Jecker and Au’s paper raises important issues concerning health equity in pandemic responses, and the importance of considering the long-term effects of pandemic strategy on population health and well-being.1 We welcome their focus on the experience of Asian countries, including Japan. However, we have some concerns with both the distinction which they draw between elimination and mitigation, and their account of the nature and origins of the Japanese response to the COVID-19 pandemic. First, we believe that the distinction between elimination (...) and mitigation is not fine grained enough to capture the various strategies which countries have taken towards the pandemic. Many of Jecker and Au’s criticisms of the elimination strategy relate to specific policies such as lockdowns, travel restrictions and restrictions on businesses, which have been employed by numerous countries irrespective of their end goal. By contrast to the simple elimination/mitigation dichotomy with which Jecker and Au work, Baker et al have identified five separate COVID-19 strategies, namely: exclusion, elimination, suppression, mitigation and no substantive strategy.2 Baker et al define an elimination strategy as ‘maximum action to exclude disease and eliminate community transmission’ with the goal of reaching ‘zero [disease] transmission in the community’. On this account, Japan’s strategy does …. (shrink)

The purpose of this study was to evaluate the effectiveness of an educational intervention regarding end-of-life discussion directed at older Japanese adults and their attitude to and acceptance of this intervention. A quasi-experimental design was used. A total of 121 older adults, aged 65 years and over, consented to participate. Data from 55 intervention and 57 control participants were used for the analysis. The intervention consisted of an education program comprising a video, a lecture using a handout, and discussion among (...) participants. The control group received only the handout. Both groups were followed up after one month. The intervention group’s attitude became more favorable towards advance directives, especially living wills (P = 0.024). In addition, their expression of preference for life-sustaining treatment by means of artificial nutrition was less at follow up, demonstrating that these older adults had become more autonomous (P = 0.008). There was greater acceptance of the intervention as a whole by the intervention group compared with the control group (P = 0.011). Although few participants overall completed living wills, at follow up twice as many in the intervention group had discussed end-of-life matters with family members and/or their physician. (shrink)

BackgroundRegulations on forgoing life-sustaining treatment (LST) have developed in Asian countries including Japan, Korea and Taiwan. However, other countries are relatively unaware of these due to the language barrier. This article aims to describe and compare the relevant regulatory frameworks, using the (more familiar) situation in England as a point of reference. We undertook literature reviews to ascertain the legal and regulatory positions on forgoing LST in Japan, Korea, Taiwan, and England.Main textFindings from a literature review are first presented to (...) describe the development of the regulatory frameworks surrounding the option of forgoing LST in each country. Based on the findings from the four countries, we suggest five ethically important points, reflection on which should help to inform the further development of regulatory frameworks concerning end-of-life care in these countries and beyond. There should be reflection on: (1) the definition of – and reasons for defining – the ‘terminal stage’ and associated criteria for making such judgements; Korea and Taiwan limit forgoing LST to patients in this stage, but there are risks associated with defining this too narrowly or broadly; (2) foregoing LST for patients who arenotin this stage, as is allowed in Japan and England, because here too there are areas of controversy, including (in England) whether the law in this area does enough to respect the autonomy of (now) incapacitated patients; (3) whether ‘foregoing’ LST should encompass withholdingandwithdrawing treatment; this is also an ethically disputed area, particularly in the Asian countries we examine; (4) the family’s role in end-of-life decision-making, particularly as, compared with England, the three Asian countries traditionally place a greater emphasis on families and communities than on individuals; and (5) decision-making with and for those incapacitated patients who lack families, surrogate decision-makers or ADs.ConclusionComparison of, and reflection on, the different legal positions that obtain in Japan, Korea, Taiwan, and England should prove informative and we particularly invite reflection on five areas, in the hope the ensuing discussions will help to establish better end-of-life regulatory frameworks in these countries and elsewhere. (shrink)

In Japan, terminating life-sustaining treatment in non-terminal patients is legally and ethically problematic given the lack of legal regulations regarding the termination of LST, including dialysis treatment. This article describes an ethically problematic case that happened at a hospital in Tokyo in March 2019, in which a patient died after a physician withdrew kidney dialysis upon the patient’s request. Most national newspapers in Japan reported the case extensively and raised the question of ethical and legal permissibility of withdrawing dialysis treatment (...) from non-terminal patients. In this article, we first examine the case within the current policy framework in Japan and then discuss how Japan can improve its end-of-life practice, focusing specifically on the patient’s right to self-determination and treatment refusal. We recommend that policymakers consider legalizing the termination of LST and the patient’s right to refuse treatment based on the principle of respect for autonomy. (shrink)

