In medical ethics, an appropriate national healthcare system that meets the requirements of justice in healthcare resource allocation is a major concern. Japan is no exception to this trend, and the pros and cons of introducing a two-tier healthcare system, which permits insured medical care services to be provided along with services not covered by social health insurance, have been the subject of debate for many years. The Supreme Court ruled in 2011 that it was valid for the government to (...) ban mixing medical treatments and both the Ministry of Health, Labour and Welfare and Japanese Medical Association oppose the introduction of such a system. In this paper, we examine the main arguments against the introduction of a two-tier healthcare system and ideas that form their basis, which can be broadly divided into opinions based on the importance of equality and those derived from the logical conclusion that the outcomes would be detrimental. We point out issues and shortcomings of each standpoint and argue that the introduction of the system would not necessarily threaten equality and social solidarity in Japanese society, and that abuses of a self-pay tier would be controllable to a certain extent. Then, the authors—who do not actively promote the introduction of a two-tier healthcare system—conclude that the allegation that is completely devoted to one side and the theory that social healthcare is collapsing, which makes the public excessively nervous, cannot be accepted. (shrink)

BackgroundNo laws or official guidelines govern voluntary assisted dying (VAD) in Japan. A legislative bill on the termination of life-sustaining measures has yet to be sent to deliberations for legislation, due to strong opposition that has prevented it from being submitted to the Diet. However, Japan has recently witnessed several cases involving VAD.Main textAgainst this backdrop, we argue that Japan should begin discussion on VAD legislation, referring to the Voluntary Assisted Dying Act 2017 (VADA2017), which was established in 2017 in (...) Victoria, Australia. VADA2017 puts in place a wide range of stringent safeguards and is considered worldwide to be the safest and most conservative policy on a physician offering assisted dying based on the patient’s premeditated request. We consider what opposing opinions from society would arise in response to the VADA2017. Among these will include arguments against VAD itself, those against the validation of this act, and opinions that oppose even the initiation of the dialogue on VAD.ConclusionsWe conclude that to protect the right to life among those placed in vulnerable positions and, at the same time, to respect decision-making of those who wish for immediate death due to unbearable suffering, the dialogue must immediately begin with that on introducing a policy more conservative than that of the VADA2017, which solidly considers arguments against VAD. (shrink)

In everyday medical settings in Japan, physicians occasionally tell an elderly patient that their symptoms are “due to old age,” and there is some concern that patient care might be negatively impacted as a result. That said, as this phrase can have multiple connotations and meanings, there are certain instances in which the use of this phrase may not necessarily be indicative of ageism, or prejudice against the elderly. One of the goals in medical care is to address pain and (...) suffering that develops with age in elderly individuals, and whether or not aging is a disease is inconsequential. However, assuming that an individualized and thorough examination has been performed, there are some conditions that can be attributed only to age. Accordingly, physicians must acknowledge the merits and drawbacks of using the phrase “due to old age,” and exercise caution when using it. Both physicians and their elderly patients must share a common awareness of the incomplete and limited nature of modern medicine and its scope, and physicians must help their elderly patients accept and live with the aging phenomenon. (shrink)

BackgroundIn the coming years, surrogate decision-making is expected to become highly prevalent in Japanese clinical practice. Further, there has been a recent increase in activities promoting advance care planning, which potentially affects the manner in which judgements are made by surrogate decision-makers. This study aims to clarify the grounds on which surrogate decision-makers in Japan base their judgements.MethodsIn this qualitative study, semi-structured interviews were conducted to examine the judgement grounds in surrogate decision-making for critical life-sustaining treatment choices in acute care (...) hospitals.ResultsA total of 228 participants satisfied the inclusion criteria, and 15 were selected for interviews. We qualitatively analysed the content of 14 interview transcripts, excluding one that did not meet the inclusion criteria. Based on this analysis, we extracted 4 core categories, 17 categories, 35 subcategories, and 55 codes regarding judgement grounds in surrogate decision-making. The four core categories were as follows: patient preference-oriented factor (Type 1), patient interest-oriented factor (Type 2), family preference-oriented factor (Type 3), and balanced patient/family preference-oriented factor (Type 4). The Type 4 core category represented attempts to balance the preferences of the patient with those of the surrogate decision-maker.ConclusionsSurrogate decision-makers based their decisions on important aspects related to a patient’s life, and they considered not only the patient’s preferences and best interests but also their own preferences. As the need for surrogate decisions will increase in the future, decision-makers will need to consider judgement grounds from a more diverse perspective. (shrink)

