Harmony is one of the most fundamental Japanese values. It is derived from Confucianism and encompasses a state of mind, an action process and outcomes of the action. This article draws on research data and discusses Japanese nurses’ perceptions of harmony as reflected in their everyday practice. The most important virtues for these nurses were reported as politeness and respect for other persons. The outcome from the nurses’ harmonious practice, it is claimed, benefited patients and created peaceful, harmonious relationships for (...) all. Because of the unique link between harmony and the location of interaction, the ideal ‘workplace harmony’ threatened some nurses’ professional decision making. These nurses confused harmony with conformity by superficial agreement. The Japanese seniority system could be a major factor contributing to this problem. Ethics education that includes traditional values and concepts in Japanese culture is strongly urged. (shrink)

This article, written from research data, focuses on the possible meaning of the data rather than on detailed statistical reporting. It defines whistleblowing as an act of the international nursing ethical ideal of advocacy, and places it in the larger context of professional responsibility. The experiences, actions, and ethical positions of 24 Japanese nurses regarding whistleblowing or reporting a colleague for wrongdoing provide the data. Of these respondents, similar in age, educational level and clinical experience, 10 had previously reported another (...) nurse and 12 had reported a physician for a wrongful act. These data raise questions about overt actions to expose a colleague in a culture that values group loyalty and saving face. Additional research is needed for an in-depth understanding of whistleblowing, patient advocacy and professional responsibility across cultures, especially those that value group loyalty, saving face and similar concepts to the Japanese Ishin Denshin, where the value is on implicit understanding requiring indirect communication. Usually, being direct and openly discussing sensitive topics is not valued in Japan because such behavior disrupts the most fundamental value, harmony (wa). (shrink)

This pilot study had two purposes: (1) to review recent Japanese nursing literature on nursing advocacy; and (2) to obtain data from nurses on advocacy. For the second purpose, 24 nurses at a nursing college in Japan responded to a questionnaire. The concept of advocacy, taken from the West, has become an ethical ideal for Japanese nurses but one that they do not always understand, or, if they do, they find it difficult to fulfil. They cite nursing leadership support as (...) necessary to enacting this role. Discussion on the meaning of and the rationale for advocacy in a society where goodness or badness is relative to social situations and its impact may reveal two parallel but overlapping views of morality. Such a situation would not only influence notions of advocacy but also possibly render them more complex. (shrink)

End-of-life issues have become an urgent problem in Japan, where people are among the longest lived in the world and most of them die while connected to high-technology medical equipment. This study examines a sensitive end-of-life ethical issue that concerns patients, families and nurses: the withdrawal of artificial food and fluid from terminally ill patients. A sample of 160 Japanese nurses, who completed a questionnaire that included forced-choice and open-ended questions, supported this act under only two specific conditions: if the (...) patient requested it, and if it relieved the patient’s suffering. They considered that the doctor’s orders, the family’s request, or the patient’s advanced age did not ethically justify this act. A small number of people who had recently lost a relative took part in semistructured interviews focusing on their experiences of their terminally ill relatives being given artificial food and fluid. Ethical, social and cultural factors surrounding this issue are discussed. (shrink)

This paper examines how inner theories influence lexical choice. Subjects in one study completed auditorily presented sentence fragments, some of which contained nonhuman antecedents such as dog and cat. Subjects were more likely to use human pronouns rather than it for referring to pets rather than nonpets , and antecedents that were liked rather than disliked , familiar rather than unfamiliar , named rather than unnamed , rational rather than nonrational , and engaging in typically human rather than nonhuman activities (...) . The beliefs and attitudes underlying these pronoun choices intruded not just hypoconsciously , but contraconsciously . A second study examined rapidly generated inferences that influenced what pronoun subjects chose to complete visually presented sentences, such as "When a student practices basketball instead of studying" and "When a student practices ballet instead of studying." The results indicated that inferences from beliefs altered the choice of pronoun from predominately he to predominantly she. Other results indicated that pronouns have semi-autonomous functions of their own, and reflect beliefs and attitudes that vary with subject sex, and are context dependent, pragmatic in nature, and dynamic over time. (shrink)

This article reports a survey of nurses in different cultural settings to reveal their perceptions of ethical role responsibilities relevant to nursing practice. Drawing on the Confucian theory of ethics, the first section attempts to understand nursing ethics in the context of multiple role relationships. The second section reports the administration of the Role Responsibilities Questionnaire (RRQ) to a sample of nurses in China (n = 413), the USA (n = 163), and Japan (n = 667). Multidimensional preference analysis revealed (...) the patterns of rankings given by the nurses to the statements they considered as important ethical responsibilities. The Chinese nurses were more virtue based in their perception of ethical responsibilities, the American nurses were more principle based, and the Japanese nurses were more care based. The findings indicate that the RRQ is a sensitive instrument for outlining the embedded sociocultural factors that influence nurses’ perceptions of ethical responsibilities in the realities of nursing practice. This study could be important in the fostering of partnerships in international nursing ethics. (shrink)

