Luck egalitarianism assigns a central role to personal responsibility in egalitarian justice. In the context of healthcare, luck egalitarianism is the view that the distribution of medical and healthcare resources—or common resources in general—should respond to the (im)prudence of individuals. Recently, Joar Björk, Gert Helgesson, and Niklas Juth have argued that it is impractical to use luck egalitarianism as a normative framework in healthcare because it has no reasonable way of dealing with the imprudent. In response to their argument, this (...) paper first suggests that the epistemic problems of applying luck egalitarianism to the healthcare context raised by Björk et al. can be circumvented by using the exemption system as a policy application of luck egalitarian healthcare justice. This paper then shows that an _ex ante_ policy, a tax system with refunds, can reasonably be adopted as a luck egalitarian institutional design of healthcare policy. We argue that the proposed conception of luck egalitarianism can deal with the problem of differential option luck. Finally, we show that the threshold problem for the definition of imprudence does not refute the proposed _ex ante_ policy. (shrink)

This article offers a characterization of what I call multiple-models juxtaposition, a strategy for managing trade-offs among modeling desiderata. MMJ displays models of distinct phenomena to...

As I have pointed out in a series of papers, which appeared about fifteen years ago in the Revue de l'histoire des religions, there are numerous resemblances between the ancient myths of the Indo-Europeans, on the one hand, and those of Japan, on the other. These resemblances, relating both to the fundamental structures of the two mythological systems and to a number of curious details, constitute an assemblage which seems too conspicuous to be regarded as either accidental or the result (...) of a similitude of human mentalities, manifesting itself, so it seems, through the creation of a great many similar myths and legends throughout the length and breadth of the surface of our planet. (shrink)

本書は、人間的営みとしての学びの広さ・深さ・自由さを確認していく。人間の成長、人間形成という視点から、学びの実践を通して「学び」の人間学的原理、学ぶ主体にとっての意味を考察。個人の具体的な経験を通して 、多様な学びのあり方を提示。日本人の学び方、教え方の伝統や特徴とその問題について考察。.

In political philosophy, reflective equilibrium is a standard method used to systematically reconcile intuitive judgments with theoretical principles. In this paper, we propose that survey experiments and a model selection method—i.e., the Akaike Information Criterion (AIC)-based model selection method—can be viewed together as a methodological means of satisfying the epistemic desiderata implicit in reflective equilibrium. To show this, we conduct a survey experiment on two theories of distributive justice, prioritarianism and sufficientarianism. Our experimental test case and AIC-based model selection method (...) demonstrate that the refined sufficientarian principle, a widely accepted principle of distributive justice, is no more plausible than the prioritarian principle. This tells us that some changes of certain intuitions revolving around sufficientarianism should be examined (separately) based on the findings of the survey experiment and AIC model selection. This shows the potential of our approach—both practically and methodologically—as a novel way of applying reflective equilibrium in political philosophy. (shrink)

AbstractThe Belmont Report continues to be held in high regard, and most bioethical analyses conducted in recent years have presumed that it affects United States federal regulations. However, the assessments of the report’s creators are sharply divided. Understanding the historic reputation of this monumental report is thus crucial. We first recount the historical context surrounding the creation of this report. Subsequently, we review the process involved in developing ethical guidelines and describe the report’s features. Additionally, we analyze the effect of (...) unfolding events on the subsequent creation of federal regulations, especially on gene therapy clinical trials. Moreover, throughout this paper we evaluate the ethical principles outlined in this report and describe how they overlap with the issue of protecting socially vulnerable groups. Based on the analysis, we conclude that the features of the Belmont Report cannot be considered as having affected the basic sections of the federal regulations for ethical reviews that were made uniform in 1981. Nevertheless, regarding the regulations on gene therapy clinical trials—which were at first expected to be applicable to research involving children—in addition to implementing policies regarding the public review of protocols that passed ethical review, this report’s principles are clearly reflected in the key notes that should have been referred to when the report was created. (shrink)

BackgroundMost medical schools in Japan have incorporated mandatory courses on medical ethics. To this date, however, there is no established means of evaluating medical ethics education in Japan. This study looks 1) To develop a brief, objective method of evaluation for moral sensitivity and reasoning; 2) To conduct a test battery for the PIT and the DIT on medical students who are either currently in school or who have recently graduated (residents); 3) To investigate changes in moral sensitivity and reasoning (...) between school years among medical students and residents.MethodsQuestionnaire survey: Two questionnaires were employed, the Problem Identification Test (PIT) for evaluation of moral sensitivity and a portion of the Defining Issues Test (DIT) for moral reasoning. Subjects consisted of 559 medical school students and 272 residents who recently graduated from the same medical school located in an urban area of Japan.ResultsPIT results showed an increase in moral sensitivity in 4th and 5th year students followed by a decrease in 6th year students and in residents. No change in moral development stage was observed. However, DIT results described a gradual rising shift in moral decision-making concerning euthanasia between school years. No valid correlation was observed between PIT and DIT questionnaires.ConclusionThis study's questionnaire survey, which incorporates both PIT and DIT, could be used as a brief and objective means of evaluating medical students' moral sensitivity and reasoning in Japan. (shrink)