Originally published as 「明治の哲学界：有機体の哲学とその系譜」in 井上克人編『豊饒なる明治』, Kansai Daigaku Shuppannbu, 2012, 3–22. Translated by Morisato Takeshi. German Idealism was introduced to Japanese intellectuals in the middle of Meiji era and was mainly received from a mystical or religious perspective, as we see in Inoue Tetsujirō’s “harmonious existence,” Inoue Enryō’s “unity of mind and body,” and Kiyozawa Manshi’s “existentialism.” Since these theories envisioned true reality as a unified and living whole, I group them under the label “philosophy of organism” and from (...) there argue that their conviction that “all is truth and truth is all” was shaped in large part by the Awakening of Faith in the Mahayana. The understanding of Buddhist concepts by Meiji philosophers was philosophical in its content, and those who devoted themselves to the study of Western philosophy were encouraged to describe Eastern thought in Western philosophical terms. As a result, the philosophical world of the Meiji era developed an original standpoint that unified Eastern and Western perspectives by means of a logic of “phenomena-in-reality.”. (shrink)

Minerals originated from eastern Democratic Republic of Congo (DRC) are blamed for financing violent conflict in the area over the past decade and have been called conflict minerals. They vividly demonstrate a key human rights issue facing responsible supply chain management. The conflict minerals issue has led to a significant shift in responsible supply chain management in two ways: extending producer responsibility to respect human rights in the total supply chain through establishing traceability and transparency; and developing legally binding supply (...) chain responsibility.This article examines an emerging effort to source conflict‐free minerals using closed‐pipe supply chain in the DRC as a new strategy to respond to the above paradigm shift. By exploring whether this new strategy can contribute to conflict prevention in the DRC, this article argues that the closed‐pipe supply chain allows building long‐term relationship with various stakeholders and has the potential to transform socio‐economic structures in the producing communities, thereby leading to peacebuilding in the long run. (shrink)

A dialectical contradiction can be appropriately described within the framework of classical formal logic. It is in harmony with the law of noncontradiction. According to our definition, two theories make up a dialectical contradiction if each of them is consistent and their union is inconsistent. It can happen that each of these two theories has an intended model. Plenty of examples are to be found in the history of science.

BackgroundFinancial interactions between pharmaceutical companies and physicians lead to conflicts of interest. This study examines the extent and trends of non-research payments made by pharmaceutical companies to board-certified allergists in Japan between 2016 and 2020.MethodsA retrospective analysis of disclosed payment data from pharmaceutical companies affiliated with the Japanese Pharmaceutical Manufacturers Association was conducted. The study focused on non-research payments for lecturing, consulting, and manuscript drafting made to board-certified allergists from 2016 to 2020. We performed descriptive analyses on payment data. Trends (...) were analyzed using generalized estimating equation models.ResultsOf the 3,943 board-certified allergists, 2,398 (60.8%) received non-research payments totaling $43.4 million over five years. Lecturing fees comprised 85.7% ($37.2 million) of the total payment amounts. For allergists who received at least one payment, the median amount per allergist was $3,106 (interquartile range: $966 – $12,124), in contrast to a mean of $18,092 (standard deviation: $49,233) over the five-year span. The top 1% and 10% of these allergists accounted for 20.8% and 68.8% of all non-research payments, respectively. The annual payment amounts significantly increased by 7.2% annual increase (95% CI: 4.4 – 10.0%, p < 0.001) each year until 2019, but saw a significant decrease in 2020 amid the COVID-19 pandemic.ConclusionThe majority of allergists received non-research payments, with a notable concentration among a small group. Payments increased annually until the pandemic’s onset, which coincided with a substantial decrease. Further research is needed to explore the implications of these financial interactions on clinical practice and patient care in Japan. (shrink)

Bioethics, Volume 36, Issue 4, Page 445-452, May 2022.

