著者

粕谷 豊

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.9, pp.95-98, 1991-07-31 (Released:2018-02-01)

著者

菅野 耕毅

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.9, pp.107-112, 1991-07-31 (Released:2018-02-01)

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In order to look for a new image for pharmacists in medical service, I want to suggest the following from a legal point of view : First, a pharmacist should have the exclusive rights of dispensing over physicians. Secondly, a hospital pharmacist should have his own liability independent of his superior in the hospital. Thirdly, a pharmacist should have the freedom to open a dispensary anywhere, without control of others in the same profession.

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.8, pp.13-24, 1990-07-31 (Released:2018-02-01)

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I want to clarify the relation between paternalism and the rights of self-determination by using medical disorder models. I have used one case to clarify the question of paternalism and the right of self-determination, using the case of real psychiatric patients: one in a self-reliant situation, one depending on others, and one chaotic situation. Paternalism and its limitations are examined for each situation. I conclude that ordinary people who are around psychiatric patients should take responsibility to help such persons.

著者

山本 善次郎 坂本 堯 高橋 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.8, pp.25-34, 1990-07-31 (Released:2018-02-01)

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A survey on terminal care was conducted in St. Marianna University School of Medicine in 1988. The results show: a) ST. Marianna staff members have a strong interest in terminal care; b) few of them consider religious support necessary for terminal patients; c) St. Marianna staff members recognize it's time to discuss hospice and hospice care earnestly. In our country, religious indifference is really quite persistent in this generation. Nevertheless, many terminal patients want religious support as well as psychochiatric support. With considerable experience of clinical pastoral care for terminal patients in the hospital, we are convinced that they need religious support.

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, 1990-07-31 (Released:2018-02-01)

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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

長島 隆

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.52-64, 1990-07-31 (Released:2018-02-01)

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Schelling's philosophy of nature has two sources, one is Kantian and Fichtian transcendental philosophy, the other is the contemporary natural science of his time. In this essay, I discuss Schelling's life-concept against the background of the medical dispute of Brown's "lrritabilitat (Erregbarkeit)-Lehre" in Germany at the turn of the 19th century. Schelling's central interest in life-organisation is the individual mediating his environment. In this context, he accepts Brown's "lrritabilitat-Lehre" through Roschlaub's revision of it and A. v. Haller's concept of "Sensibilitat". So he criticizes its "Ungegrundetsein" and develops it into his triad of Erregbarkeit-Sensibilitat-Bild- ungstrieb. He then inserts this triad into his theory of nature.

著者

大林 雅之

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.65-78, 1990-07-31 (Released:2018-02-01)

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From the late 1960s, arguments concerning ethical problems in clinical applications and experiments of life sciences and biomedical sciences began in the United States. They caused the birth of a new discipline, bioethics. This situation influenced American medical education and showed various difficulties in the traditional ways of training physicians in professional ethics. American medical schools had to make new educational programs, that is, medical humanities, whereby students would have special courses in human values. The purpose of this paper is to consider historically the connection between the bioethics movement and the development of humanistic medical education in the United States and to make clear the influence of bioethical ideas in medical humanities. The author concludes that the medical humanities program is based on the ideas of bioethics. One of these is that a patient's autonomy has to be respected in medicine. Another is that we must participate in interdisciplinary discussions in order to make correct decisions in ethical problems of life sciences and medicine. The necessity of humanistic medical education in Japanese medical schools is also discussed.

著者

スピッカー スチュアート・F 酒井 明夫

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.90-101, 1990-07-31 (Released:2018-02-01)

著者

矢崎 光圀

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.102-116, 1990-07-31 (Released:2018-02-01)

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I live in the same world as others. And it is the seemingly same natural fact that each of us is born in the world and is destined to die. The present situation we are involved in, however, seems gradually to make this natural fact unnatural due to the great change directly or indirectly caused by the development of science and technology. For example, such developments make it possible for a patient, who would have died in accordance with the traditional techniques of medicine hitherto, now to continue to be alive by means of the respirator, or something like it in the I.C.U.. This situation raises a series of questions interwoven in medical, ethical, philosophical, and legal areas, as we can easily understand by remembering the "Karen Quinlan" case. Indeed, I know these are very difficult questions to answer. I merely aim here to find a possible way to answer them in the light of "nature" as a human identity, a naturalistic, but not a natural law approach.

著者

エンゲルハート トリストラム 酒井 明夫

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.117-128, 1990-07-31 (Released:2018-02-01)

著者

星野 一正

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.7, pp.89-101, 1989-07-31 (Released:2018-02-01)

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As a senior medical teacher, I should like to analyze what teaching medical students means to me. There seems to be three fundamental principles in teaching medical students: The first principle is to teach students from the teacher's own knowledge and experiences what is deemed necessary for students, as future medical doctors, to know and understand as basic medical knowledge and techniques, and also to acquire the professional common sense that is needed when dealing with a number of patients and their families in a morally and ethically acceptable manner as future physicians and surgeons. The second teaching principle is to improve up to professionally acceptable levels the incomplete or immature knowledge that students have already obtained during their previous schooling or daily life. At the same time, a teacher has to guide students to acquire the ability to self-learn. However, the principle involved in teaching medical ethics and bioethics to medical students appears to be different from these two teaching principles. This is because ethical analysis of a medical problem provides no single answer due to the different ways that the values involved both in the medical problem and also in the quality of life of a patient may be treated by different people having different viewpoints. It is important to note that no teacher must force students to accept the teacher's personal opinions or viewpoints concerning his own ethical judgements related to any medical problems. A teacher and his / her students should freely exchange their opinions and viewpoints to analyze various aspects involved in a medical problem and learn together to reach some reasonable solutions. This collaborative learning process is vitally important in teaching medical ethics and bioethics to students. It is the third principle in teaching medical students.