This paper analysed the nature of autonomy, in particular respect for autonomy in medical ethics/bioethics in Japan. We have undertaken a literature survey in Japanese and English and begin with the historical background and explanation of the Japanese wordJiritsu (autonomy). We go on to identify patterns of meaning that researchers use in medical ethics / bioethics discussions in Japan, namely, Beauchamp and Childress’s individual autonomy, relational autonomy, and O’Neill’s principled autonomy as the three major ways that autonomy is understood. We (...) examine papers discussing these interpretations. We propose using the term ‘a form of autonomy’ first used by Edmund Pellegrino in 1992 and examine the nature of ‘a form of autonomy.’ We finally conclude that the crux of what Pellegrino calls ‘something close to autonomy,’ or ‘a form of autonomy' might best be understood as the minimization of physician paternalism and the maximization of respect for patient preference. Simultaneously, we introduce a family-facilitated approach to informed consent and respond to criticism by Laura Sullivan. Finally, we discuss cross-cultural approaches and global bioethics. Furthermore, we use the term ‘Bioethics across the Globe’ instead of ‘Global Bioethics’, calling for international scholars to write works to provide an in-depth understanding of each country. We conclude that deep understanding of others is pivotal for dialogue to be of value. We hope this article will deepen the reader’s understanding of Japan and will contribute to the progress of bioethics worldwide. (shrink)

Informed consent, decision-making styles and the role of patient-physician relationships are imperative aspects of clinical medicine worldwide. We present the case of a 74-year-old woman afflicted with advanced liver cancer whose attending physician, per request of the family, did not inform her of her true diagnosis. In our analysis, we explore the differences in informed-consent styles between patients who hold an "independent" and "interdependent" construal of the self and then highlight the possible implications maintained by this position in the context (...) of international clinical ethics. Finally, we discuss the need to reassess informed-consent styles suitable to the needs of each patient regardless of whether he or she resides in the United States or in Japan. (shrink)

The pervasive use of distributional semantic models or word embeddings for both cognitive modeling and practical application is because of their remarkable ability to represent the meanings of words. However, relatively little effort has been made to explore what types of information are encoded in distributional word vectors. Knowing the internal knowledge embedded in word vectors is important for cognitive modeling using distributional semantic models. Therefore, in this paper, we attempt to identify the knowledge encoded in word vectors by conducting (...) a computational experiment using Binder et al.'s (2016) featural conceptual representations based on neurobiologically motivated attributes. In an experiment, these conceptual vectors are predicted from text‐based word vectors using a neural network and linear transformation, and prediction performance is compared among various types of information. The analysis demonstrates that abstract information is generally predicted more accurately by word vectors than perceptual and spatiotemporal information, and specifically, the prediction accuracy of cognitive and social information is higher. Emotional information is also found to be successfully predicted for abstract words. These results indicate that language can be a major source of knowledge about abstract attributes, and they support the recent view that emphasizes the importance of language for abstract concepts. Furthermore, we show that word vectors can capture some types of perceptual and spatiotemporal information about concrete concepts and some relevant word categories. This suggests that language statistics can encode more perceptual knowledge than often expected. (shrink)

Compared to institutional and area-based ethics committees, little is known about the structure and activities performed by ethics committees at national medical organizations and societies. This five year follow-up study aimed to determine (1) the creation and function of ethics committees at medical organizations in Japan, and (2) their general strategies to deal with ethical problems. The study sample included the member societies of the Japanese Association of Medical Sciences (n=92 in 1998, n=96 in 2003). Instruments consisted of two sections: (...) (1) the structure, function and activities of ethics committees, and (2) the strategies for dealing with ethical problems. Response rates were 84.4% in 1998 and 64.4% in 2003. Findings showed a significant increase of ethics committees at medical organizations between 1998 (25.6%) and 2003 (50.0%). Members were mostly male, medical doctors in clinical or basic medicine, and members of the organization. The major functions of ethics committees were ethical reviews of research protocols, policy making and ethical reviews of manuscripts submitted for journal publication. Among organizations that did not have an ethics committee, a significant decrease was found in organizations that replied that they had never experienced an ethical problem which needed further investigation (p<0.01). Findings suggested an overall rise in awareness of the importance of ethical issues and also highlighted an increase in recognition of responsibility regarding ethical problems. (shrink)

ポストモダン思想は教育学に何をもたらしたのか。戦後から現在に至る教育学の変遷と、ポストモダン以後の教育思想・教育哲学の新動向を描き出し、教育と教育学の未来を展望する。.

Today Asia is attracting attention in the area of bioethics. In fact, the potential of bioethics is beginning to be discussed seriously at academic centers across Asia. In Japan, this discussion began a decade ago with the publication The book is one of the principal explorations of biomedical ethics involving Japan to date. Tom Beauchamp, an author of one of the book's chapters, compares Japanese and American standards of informed consent and refutes relativistic positions, concluding that.