BackgroundInstances of surrogate decision-making are expected to increase with the rise in hospitalised older adults in Japan. Few large-scale studies have comprehensively examined the entire surrogate decision-making process. This study aimed to gather information to assess the current state of surrogate decision-making in Japan.MethodsA cross-sectional survey was conducted using online questionnaires. A total of 1000 surrogate decision-makers responded to the questionnaire. We examined the characteristics of surrogate decision-makers and patients, content of surrogate decision-making meeting regarding life-sustaining treatment between the doctors (...) and surrogate decision-makers, extent of involvement of the various parties in the surrogate decision-making process, judgement grounds for surrogate decision-making, and frequency of involvement in the surrogate decision-making process.ResultsOf the participants, 70.5% were male and 48.3% were eldest sons. Only 7.6% of the patients had left a written record of their preferences and 48.8% of the surrogates reported no knowledge of the patient having expressed their prior intentions regarding medical care in any form. Respondents indicated that their family meetings with healthcare professionals mostly included the information recommended by guidelines in a surrogate decision-making meeting in Japan. Most participants reported a good understanding of the meeting content. Although many participants based their decisions on multiple grounds, surrogates’ considerations may not adequately reflect respect for patient autonomy in Japan. Specifically, the eldest son considered his own preference more frequently than that of the other surrogate decision-makers. In 26.1% of the cases, either zero or one family meeting with healthcare professionals was held. In these cases, significantly fewer decisions involved the participation of healthcare professionals other than the doctor compared to cases with multiple meetings.ConclusionsSurrogate decisions in Japan are most commonly made by eldest sons and may not frequently consider the perspectives of other surrogates. The finding that patient preferences were rarely known suggests a role for increased advance care planning. (shrink)

In his book review of Graham Priest's The Fifth Corner of Four, Mark Siderits, while criticising Priest's philology, suggests that Priest's work is 'of considerable interest' for two reasons. First, 'when two independent traditions use similar methods to work on similar issues, it is always possible that one may have hit on approaches that the other missed'. Second, 'the decentering that can be induced by looking at another tradition may trigger fresh insights, even if those insights are not ones that (...) were actually developed by the tradition marked 'other''. The main task of this paper is to unpack Siderits' thought. By analysing some of Priest's work, I will suggest a decentering that must have taken place in China when Buddhism was 'exported to China in Buddhist shipping containers'. For anyone familiar with the forms of Buddhist philosophy developed in India, various forms of Chinese Buddhism can often look strange. Some ideas that were debated and defended by Indian Buddhists do not appear anywhere in Chinese Buddhism and some assumptions have been quietly added to Buddhism by Chinese Buddhists. By showing that Priest's work brings out the 'innovation' that Chinese Buddhists gave to Buddhism, I will suggest that it is this decentering that Siderits suggests Priest makes use of. (shrink)

In this paper, we explore the traditional conception of a prioricity as epistemic independence of evidence from sense experience. We investigate the fortunes of the traditional conception in the light of recent challenges by Timothy Williamson. We contend that Williamson’s arguments can be resisted in various ways. En route, we argue that Williamson’s views are not as distant from tradition as they might seem at first glance.

La crise de la démocratie d’aujourd’hui a remis en cause la notion même de la solidarité. Le philosophe japonais, Hiroki Azuma, dans Volonté générale 2.0, présente un argument qui repense les conditions de participation et de présence de la politique. En prenant pour fil conducteur la notion rousseauiste de « volonté générale », il essaie de mettre à jour cette notion classique, en se référant au développement de la technologie informatique. Notre article vise à mesurer la portée politico-philosophique de la (...) « volonté générale 2.0 ». (shrink)

We prove that every countable non-standard model of WKL0 has a proper initial part isomorphic to itself. This theorem enables us to carry out non-standard arguments over WKL0.

