Just as sadness is not always a symptom of mood disorder, irrational beliefs are not always symptoms of illness. Pathological irrational beliefs are distinguished from non-pathological ones by considering whether their existence is best explained by assuming some underlying dysfunctions. The features from which to infer the pathological nature of irrational beliefs are: un-understandability of their progression; uniqueness; coexistence with other psycho-physiological disturbances and/or concurrent decreased levels of functioning; bizarreness of content; preceding organic diseases known to be associated with irrational (...) beliefs; treatment response to medical intervention, etc. Severe irrationality is sometimes caused by normal human motivation rather than by mental or physical dysfunction. Pure forms of self-deception may satisfy the diagnostic criteria of delusional disorder, but there may be no evidence that suggests that they are caused by illness. Although those with pathological delusions do not recognize their delusions as symptomatic of illness, differentiating pathological beliefs from normal irrational beliefs is vitally important: If a belief is pathological, psychiatrists must seriously consider treating the patient against her will. If it is not pathological, conversely, involuntary treatments are prohibited because they offend her basic autonomy. (shrink)

Maher proposed in 1974 that schizophrenic delusions are hypotheses formed to explain anomalous experiences. He stated that they are “rational, given the intensity of the experiences that they are developed to explain.” Two-factor theorists of delusion criticized Maher’s theory because 1) it does not explain why some patients with anomalous experiences do not develop delusions, and 2) adopting and adhering to delusional hypotheses is irrational, considering the totality of experiences and patients’ other beliefs. In this paper, the notion of the (...) intensity of experience is reappraised to uphold Maher’s basic conception. Regarding 1), I propose that differences in the intensity of anomalous experience are vital to whether the patient forms delusions, while partially reforming his rationality claim regarding 2). Although adopting delusions is irrational, it is inevitable and excusable, given the intensity of the patient’s anomalous experience. With the aid of this notion, it is maintained that anomalous experience is sufficient for the development of delusions, at least in some cases of schizophrenia. Compared to other theories of schizophrenic delusion, Maher’s theory, which embraces the notion of intensity of experience, better explains why such irrational mental states as delusions develop from anomalous experiences, and why delusional patients persist in believing specific thematic content. (shrink)

The notion of epistemic injustice was first applied to cases of discrimination against women and people of color but has since come to refer to wider issues related to social justice. This paper applies the concept of epistemic injustice to problems in the therapeutic relationship between psychiatrists and psychiatric patients. To this end, it is necessary to acknowledge psychiatrists as professionals with expertise in treating mental disorders, which impair the patient’s rationality, sometimes leading to false beliefs, such as delusions. This (...) paper classifies the characteristic features of the therapeutic relationship in psychiatry into three stages: those of a professional–client relationship, those of a doctor–patient relationship, and those of a psychiatrist–psychiatric patient relationship. Epistemic injustice is prevalent in psychiatric care owing to prejudice against patients with mental disorders. However, it is also predisposed by the roles that psychiatrists play in relation to psychiatric patients. This paper suggests some ameliorative measures based on the analysis. (shrink)

Kengo Miyazono’s Delusions and Beliefs: A Philosophical Inquiry is an attempt to provide a unified account of the nature, pathology, and etiology of delusions. The strength of his book resides in the clarity of arguments and its consistent adoption of a biological explanation of delusions, based on teleo-functionalism about mental states. However, there are some weaknesses in each of his arguments regarding the nature, pathology, and etiology of delusions. Regarding the nature of delusions, teleo-functionalism makes it difficult to confirm that (...) delusions are beliefs. Regarding the pathology of delusions, I suggest that the existence of harmful malfunction is a necessary but not a sufficient condition for a belief to be considered pathological, and that additional evidence is needed to justify the separation of the belief and the holder’s personhood. Regarding the etiology, it is not reasonable to incorporate the prediction error theory into a kind of two-factor theory. Therefore, the details of his arguments require further modification. (shrink)

Although Kripke’s skepticism leads to the conclusion that meaning does not exist, his argument relies upon the supposition that more than one interpretation of words is consistent with linguistic evidence. Relying solely on metaphors, he assumes that there is a multiplicity of possible interpretations without providing any strict proof. In his book The Taming of the True, Neil Tennant pointed out that there are serious obstacles to this thesis and concluded that the skeptic’s nonstandard interpretations are “will o’ wisps.” In (...) this paper, contra Tennant, I demonstrate how to construct alternative interpretations of the language of algebra. These constructed interpretations avoid Tennant’s objections and are shown to be interdefinable with the standard interpretation. Kripke’s skepticism is, as it were, an incarnate demon. In contrast, it is currently uncertain whether the same technique is generally applicable to the construction of an alternative interpretation of natural language. However, the reinterpretation of those aspects of natural language that directly relate to numbers seems to be a promising candidate for the development of nonstandard interpretations of natural language. (shrink)