In Matter and Memory, Bergson identifies a problem with perception and resolves it by arguing that matter is an aggregate of images. However, it is unclear whether and how Bergson justifies this thesis, and interpreters differ considerably on this question. This paper formulates and analyzes Bergson’s arguments for this thesis in Chapter 1 of Matter and Memory. Bergson presents five arguments, some of which echo arguments in early modern philosophy. They jointly compose a substantive, well-structured defense of his thesis. This (...) paper also illuminates an aspect of Bergson’s method that departs from his famous reliance on intuition and is grounded in his conception of the clarity required in philosophy. (shrink)

This pilot study examines how a number of American and Japanese journalists make the tough calls regarding an escalating social problem: whether to identify juveniles who have been charged with serious capital crimes. Divergent societal and journalistic values of the two countries are explored via a survey of journalists from Honolulu and Hiroshima. Newsroom policies and practices are described regarding general and specific cases of juvenile crime. In general, Japanese journalists are far more likely than U.S. journalists to withhold names. (...) Tables and additional background information are found at jmme.org. (shrink)

The constructs of motivation (or needs, motives, etc.) to explain higher-order behavior have burgeoned in psychology. In this article, we critically evaluate such high-level motivation constructs that many researchers define as causal determinants of behavior. We identify a fundamental issue with this predominant view of motivation, which we called the black-box problem. Specifically, high-level motivation constructs have been considered as causally instigating a wide range of higher-order behavior, but this does not explain what they actually are or how behavioral tendencies (...) are generated. The black box problem inevitably makes the construct ill-defined and jeopardizes its theoretical status. To address the problem, we discuss the importance of mental computational processes underlying motivated behavior. Critically, from this perspective, motivation is not a unitary construct that causes a wide range of higher-order behavior --- it is an emergent property that people construe through the regularities of subjective experiences and behavior. The proposed perspective opens new avenues for future theoretical development, i.e., the examination of how motivated behavior is realized through mental computational processes. (shrink)

The use of contraceptives has become prevalent among females in Thailand in the past 20 years, and oral contraceptive use has been suggested to trigger changes in fat intake, energy expenditure, fat metabolism and blood pressure. Based on field investigations of 391 married women aged 20 years or over in Yasothon Province, North-east Thailand, this study aims to elucidate the effects of oral contraceptive use on body mass index (BMI: kg/m2 ) and blood pressure, taking into account reproductive histories and (...) socioeconomic conditions. The proportion of obese (BMI> 25) subjects was high in the age groups 3049 and 5049, 5069 age groups. Current contraceptive practices in the studied population included sterilization by operation, oral contraception and injection. These methods accounted for 43·0%, 12·8% and 8·2% of the population, respectively. Sociodemographic factors such as reproductive history, years of education and household income were not significantly related to BMI or to blood pressure (ANOVA with age adjustment). In contrast, oral contraceptive users had significantly higher BMIs and diastolic blood pressures (p<0·01, ANOVA with age adjustment). Multiple regression analysis also revealed that oral contraceptive use was a weak but significant contributing factor to both high BMI and blood pressure when sociodemographic factors were taken into account and controlled for statistically. It can thus be concluded that the use of contraceptive pills, which contain oestrogen and progestin and are provided free of charge to Thai women, tend to increase BMI and to elevate blood pressure. (shrink)

In this paper, we examine the ethico-legal issue of P2P file sharing and copyright infringement in two different countries - Japan and Sweden - to explore the differences in attitude and behaviour towards file sharing from a socio-cultural perspective. We adopt a comparative case study approach focusing on one Japanese case, the Winny case, and a Swedish case, the Pirate Bay case. Whereas similarities in attitudes and behaviour towards file sharing using P2P software between the two countries are found in (...) this study, the Swedish debate on file sharing has been coloured by an ideological and political dimension, which is absent in the Japanese context. This might indicate that Swedes have been more interested in issues of right and wrong, and the creation of political subject of piracy, while the Japanese are more interested in their own individual well being. (shrink)

This paper offers a new insight on the Condorcet Jury Theorem (CJT) in the theory of epistemic democracy. This theorem states that democratic decision-making leads us to correct outcomes under certain assumptions. One key assumption is the ‘independence condition’, which requires that voters form their beliefs independently when they vote. This paper examines the role of an opinion leader as an informational source, which potentially violates independence. We demonstrate that voters’ beliefs may be correlated in the presence of the leader, (...) and that the CJT can fail if the leader’s opinions are reliable. This leads us to the following paradoxical observation: for epistemic democracy, good leaders may be bad, while bad leaders may be good. (shrink)

We examined the differences between estimating the emotions of protagonists and evaluating those of readers in narrative comprehension. Half of the participants read stories and rated the emotional states of the protagonists, while the other half of the participants rated their own emotional states while reading the stories. The results showed that reading comprehension was facilitated when highly extraverted participants read stories about, and rated the emotional experiences of, extraverted protagonists, with personalities similar to their own. However, the same facilitative (...) effect was not observed for less extraverted participants, nor was it observed for either type of participants under the condition in which participants rated their own emotional experiences. Thus, at least for highly extraverted participants, readers both facilitated the construction of a situation model and correctly estimated the emotional states of protagonists who were similar to themselves, perhaps due to empathy. (shrink)

Although creativity and curiosity can be similarly construed as knowledge-building processes, their underlying motivation is fundamentally different. Specifically, curiosity drives organisms to seek information that reduces uncertainty so that they can make a better prediction about the world. On the contrary, creative processes aim to connect distant pieces of information, maximizing novelty and utility.

