).
著者
新山 喜嗣
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
no.25, pp.99-109, 2007-10-18

Patients with Capgras syndrome complain that real persons close to them have been replaced by identically looking imposters. This syndrome is interpreted as the total replacement of the "haecceity" that is distinct from one's attributes. Capgras syndrome suggests that possible worlds around a person come in two different series: one of possible worlds in which the attributes of the real person change in a variety of forms with his "haecceity" unchanged, and the other of possible worlds in which the "haecceity" of the real person is replaced by something else with his attributes unchanged. Possible worlds involving these two series could develop without limitations, and hence impart unlimited diversity to the variants of myself living in possible worlds. Thus, the variants in possible worlds must include some who possess both haecceity and attributes that are identical to those of others in the real world. It can thus be speculated that others in the real world are nothing but variants of myself who have turned up in the real world from possible worlds they originally inhabited. In this context, it may be assumed that I am keeping in touch with my own variants every day here in this real world. In the real world, I myself always create a singular point characterized as "I," "now," and "here". In a certain possible world, however, another person generates this singular point. As a result, I myself become the other to him. Such worlds where I turn up as the other probably include ones whose contents are exactly the same as those of the real world. Because these worlds are perfect mirror images of the real world, we mistakenly assume that they are the same one world. Because of this confusion, we see many generators of the singular points coexisting in the real world.
著者
尾崎 恭一
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.14, pp.81-94, 1996-10-01 (Released:2018-02-01)

Not a few people in Japan are killed in active euthanasia. However, most cases are hidden, as active euthanasia is prohibited in any situation. Consequently some people are killed by immoral ways, for example involuntarily or cruelly, though they could survive with handicaps, or though they could die calmly in voluntary active euthanasia. Voluntary active euthanasia should be permitted legally, and the Involuntary one should be prohibited strictly. Why is Voluntary active euthanasia prohibited? Because people think that no one has the right of death and believe in the theory of the slippery slope. But everyone has the right of self-determination. Does this right imply that? And cannot we put the brake on unlimited killing performed under active euthanasia? In order to answer these questions, I first investigated how the right of self-determination is justified by two theories which differ from each other:social contract theory and utilitarianism. This call give an impartial solution for them. The solution is that each person has the right to decide all one's own affairs and even commit suicide if the right is not misused and makes no one unhappy. Secondly I studied the meaning of death for the dying person, especially with regard to its positive meaning, i.e. the completion of his life. It is important what he does as the last act in his life when he suffers terribly from fatal wounds or diseases. Is it morally good that doctors prolong the severe pain of the patient as long as possible? It is bad that they rob him of self-determination and his happiness. He doesn't only have the right to die,but also should exercise the right in oder to get rid of his fatal pains. Thirdly I think through the new legal systems which permit the right to die and prevent patients from misusing it. Judging from the above, these systems must be based on the principles of self-determination and state of necessity. In the case of voluntary active euthanasia, to help one commit suicide can be legally justified. However, to kill one based on the one's serious request cannot justified, but only irresponsible for the murder.