Protein ubiquitination constitutes a post‐translational modification mediated by ubiquitin ligases whereby ubiquitinated substrates are degraded through the proteasomal or lysosomal pathways, or acquire novel molecular functions according to their “ubiquitin codes.” Dysfunction of the ubiquitination process in cells causes various diseases such as cancers along with neurodegenerative, auto‐immune/inflammatory, and metabolic diseases. KCTD10 functions as a substrate recognition receptor for cullin‐3 (CUL3), a scaffold protein in RING‐type ubiquitin ligase complexes. Recently, studies by ourselves and others have identified new substrates that are (...) ubiquitinated by the CUL3/KCTD10 ubiquitin ligase complex. Moreover, the type of polyubiquitination (e.g., K27‐, K48‐, or K63‐chain) of various substrates (e.g., RhoB, CEP97, EIF3D, and TRIF) mediated by KCTD10 underlies its divergent roles in endothelial barrier formation, primary cilium formation, plasma membrane dynamics, cell proliferation, and immune response. Here, the physiological functions of KCTD10 are summarized and potential mechanisms are proposed. (shrink)

Jennifer Lackey challenges the sufficiency version of the knowledge-action principle, viz., that knowledge that p is sufficient to rationally act on p, by proposing a set of alleged counterexamples. Her aim is not only to attack the knowledge-action principle, but also to undermine an argument for subject-sensitive invariantism. Lackey holds that her examples are counterexamples to the sufficiency version of the knowledge-action principle because (a) S knows the proposition in question, but (b) it is not rational for S to act (...) on it. In this paper, first, I argue against (a) on intuitive and on theoretical grounds. Second, I point out that (b), even if combined with (a), is not sufficient to make for counterexamples to the knowledge-action principle of the relevant kind. Third, I offer two alternative explanations of the intuition Lackey relies on. If either one of them is right, (b) may not be satisfied in her examples. (shrink)

The intellectual foundation of early modern Japan was provided by Confucianism—a system of knowledge set forth in Chinese classical writings. In order to gain access to this knowledge, the Japanese applied reading markers to modify the original Chinese to fit the peculiarities of Japanese grammar and pronunciation. Confucian education started by having the children memorize these Japanese readings of the Chinese classics by endless recitation. This article will examine the significance of this study method in order to demonstrate the following: (...) 1. The recitation of the Chinese classics led to these texts being ‘incorporated’ into the body, where they become the ‘intellectual language’ of thought and speech. 2. This quality of ‘incorporation’ was appreciated because it fostered the unity of thought and behavior, leading to the formation of a strong-willed subject. 3. This idea of ‘incorporation’ stands in stark contrast to the modern conception of knowledge that stresses objectivity and transparency, and ignores the pedagogical significance of the body. (shrink)

Dharmakīrti argues that there is no pramāṇa (valid means of cognition or source of knowledge) for a thesis that is a self-contradiction (svavacanavirodha). That is, self-contradictions such as ‘everything said is false’ and ‘my mother is barren’ cannot be known to be true or false. The contemporary scholar Tillemans challenges Dharmakīrti by arguing that we can know that self-contradictions are false by means of a formal logical inference. The aims of the paper are to answer Tillemans’ challenge from what we (...) take to be Dharmakīrti’s or Dharmakīrtian (someone who is like Dharmakīrti) perspective and to demonstrate the unique features of Dharmakīrti’s view of inference. By so doing, we show that the epistemology in relation to the formal conception of logic that underlies Tillemans’ challenge is problematic from Dharmakīrti’s or Dharmakīrtian perspective. The paper, thus, presents Dharmakīrti’s view of inference and logical reasoning as well as a Dharmakīrtian challenge to the formal conception of logic that is the dominant contemporary conception. (shrink)