D. Davidson argued that shared conventions learned in advance are not essential for the success of communication. In this paper, holding the validity of his contention in suspense, I argue that linguistic conventions play essential roles when communication fails. In everyday communication, when discrepancies are detected between what the speaker intended to inform the hearer and what the hearer actually understood, it becomes necessary to determine whether the speaker or the hearer caused the communication failure. For in everyday communication, the (...) hearer often changes her position based on her misunderstanding about the intention of the speaker, and it is sometimes too late when the hearer realizes the speaker’s true intention. In such cases, it is necessary to determine who is responsible for the hearer’s loss. What the speaker said, which is determined by linguistic conventions, arbitrates the conflict between them. From the fact that shared conventions mainly relate to the evaluation aspect of communication, it follows that the speaker and the hearer need not learn shared linguistic conventions in advance of the conversation, and have only to learn them later, when failures are detected among past communication. (shrink)

BackgroundEnhancement involves the use of biomedical technologies to improve human capacities beyond therapeutic purposes. It has been well documented that enhancement is sometimes difficult to distinguish from treatment. As a subtype of enhancement, neuroenhancement aims to improve one’s cognitive or emotional capacities.Main bodyThis article proposes that the notion of neuroenhancement deserves special attention among enhancements in general, because apart from the notion of treatment, it also overlaps with other concepts such as prevention, pain relief, and pleasure seeking. Regarding prevention, patients’ (...) mental endurance can be enhanced when a patient is prescribed a selective serotonin reuptake inhibitor for the purpose of preventing the relapse of depression following a stressful situation. As for pain relief, psychiatrists use medication to alleviate distress in patients who experience various types of anxiety; the alleviation of distress is equal to psychological pain relief, but is also an enhancement of the patient’s temperamental traits. Regarding pleasure seeking, insidious transition exists between neuroenhancement and pleasure seeking when using psychotropic drugs. It is well known that people use psychostimulants for recreational purposes and to induce overconfidence in one’s performance. The polysemy of psychotropics derives from their effects on human sensibility. Therefore, when using psychotropic agents, psychiatrists should pay close attention to what the agent is used for on each patient in each situation, and explicitly share the continuity and overlap in the purpose of prescribing a medication with the patients to make a better clinical decision.ConclusionsThe notion of neuroenhancement overlaps not only with the notion of treatment, but also with other concepts of prevention, pain relief, and pleasure seeking. The continuity between those concepts makes the issues concerning the prescription of psychotropic drugs subtler. Psychiatrists should explicitly share the continuity with the patients to make a better clinical decision. (shrink)

This paper examines the ethical aspects of organ transplant surgery in which a donor heart is transplanted from a first recipient, following determination of death by neurologic criteria, to a second recipient. Retransplantation in this sense differs from that in which one recipient undergoes repeat heart transplantation of a newly donated organ, and is thus referred to here as “reuse cardiac organ transplantation.” Medical, legal, and ethical analysis, with a main focus on ethical analysis. From the medical perspective, it is (...) critical to ensure the quality and safety of reused organs, but we lack sufficient empirical data pertaining to medical risk. From the legal perspective, a comparative examination of laws in the United States and Japan affirms no illegality, but legal scholars disagree on the appropriate analysis of the issues, including whether or not property rights apply to transplanted organs. Ethical arguments supporting the reuse of organs include the analogous nature of donation to gifts, the value of donations as inheritance property, and the public property theory as it pertains to organs. Meanwhile, ethical arguments such as those that address organ recycling and identity issues challenge organ reuse. We conclude that organ reuse is not only ethically permissible, but even ethically desirable. Furthermore, we suggest changes to be implemented in the informed consent process prior to organ transplantation. The organ transplant community worldwide should engage in wider and deeper discussions, in hopes that such efforts will lead to the timely preparation of guidelines to implement reuse cardiac organ transplantation as well as reuse transplantation of other organs such as kidney and liver. (shrink)

井筒俊彦の交流や思想の影響を巡り、世代も分野も全く異なる国内外の作家・学者たちが縦横無尽に語り尽くす――。.

Shinpi tetsugaku: The Birth of a Poet-Philosopher -- The Encounter with Islam -- Russia: The Spirituality of Night -- A Contemporary and the Biography of the Prophet -- Catholicism -- Words and WORD -- Translator of the Heavenly World -- Eranos-Dialogue in the Beyond -- Consciousness and Essence -- The Philosophy of Mind.

武士教訓の特質とは―定説化された士道・武士道論の枠組みに飛び込み、そこからの脱却をはかる意欲的論考―.

なぜ人は美・芸術に惹かれるのか。過去の学説にとらわれず、自ら思索することを促し、人生を豊かにする手がかりとなることを目指す。.