We examined the ethical justification for a national policy governing public funding for the induced pluripotent stem cell stock project in Japan and argue that the initiation of the iPSC stock project in 2012, when no clinical trial using iPSC-derived products had yet succeeded, was premature and unethical. Our analysis considers a generally accepted justice criterion and shows it fails to justify public funding of the iPSC stock project. We also raise concerns related to the massive amounts of public funding (...) at stake and the absence of evidence supporting claimed success rates. We conclude that the iPSC stock project should be re-considered and deferred until a substantial number of clinical trials using iPSC-derived products are deemed successful. This analysis should benefit others worldwide as they consider their own public funding policies. (shrink)

Until recently, many of Japan's medical and bioethical communities had ignored the issue of conflicts of interest . This is no longer the case. Discussion on the economic and ethical problems defined by CIs is now apparent in academic, political, and even industrial spheres. In June 2004, this debate was sparked by a scandal involving AnGes MG, Inc., a bioventure company set up by a faculty member at Osaka University Graduate School of Medicine. AnGes MG developed a gene therapy using (...) the Hepatic Growth Factor for obstructive blood vessel disease. Japanese newspapers reported that “several physicians involved with clinical trials for AnGes obtained unlisted shares of stock. One physician allegedly received 32 million yen after AnGes MG went public on the ‘Mothers’ stock exchange”. (shrink)

In Japan, discussion concerning advance directives (ADs) has been on the rise during the past decade. ADs are one method proposed to facilitate the process of communication among patients, families and health care providers regarding the plan of care of a patient who is no longer capable of communicating. In this paper, we report the results of the first in-depth survey on the general population concerning the preferences and use of ADs in Japan. A self-administered questionnaire was sent via mail (...) to a stratified random sampling of 560 residents listed in the residential registry of one district of Tokyo, Japan (n = 165,567). Association between correlating factors and specific preferences toward ADs was assessed using contingency table bivariate analysis and multivariate regression model to estimate independent contribution. Of the 560 questionnaires sent out, a total of 425 participants took part in the survey yielding a response rate of 75.9 %. The results of the present study indicate that: 1) the most important components to be addressed are the specifics of medical treatment at the end of life stage and disclosure of diagnosis and prognosis; 2) the majority of participants found it suitable to express their directives by word to family and/or physician and not by written documentation; 3) there is no strong need for legal measures in setting up an AD; 4) it is permissible for family and physician to loosely interpret one's directives; 5) the most suitable proxy is considered to be a family member, relative, or spouse. Multivariate analysis found the following five factors as significantly associated with preferences: 1) awareness regarding living wills, 2) experience with the use of ADs, 3) preferences for end-of-life treatment, 4) preferences for information disclosure, and 5) intentions of creating a will. Written ADs might be useful in the Japanese setting when the individual either wishes: 1) to not provide a lot of leeway to surrogates and/or caregivers, and/or 2) to ensure his or her directives in the cases of terminal illness, brain death, and pain treatment, as well as regarding information disclosure. (shrink)

The literature on human and animal learning suggests that individuals attend to and act on cues differently based on the order in which they were learned. Recent studies have proposed that one specific type of learning outcome, the highlighting effect, can serve as a framework for understanding a number of early cognitive milestones. However, little is known how this learning effect itself emerges among children, whose memory and attention are much more limited compared to adults. Two experiments were conducted using (...) different versions of the general highlighting paradigm: Experiment 1 tested 3 to 6 year olds with a newly developed image-based version of the paradigm, which was designed specifically to test young children. Experiment 2 tested the validity of an image-based implementation of the highlighting paradigm with adult participants. The results from Experiment 1 provide evidence for the highlighting effect among children 3–6 years old, and they suggest age-related differences in dividing attention among multiple cues during learning. Experiment 2 replicated results from previous studies by showing robust biases for both image-based and text-based versions of the highlighting task. This study suggests that sensitivity to learning order emerges early through the process of cued attention, and the role of the highlighting effect in early language learning is discussed. (shrink)

In Japan, modern biomedical ethics emerged in the early 1980s. One of the main triggers was the nationwide debate on organ transplantation and brain death. A lengthy process of academic, religious, and political discussion concerning organ transplantation, lasting well over a few decades, resulted in the enactment of the Organ Transplantation Law in 1997.1 The defining of death and other bioethical issues, including death with dignity and euthanasia, were also stimulating topics throughout the latter end of the twentieth century. For (...) instance, the death-with-dignity movement, which started around the late 1960s, developed into a hospice/palliative-care movement by the end of the 1980s. (shrink)

This is the first book to bring West and East together in a broad investigation of contemporary bioethics. A distinguished international team of experts presents original research addressing issues that emerge from new medical technologies, address global challenges arising from social change, and set the agenda for the future.