Konrad Lorenz, an ethologist, proposed that certain physical elements are perceived as cute and induce caretaking behavior in other individuals, with the evolutionary function of enhancing offspring survival. He called these features Kindchenschema, baby schema. According to his introspection, these include a large forehead, chubby round features, and chubby cheeks. Previous studies are limited to examining the effects of these facial features on perceived cuteness. However, other morphological factors may be related to perceived cuteness. This study uses Bayesian optimization, one (...) of the global sequential optimization methods for estimating unknown functions, to search for facial morphological features that enhance the perceptions of facial cuteness. We applied Bayesian optimization incorporating Gaussian process ordinal regression, which allows an estimation of the latent cuteness function based on evaluations using the Likert scale. A total of 96 preschool children provided the facial images used in this study. We summarized the facial shape variations using methodologies of geometric morphometrics and principal component analysis up to the third principal component, which we refer to as the face space. A total of 40 participants evaluated the images created by warping the average facial texture of the children's faces with randomly generated parameters in the face space. Facial traits related to perceived cuteness were estimated based on the averaged cuteness function. Perceived cuteness was linked to the relative lower position of facial components and narrower jawline but not to the forehead height. (shrink)

In this paper, we argue that a distinction ought to be drawn between two ways in which a given world might be logically impossible. First, a world w might be impossible because the laws that hold at w are different from those that hold at some other world (say the actual world). Second, a world w might be impossible because the laws of logic that hold in some world (say the actual world) are violated at w. We develop a novel (...) way of modelling logical possibility that makes room for both kinds of logical impossibility. Doing so has interesting implications for the relationship between logical possibility and other kinds of possibility (for example, metaphysical possibility) and implications for the necessity or contingency of the laws of logic. (shrink)

Kripke completeness of some infinitary predicate modal logics is presented. More precisely, we prove that if a normal modal logic above is -persistent and universal, the infinitary and predicate extension of with BF and BF is Kripke complete, where BF and BF denote the formulas pi pi and x x, respectively. The results include the completeness of extensions of standard modal logics such as , and its extensions by the schemata T, B, 4, 5, D, and their combinations. The proof (...) is obtained by extending the correspondence between the representation of modal algebras and the completeness of propositional modal logic to infinite. (shrink)

A logic is called 'paraconsistent' if it rejects the rule called 'ex contradictione quodlibet', according to which any conclusion follows from inconsistent premises. While logicians have proposed many technically developed paraconsistent logical systems and contemporary philosophers like Graham Priest have advanced the view that some contradictions can be true, and advocated a paraconsistent logic to deal with them, until recent times these systems have been little understood by philosophers. This book presents a comprehensive overview on paraconsistent logical systems to change (...) this situation. The book includes almost every major author currently working in the field. The papers are on the cutting edge of the literature some of which discuss current debates and others present important new ideas. The editors have avoided papers about technical details of paraconsistent logic, but instead concentrated upon works that discuss more 'big picture' ideas. Different treatments of paradoxes takes centre stage in many of the papers, but also there are several papers on how to interpret paraconistent logic and some on how it can be applied to philosophy of mathematics, the philosophy of language, and metaphysics. (shrink)

It has been an open question whether or not we can define a belief revision operation that is distinct from simple belief expansion using paraconsistent logic. In this paper, we investigate the possibility of meeting the challenge of defining a belief revision operation using the resources made available by the study of dynamic epistemic logic in the presence of paraconsistent logic. We will show that it is possible to define dynamic operations of belief revision in a paraconsistent setting.

Following on from Shaun Gallagher's influential 2005 book How the Body Shapes the Mind, this volume brings together leading experts from the fields of philosophy, neuroscience, psychology, and psychiatry in a productive dialogue, exploring key questions and debates about the relationship between body schema and body image.

The generality problem is usually taken to arise only for externalist theories of knowledge or justification. In this paper, first, I argue that even internalist theories run afoul of a variant of the generality problem. This is because S may have multiple pieces of evidence concerning the reliability of the token process by which S forms the belief in question, and they determine the degree of Sʼs internalist justification differently. Second, I offer a solution to the generality problem for internalist (...) theories: Sʼs practical reason rather than epistemic reason picks out a piece of evidence concerning reliability as relevant. (shrink)

