著者

バロン パトリック

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.144-148, 1997-09-20 (Released:2018-02-01)

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This paper attempts to look at some of the changes that have taken place in the Japanese health care environment during the last 30 years from the point of view of the patient. In the U.S. the period after the Second World War was marked by increasing litigation concerning the outcome of health care, and this in turn created demand for second opinions and expert opinions in law cases. Hand-in-hand with this development came the concept of informed consent, i.e. that the patients had the right to know everything about their own condition and the type of treatment that they were receiving. By extension, this came to mean that in any clinical trial the patients not only had the right to know but had to know their condition and the type of treatment they were receiving. While the number of persons in metropolitan areas in Japan who wish to be fully informed about their condition has increased, questionnaires have confirmed that in rural areas there is an unchanging large amount (@40%) of patients who do not want to be told directly by their physicin. This raises the question of "right to know" actually "a duty to be forced to know" ? Furthermore, in the field of medical publications, which are essential for most persons in academic medicine who want to develop a career, it has become increasingly common to enforce the demands of the US litigation / health care environment on all those wishing to publish papers in international journals, the overwhelming majority of which are published in the United States. Reference is made to a recent study by the Council of Biology Editors concerning the questionnaire they distributed to their members. The results of the questionnaire favored the idea that it would not be correct for one country to impose its cultural values on all papers submitted to a journal submitted in that country. This paper also suggests that, in order to allow comparison of traditional oriental medicine such as acupuncture and western medicine such as drug treatment, and given the different cultural situation of various countries in Asia, they should develop their own ethical and compassionate approaches to the scientific elucidation of treatment effects without necessarily copying in every detail the present approaches used in North America.