This research explored the ethical issues that nurses reported in the process of elaboration and further disclosure after an initial diagnosis of a terminal illness had been given. One hundred and six hospice nurses in Norway and Denmark completed a questionnaire containing 45 items of forced-choice and open-ended questions. This questionnaire was tested and used in three countries prior to this study; for this research it was tested on Danish and Norwegian nurses. All respondents supported the ethics of ongoing disclosure (...) to terminally ill patients based on ethical principles embedded in their country’s Patients’ Rights Acts. Truth, as an intrinsic value, proved foundational to patient autonomy, the most frequent ethical principle these nurses reported to justify their ethical position on information disclosure to terminally ill people. Telling the truth about a diagnosis was not the end of ethics in hospice care, but rather the beginning because what occurs ethically in dealing with prognosis issues became central to these hospice nurses, the patients and their families. Coupled with truth-telling, compassionate interaction and care become extensions of patients’ rights. (shrink)

We examined amygdala subregion volumes in patients with a first episode of major depression and in healthy subjects. Covariate-adjusted linear regression was performed to compare the MD and healthy groups, and adjustments for age, gender, and total estimated intracranial volume showed no differences in amygdala subregion volumes between the healthy and MD groups. Within the MD group, we examined the association between amygdala subregion volume and the 17-item Hamilton Rating Scale for Depression score and the HAMD subscale score, and found (...) no association in the left amygdala. In the right amygdala, however, there was an inverse linear association between the HAMD total and the HAMD core and lateral nucleus and anterior-amygdaloid-regions. Furthermore, an inverse linear association was seen between the HAMD psychic and the lateral nucleus, anterior-amygdaloid-regions, transition, and whole amygdala. The findings of this study suggest that the severity of MD and some symptoms of MD are associated with right amygdala volume. There have been few reports on the relationship between MD and amygdala subregional volume, and further research is needed to accumulate more data for further validation. (shrink)

This study examines public health nurses’ perceptions and concerns about the implications of Japan’s new long-term care insurance law concerning care provision for elderly people and their families. Respondents voiced their primary concern about this law as access to services for all elderly people needing care, and defined their major responsibility as strengthening health promotion and illness prevention programmes. Although wanting to expand their roles to meet the health care, social and public policy advocacy needs of elderly persons and their (...) families, respondents also stated their concern for the possible lack of enough resources for this expansion to support family caregivers adequately. They viewed their first function as developing collaborative relationships with local government officials to help to assure sufficient resources to provide the necessary foundation for long-term care programmes to deliver services to all those in need. These concerns fall within the larger ethical issue of distributive justice in a society based on the obligations of the state to citizens and the family to its members, especially elderly relatives, who, according to traditional Japanese values, retain respect. (shrink)

This tribute to the breadth and influence of Trudy Govier's philosophical work begins with her early scholarship in argumentation theory, paying special attention to its pedagogical expression. Most people first encounter Trudy Govier's work and many people only encounter it through her textbooks, especially A Practical Study of Argument, published in many editions. In addition to the work on argumentation that has continued throughout her career, much of Govier's later work addresses social philosophy and the problems of trust and response (...) to moral wrongs. The introduction by Catherine Hundleby situates Govier's research along the path of her unusual academic life. While following the timeline of Govier's research publication, in this collection the authors build on her work and suggest certain new connections between her argumentation theory and social philosophy. A Practical Study of Argument, first published in 1985, situates Govier among a distinct segment of informal logicians whose concerns about teaching reasoning to post-secondary students orient their research, Takuzo Konishi argues. Moira Kloster evaluates Govier's progress in the challenge of providing critical thinking education to diverse and changing social contexts. Shifting gears to social philosophy but still addressing education, Laura Elizabeth Pinto explores the significance of Govier's work on trust for explaining the problem of "audit culture" for teaching. At the centre of this volume, social philosophy receives an abstract meta-ethical defense from Linda Radzik. Moving solidly into the domain of normative social philosophy, Alice MacLachlan reconsiders Govier's condemnation of revenge by viewing it as a form of moral address, but she notes how revenge as an act of communication contrasts with argumentation in lacking the respect that Govier maintains is intrinsic to argumentation. MacLachlan ultimately agrees that revenge is morally indefensible. The practical challenges of addressing others in the aftermath of wrongdoing, especially in public contexts, can make it difficult to distinguish between victims and combatants or wrongdoers, Alistair Little and Wilhelm Verwoerd explain, and Kathryn Norlock argues that forgiveness is psychologically vexed too. People may recognize transformation to be in principle possible for all people, Norlock argues, and yet we may find the evidence regarding some particular evildoer sufficient to count that person as an exception. Finally Govier responds to the various papers. (shrink)