A system for analyzing concerns of people from Weblog articles is proposed. The system called KANSHIN analyzes concerns of people by collecting Japanese, Chinese, and Korean Weblog articles. Users can find concerns of people in each language. Users can also compare differences of concerns between Japanese, Chinese, and Korean language communities. We describe several analysis results: (1) patterns of social concerns, (2) change of focuses on a problem along with the time, (3) differences of concerns on a problem between Japanese, (...) Chinese, and Korean Weblog sites, and (4) relation between words in Weblog articles and real world natural phenomenon. (shrink)

AimTo examine the association of body mass index (BMI) [kg/m2] and its classifications (underweight [BMI < 18.5], normal [18.5 ≤ BMI < 25], overweight [25 ≤ BMI < 30], and obese [BMI ≥ 30]) with brain structure in individuals with a wide range of BMI group.Materials and methodsThe participants included 382 right-handed individuals (mean age: 46.9 ± 14.3 years, 142 men and 240 women). The intelligence quotient was assessed using the Japanese Adult Reading Test. Voxel-based morphometry (VBM) and diffusion tensor (...) imaging (DTI) were performed to analyze the association of BMI and its classifications with gray and white matter structures, respectively.ResultsAccording to VBM, BMI was significantly and negatively correlated with the bilateral cerebellum exterior volumes. In group comparisons, the right cerebellum exterior volume was significantly lower in the overweight or obese group than in the underweight or normal group, while the bilateral cuneus and calcarine cortex, left cuneus, and left precuneus volume was significantly lower in the underweight group than in the non-underweight group. Sex-related stratification analyses for VBM revealed that BMI was significantly and negatively correlated with the bilateral cerebellum exterior volumes only in women. In group comparisons, the left cerebellum exterior volume was significantly lower in obese women than in non-obese women. The left thalamus proper and the right cerebellum exterior volumes were significantly lower in overweight or obese group than in underweight or normal group in men and women, respectively. The bilateral cuneus and calcarine cortex, left cuneus and carcarine cortex, and bilateral cuneus volume was significantly lower in underweight men than in non-underweight men. In contrast, there were no notable findings on DTI.ConclusionOur results suggest association of continuous BMI, being overweight or obese, and being underweight with decreased gray matter volume in individuals with a wide range of BMI group. Furthermore, sex-related differences are seen in the association of BMI and its classifications with regional gray matter volume reductions. Abnormally high or low BMIs may have a negative influence on regional gray matter volumes. (shrink)

Ongoing research on making “human-animal chimeras” or “animals containing human material” to solve the shortage of organs available for transplantation has raised many ethical issues regarding the creation and utilization of such constructs, including cultural views regarding the status of those creations. A pilot study was conducted to explore Japanese public attitudes toward human-animal chimeras or ACHM. The February 2012 study consisted of focus group interviews with citizens from the Greater Tokyo Area, aged between 20 and 54. The 24 participants (...) were divided into four groups. Transcripts of the interviews were analyzed and participants’ attitudes categorized. Five categories of participant attitudes were identified: resistance to the unnatural, concerns about animal welfare, concerns about controlling human-animal chimeras, concerns about the possible birth of intermediate entities, and resistance to creating and utilizing animals containing my material or my child’s material. Our FGI results showed a broader and greater variety of public concerns than those reported in previous studies. While researchers have tried to establish new methods to avoid creating intermediate entities, our participants expressed concerns about not only intermediate entities but also animals containing their own material or their child’s material. Based upon their responses in the interviews, we are introducing a new ethical concern: “animals containing my material/my child’s material.”. (shrink)

Research ethics consultation services (RECS), which function as an advisory service to facilitate the resolution of complex ethical issues in clinical research, have been proliferating over the last decade. However, the qualification of an individual who provides RECS, or “a research ethics consultant,” has not been thoroughly investigated, in contrast to healthcare ethics consultants, whose core competencies have been discussed and clarified to a great extent. In this study, we investigated core competencies necessary for research ethics consultants, referring to the (...) core competency models of ethics consultants developed in the healthcare practice context, and propose a competency model for research ethics consultants. (shrink)