著者

高間 直道

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.1, 1983

著者

児玉 正幸

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.21, pp.167-175, 2003

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The medical staff of Obstetrics and Gynecology Department, Kagoshima University was considering plans to conduct clinical trials to test the embryos of Duchenne muscular dystrophy patients, but they were unable to gain approval from the Japan Society of Obstetrics and Gynecology. Groups and organizations that support the handicapped pointed out that there are problems with trying to make life and death decisions based on such tests. They argued that such testing implies a desire to lower the level of social services for the handicapped and to inflame the public's prejudices. In other words, the tests are considered as another example of discrimination towards families with a history of genetic disease, in the tradition of discrimination in jobs and marriage. However, as long as the freedom of the clients (the parents of the unborn child) for whom the tests are conducted is preserved, and their right to decide what to do with the results is protected, this reproduction medical technology does not threaten the constitutional rights of the handicapped, as provided in Articles 13, 14, and 25 of the Japanese Constitution. Allowing parents to decide whether to give birth to a handicapped child is not inconsistent with a policy aimed at improving welfare services.

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

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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

船木 祝

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.22, pp.17-25, 2004

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Bei der Forschung an importierten ES-Zellen handelt es sich um eine aktuelle Frage der deutschen Bioethik. Die deutschen Vertreter der verschiedenen Bereiche versuchen, aus zwei Gesichtspunkten bezuglich des Begriffs 'Menschenwurde'diese Frage zu behandeln: zum Ersten Menschenwurde als Eigenschaft des Gegenstandes and zum Zweiten Menschenwurde, welche sich im Umgang mit Menschen verwirklicht. Aus dem ersten Standpunkt lasst sich behaupten, dass die importierten ES-Zellen als pluripotente Zellen keine Gegenstande der Menschenwurde seien. Daher konnten die Wissenschaftler diese ES-Zellen fur wissenschaftliche und medizinische Zwecke nutzen. Im Gegensatz dazu lasst sich nach dem letzteren Standpunkt sagen, dass die Menschenwurde der menschlichen Embryonen kein Faktum, sondern eine Entwicklungsform darstellt. Daher hatten die umgebenden Menschen die Aufgabe, einen Ungeborenen zu schutzen und seine individuelle und moralische Entwicklung zu ermoglichen. Meine Lekture einiger japanischer Berichte uber die Behandlung der Probleme der menschlichen embryonalen Stammzellen legt die Vermutung nahe, dass dem obigen zweiten Gesichtspunkt in Deutschland fast keine Rechnung getragen wird. Man legt also das Gewicht vielmehr auf die medizinische Perspektive als auf das Leben der menschlichen Embryonen. Der zweite Gedanke bezuglich der Menschenwurde konnte aufschlussreiche Hinweise zum Umgang mit dem menschlichen Leben geben.

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

no.25, pp.61-70, 2007

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出版社版

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

no.29, pp.53-62, 2011-09-30

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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.

著者

大橋 博司

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

no.5, 1987-07-10

著者

田代 志門

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.21-29, 2007-10-18

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The purpose of this paper is to clarify the logical construction of Robert J. Levine's model for the distinction between research and therapy. Levine's model has been adopted in well-known ethical guidelines such as the Belmont Report (1979) and the CIOMS guidelines (1993). Levine introduced into research ethics two theoretical models, the intent-based model and the approval-based model, for the distinction between research and therapy. He also recommended that physician-investigators deal with "innovative therapy" as research, which should be reviewed by IRBs. Levine criticized two assumptions which were largely shared in the medical community in the 1960's. Some physician-investigators thought that it was impossible to distinguish research from therapy because all medical practice was in a sense experimental. Others thought we should distinguish therapeutic research from non-therapeutic research and that the former can be conducted according to relatively relaxed standards. This was also the standpoint of the Declaration of Helsinki in 1964. These assumptions interfered with effective regulation of clinical research. Levine's model introduced a new perspective into research ethics and became a foundation of the contemporary regulation of clinical research. The purpose of this paper is not only to reconstruct past discussion and share its heritage but also to obtain suggestions for the regulation of clinical research in Japan.

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

no.28, pp.1-9, 2010

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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

阪本 恭子

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.26, pp.21-29, 2008-10-22

被引用文献数

1

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In this paper, I would like to take up the issue of "White Stork Cradle" (Kounotori-no-yurikago) or "Baby-Post," which was established at Jikei Hospital in Kumamoto City in May 2007. I examine its current situations and problems in contrast to "Babyklappe" in Germany, as its precedent. The problems addressed include the follwing: the conflict between the mother's right to anonymity and the baby's right to know where he or she came from; the style and policy of disclosing information on the usage of "Baby-Post"; and how the entire system can be legalized. Furthermore, I consider "anonymous birth" in the hope that it could be the next best way after "Baby-Post." Through addressing these problems, I would like to review aspects of family and life appropriate for a Japanese society in the future, which would exhibit tolerant compassion for the weak and never abandon them.

著者

宮脇 美保子

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.21, pp.140-152, 2003-10-05

被引用文献数

1

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Nursing is an emerging profession trying to fulfill the criteria that define a true profession. The professional work of nursing is approached in a scientific manner. The nursing process is defined as an intellectual activity meant to be approached regularly and systematically now that the nursing process is the accepted method of professional practice. However, the nursing process is not the only capability required of nurses. The nursing process is nothing more than a problem-solving process by which nurses meet patients' needs. The patient's set of problems, referred to as the "nursing diagnosis," is undergoing international standardization. To standardize is to risk overshadowing the care that originally motivated the more scientific approach to solving patients' problem. Still more, with the increased complexity of medical care, nurses have taken over more and more of the activities associated with medical practice. Consequently, in the actual reality of practice, nurses sometimes lose sight of caring. What is the primary expertise to which nursing lays claim? So far, nurses have always valued the idea of caring for persons. Has nursing abandoned its caring role? Caring means that persons, the subjects of nursing care, are treated not as objects or impersonally but always in a way that considers the essence of the person, i. e., the opposite of mechanization and depersonalization. Also, what patients want and need most from nurses has been and still remains quality, humanized care. Therefore, nurses are challenged to enhance and develop the caring tradition of nursing as expressed through the nursing process.

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

no.22, pp.69-75, 2004

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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.