In this article, we perform a thought experiment about living donor kidney transplantation. If a living kidney donor becomes in need of renal replacement treatment due to dysfunction of the remaining kidney after donation, can the donor ask the recipient to give back the kidney that had been donated? We call this problem organ restitution and discussed it from the ethical viewpoint. Living organ transplantation is a kind of ‘designated donation’ and subsequently has a contract-like character. First, assuming a case (...) in which original donor wishes the return of the organ which had been transplanted into B, and the original recipient agrees, organ restitution will be permissible based on contract-like agreement. However, careful and detailed consideration is necessary to determine whether this leaves no room to question the authenticity of B’s consent. Second, if B offers to give back the organ to A, then B’s act is a supererogatory act, and is praiseworthy and meritorious. Such an offer is a matter of virtue, not obligation. Third, if A wishes B to return the organ, but B does not wish/allow this to happen, it is likely difficult to justify returning the organ to A by violating B’s right to bodily integrity. But B’s refusal to return the donated organ cannot be deemed praiseworthy, because B forgets the great kindness once received from A. Rather than calling this an obligation, we encourage B to consider such virtuous conduct. (shrink)

Societies of the East are often contrasted with those of the West in their stances toward technology. This paper explores these perceived differences in the context of international ethics guidance for artificial intelligence (AI) and robotics. Japan serves as an example of the East, while Europe and North America serve as examples of the West. The paper’s principal aim is to demonstrate that Western values predominate in international ethics guidance and that Japanese values serve as a much-needed corrective. We recommend (...) a hybrid approach that is more inclusive and truly ‘international’. Following an introduction, the paper examines distinct stances toward robots that emerged in the West and Japan, respectively, during the aftermath of the Second World War, reflecting history and popular culture, socio-economic conditions, and religious worldviews. It shows how international ethics guidelines reflect these disparate stances, drawing on a 2019 scoping review that examined 84 international AI ethics documents. These documents are heavily skewed toward precautionary values associated with the West and cite the optimistic values associated with Japan less frequently. Drawing insights from Japan’s so-called ‘moonshot goals’, the paper fleshes out Japanese values in greater detail and shows how to incorporate them more effectively in international ethics guidelines for AI and robotics. (shrink)

In organ transplantation, there is a lack of ethical discussion about the recipient’s right not to receive a transplant. Using the current situation of living organ transplantation and deceased organ transplantation in Japan as an example, we prospectively discussed to what extent the recipient’s right not to receive a transplant is ethically acceptable. In directed transplantation from a living donor, a recipient may refuse organ donation from a particular donor. It is preferable that a recipient’s request for organ donation from (...) a donor occurs as part of a transparent process. In nondirected transplantation from a deceased donor, refusal of transplantation from a particular type of donor appears potentially justifiable. There are both moral and pragmatic considerations. Certain refusals based solely on belief are morally unacceptable, and refusal to transplant a recipient based on the donor’s age jeopardizes the entire transplant system. When religious beliefs affect mental and physical health, individualized measures are required for transplant rejection. We also deductively developed a prospective argument based on the current status of donor–recipient communication in living organ transplantation in Japan and the 2010 amendment of the law allowing relatives to be given priority in organ transplantation from deceased donors. (shrink)

The problem of the destruction of nature and the natural environment is one of the most serious problems that confronts humanity at the end of the twentieth century. This destruction has its basis in the dualistic way of thinking that has dominated the Modern age: Humanity has been accustomed to think of the world dualistically as a confrontation between subject and object, soul and body, and spirit and nature. Both Modern natural sciences and scientific technology in general are grounded in (...) such a dualistic way of thinking. But this way of thinking itself, in other words, the Modern dualistic paradigm, is now one of the most serious problems of present-day philosophy. It has become clear that a new relation between humanity and nature must be established. In this paper, I will re-examine the relationship between “nature” and “spirit” in the context of Husserl’s phenomenology in which, in my opinion, a new concept of nature can be found. In the course of this investigation, I shall try to elucidate the present-day situation of human spirit in a phenomenological way. (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)

In Husserl's phenomenology, the phenomenological reduction only when the content can be expressed in language, and describe the time being, in order to study the phenomenon of cognitive achievement. The purpose of this paper is to discuss by "viewing" and the "expression" the general relationship between the phenomenological description to understand exactly why. Beginning of this first set out to clarify the text of Husserl's "intuitive" and "expression" of the general relationship. Then I will try to discuss the phenomenology of (...) visual expression and the relationship between phenomenology, Husserl of such relationships rarely considered. After discussion, you can expose the phenomenological description of the functionality expressed in metaphor. Finally, I will clear depicted in the ultimate and most profound phenomenological description, which is the ultimate goal of phenomenology. In Husserl's phenomenology, phenomenological cognition is to be accomplished only when what is seen in the phenomenological reduction becomes expressed in language and described. The aim of this paper is to understand what phenomenological description really is, by discussing the general relationship between 'seeing' and 'expressing'. The research begins with a clarification of the general relationship between 'intuition' and 'expression' as elucidated in Husserl's texts. The author will then try to discuss the relationship between phenomenological intuition and its expression, a relationship which Husserl scarcely considered . This discussion will lead to a revelation of the function of metaphorical expression in phenomenological description . Finally, the author will give a clear if paradoxical depiction of phenomenological description of the ultimate and deepest constituting dimension, which would be the final aim of phenomenology. (shrink)