著者

太田 富雄

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.7, pp.102-112, 1989-07-31 (Released:2018-02-01)

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Once people said that medicine was the art of ethics. However, it is now impossible for a practitioner to treat a patient in such a manner. Revolutionary advances in medicine have placed the problem of ethical attitude in the field of practice. Considering these points, it has been asked why the statements about the right to the choice of treatments have been proposed. Of course, it is true even now that patients can not be satisfied without the devotion of medical teams. However, it is really in the field of the most advanced medical technique that ethical problem should be resolved. Here we have discussed the subject of organ transplantation in relation to the brain-dead and persistently vegetative patients, with whom we neurosurgeons are so familiar. In fact, organ transplantation as a medical practice must be one of the major subjects of philosophy, not only as an ethical problem, but also since it involves the existence of human being in the 21th century. Since human life is so transitory, we should search for harmony by identifying ourselves with the universe. Brain-dead and persistently vegetative patients should not be recognized as dead, but respected as among the poorest human beings. Now it is essential, in order to establish the harmony of the universe, that we create a God who is more appropriate in the modern age.

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.7, pp.70-73, 1989-07-31 (Released:2018-02-01)

著者

坂本 堯

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.7, pp.74-84, 1989-07-31 (Released:2018-02-01)

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Opinions concerning the essence of medical ethics, their significance and their educational methods differ fundamentally according to one's religious and philosophical orientation. Many questions of medical ethics have to do with the most difficult, eternal, and probably insoluble questions concerning what we know about the essence of human beings and the meaning of truth, love, values, happiness, etc. Problems which reappear in the course of history must be considered from many viewpoints. From the Meiji Restoration in the middle of the nineteenth century until the present, Japan has imported Western science, particularly medicine, at an extremely rapid rate, with the result that traditional methods of Oriental medicine have come to be looked down upon. Unfortunately, these cultural changes have caused a lot of turmoil in the area of medical ethics in Japan and this is due to overestimation of the value of European technology and natural sciences. As a result, it would not be too much to say that an indifference to ethical considerations and a related high degree of selfishness and greed are present in many sectors related to health care in Japan today. However, it is comforting to note that there is some movement for the improvement of this situation. Against this background, it is the purpose of this report to examine certain considerations related to these movements as follows: 1) the history of European medical ethics; 2) the history of European philosophy and religion; 3) the humanism of Nicholas of Cusa; 4) the educational thought of Maria Montessori.

著者

高島 學司

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

vol.7, pp.85-88, 1989-07-31 (Released:2018-02-01)

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When we want to discuss medical ethics in education, we have to consider the roll and the activity of the law, especially in malpractice cases, as well as philosophical viewpoints. Since World War H, the number of malpractice cases and suits has been increasing at an unprecedented rate in Japan. This increase has brought law and medicine into closer relationship, but also has created tention between the two. Today,the lack of moral foundations among physicians, the secretiveness of the medical profession and the resulting uneasy relationship between physicians and patients is often pointed out. Since Japanese law has traditionally respected the autonomy of physicians, until recently, the question whether certain medical practices violated medical ethics has seldom been brought to trial. But soon, as the result of court decisions, we can expect to see the enactment of improved civil and medical laws. So medical students should focus on building character, and need to take a stronger interest in such laws, to develop their discipline and bring it into line with other sciences and humanities.

著者

スピッカー ステュアート・F 酒井 明夫

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.7, pp.113-122, 1989-07-31 (Released:2018-02-01)

著者

アチュレー ウィリアム・A クシュナー トマシン 渡辺 義嗣

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

vol.7, pp.123-132, 1989-07-31 (Released:2018-02-01)

著者

堀田 輝明

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.1-12, 1990-07-31 (Released:2018-02-01)

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Medical ethics should be considered from the point of view of the helpless patient. N. Hartmann once defined the human being in relation to four phases: 1. inorganic (unorganisch) 2. organic (organisch) 3. psychic (seelisch) 4. spiritual (geistig). All human beings are composed of these four phases, and he describes the dominant roles in each phase. If we try to apply these concepts to medical practice, we find patients tend to see themselves in terms of the psychic and organic phases, while doctors should act in terms of the spiritual phase. So patients generally tend to desire hedonistic satisfaction, while doctors tend to pursue normative goals. These are the fundamental ethical differences between doctors and patients in the field of medical practice. Medical practice should be founded on the modern social values of respect for human dignity and happiness. Japanese medical practice in particular must try to respect these humanistic values while maintaining its traditional cultural and ethical standards. In other words our medical activity should be based not only on the American medical concept of "quality of life" , but also on the Japanese traditional attitude of caution in medical matters.

著者

楠 正三

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.7, pp.64-69, 1989-07-31 (Released:2018-02-01)

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'Naikan' means "introspection" in Japanese. The Naikan method is a form of meditation practiced in Japan over the past forty years. This is a fixed method of self-observation and self-reflection. This method is suited for medical staff who hope to interact with patients in a humane fashion. The Naikan client is asked to look at himself in his relationships with other people from the following three perspectives. "Examine your memories on 1) the care and kindness that you have received from a particular person (for example, your mother), 2) what you have one for that person in return, 3) inconveniences you have caused that person." If a medical staff experiences the Naikan meditation, he will find it useful in improving the human relations with his patient.

著者

大槻 真一郎

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.6, pp.91-102, 1988-07-31 (Released:2018-02-01)