In this paper, first, I distinguish four questions concerning evidence: (a) the ontological question: what kind of entity qualifies as evidence? (b) the possession question: what is it for S to possess evidence? (c) the evidential relation question: what is it for one or a set of things to be evidence for another? And (d) the evidential basis question: how does S’s evidence contribute to forming, maintaining, or revising S’s doxastic attitudes? Williamson’s E = K thesis is only concerned with (...) question (b). Next, I argue that three recent arguments against the E = K thesis miss the target either because they combine the E = K thesis with something alien, or because they conflate these questions. The arguments I address are the argument from access to evidence, the argument from evidential bootstrapping, and the argument from true belief based on falsehood. The argument from access to evidence combines the E = K thesis with a quasi-skeptical consideration. The argument from evidential bootstrapping is only directed at Williamson’s theory of probability, which is his answer to question (c). The argument from true belief based on falsehood derives its force from an assumption about the basing relation as an answer to question (d). Although I do not deny that it is possible to argue for or against the E = K thesis by appealing to answers to other questions than (b), it is no easy task. (shrink)

In this paper, first, I briefly discuss various types of obstacles and difficulties for cross-cultural study and in particular failure of translational equivalence of linguistic stimuli and questions by referring to the literature in cultural psychology. Second, I summarize the extant cross-cultural studies of semantic judgments about reference and truth-value with regard to proper names, with a focus on Sytsma et al.’s (2015) study that examined the differences between English and Japanese. Lastly, I introduce and discuss the two recent studies (...) of semantic judgments in Japanese that my colleagues and I conducted. These two studies suggest that the translation Sytsma et al. used failed to consider the linguistic features characteristic of Japanese and other East Asian languages, and thereby failed to ensure translational equivalence. (shrink)

Virtue epistemology has it that knowledge is a kind of success through ability, and explains the value of knowledge in terms of the general value of success through ability. However, Duncan Pritchard, in a series of recent writings, argues that knowledge is not merely a success through ability, and the virtue-theoretic explanation of the value of knowledge fails. He derives general claims about what he calls ‘environmental luck’ from certain examples, and uses them against virtue epistemology. First, I propose counterexamples (...) to Pritchard’s general claims about environmental luck. Second, I offer a diagnosis of both Pritchard’s and my examples, according to which they differ as to how many abilities are responsible for the performance in question. Different structures of performance make for different conditions for success to be fully creditable to a subject. Once this is taken account of, virtue epistemology can deal with all the examples, while maintaining its main tenet that the value of knowledge is explained in terms of the value of success through ability. Third, I show that my response to Pritchard’s argument against virtue epistemology is more plausible then the ones offered by John Greco and Ernest Sosa. (shrink)

BackgroundThe objective of this study was to describe, through measurement of physical activity and observation of free outdoor play, the relation between children’s free play and the spatial layout of the playground. To accomplish this, we altered the spatial layout of the same playground to see how the layout affects the play activity and the physical activity levels in the same children.MethodsParticipants were six young children. Participants’ physical activity level and the duration of different types of action that occurred in (...) each area and their transitions were compared before and after the alteration of the play-equipment layout using the data from accelerometers and video recordings.ResultsA significant increase in physical activity occurred after the spatial layout alteration, which was related to action differences. Before the alteration, children tended to play in a similar manner for a given play area; however, after the alteration, pronounced interindividual variation in play activity across children was observed.ConclusionThe present pilot study found that in free play situations in the outdoor playground, the spatial layout of playground affects the pattern of play activity and the physical activity levels of young children. (shrink)

In this paper, we propose an extension of the Minimal Generation Gap (MGG) to reduce the number of fitness evaluation for the real-coded GAs (RCGA). When MGG is applied to actual engineering problems, for example applied to optimization of design parameters, the fitness calculating time is usually huge because MGG generates many children from one pair of parents and the fitness is calculated by repetitive simulation or analysis. The proposed method called Saving MGG reduces the number of fitness evaluation by (...) estimating the promising degrees of children using individual distribution and fitness information of population, and selecting children based on the promising degree before evaluating the fitness. Experimental results show that RCGA with Saving MGG can provide large reducing effects on 20 or 30 dimensional Sphere functions, Rosenbrock functions, ill-scaled Rosenbrock functions, and Rastrigin function. (shrink)