In this essay, we will discuss the lessons that we have learned in a course titled “Indigenous Peoples and Climate Change” regarding Indigenous efforts and epistemologies to cope with stresses and plights induced by global climate change. Primarily informed by humanistic perspectives, we examine how Indigenous peoples, especially those of North America, process climate change through their cultural values and social priorities, with a particular focus on human emotions or feelings associated with their homeland, which often called sense of place (...) or belonging, in contrast to the abstract concepts that originate from the natural sciences. (shrink)

The aim of this paper is to clarify what “phenomenological” means in the phenomenological researches of nursing and what “method” is or should beadopted in phenomenological researches of nursing. The essay first defines a traditional classification of the phenomenological researches of nursing by Cohen and Omery, and then gives a new attempt to classify the phenomenological approaches in the theories of nursing. On this basis, the essay reviews some representative “phenomenological” researches of nursing today and addresses critical comments to them. (...) Finally, the essay will make clear what “phenomenological” should mean in the phenomenological research of nursing and what kind of “method” should be adopted in those researches. (shrink)

In seiner Fünften Cartesianischen Meditation entwickelt Husserl eine transzendentale Theorie der Fremderfahrung, der sogenannten ,,Einfühlung . Diese Theorie charakterisiert er in dieser Schrift als ,,statische Analyse . Genau besehen werden darin jedoch mehrere genetische Momente der Fremderfahrung in Betracht gezogen. In diesem Aufsatz versucht der Verfasser, zuerst aufgrund einiger nachgelassener Texte Husserls die wesentlichen Charaktere der statischen und der genetischen Methode und auch den Zusammenhang der beiden festzustellen, um dann aus der Analyse der Fünften Meditation die statischen und die genetischen (...) Momente konkret herauszuarbeiten. Aus dieser Untersuchung wird deutlich, dass die Theorie der Fremderfahrung in der Fünften Meditation als statische Analyse angesehen werden kann, insofern sie die ,,Fundierungsstruktur der Fremderfahrung klärt. Es ergibt sich aber auch, dass sie bereits in die genetische Sphäre eingetreten ist, sofern sie durch den ,,Abbau der höheren Sinnesschicht der Fremderfahrung die primordiale Eigenheitssphäre als Unterschicht freilegt, und wenn sie dann versucht, von dieser Eigenheitssphäre her die höhere Konstitution des fremden Leibes und des alter ego durch die ,,paarende Assoziation als ,,passive Genesis aufzuklären. Dieser halb-genetischen Theorie fehlt jedoch ein weiteres notwendiges Verfahren der genetischen Methode (das der Rückfrage nach der ,,Urstiftung ), das überprüfen soll, ob und wie alle zur primordialen Sphäre gehörigen Sinne (,,mein Leib , ,,mein Menschen-Ich usw.) wirklich ohne konstitutive Leistungen der auf fremde Subjektivität bezogenen Intentionalität urgestiftet werden können. Einige Stellen der Fünften Meditation weisen darauf hin, dass eine solche Urstiftung unmöglich wäre. In der Tat hat der späte Husserl seine ehemalige Konzeption, die die statische Fundierungsabfolge zugleich als notwendiges genetisches Nacheinander auffasste, revidiert. (shrink)

The PIWI-interacting RNA pathway, one of the major eukaryotic small RNA silencing pathways, is a genome surveillance system that silences selfish genes in animal gonads. piRNAs guide PIWI protein to target genes through Watson–Crick RNA–RNA base-parings. Loss of piRNA function causes genome instability, inducing failure in gametogenesis and infertility. Studies using fruit flies and mice as key experimental models have resulted in tremendous progress in understanding the mechanism underlying the piRNA pathway. Recent work using cultured silkworm germline cells has also (...) expanded our knowledge of piRNA biogenesis in particular, since these silkworm cells are the only cells of germline origin that can be cultured. In this review, we describe elucidation of the piRNA pathway using cultured silkworm cells as an experimental model by focusing on recent work in biochemistry and structural biology. Earlier studies that made important contributions to the field are also described. PIWI-interacting RNAs are germline-enriched small RNAs that silence transposons to maintain genome integrity. Recently, cultured silkworm germline cells such as BmN4 made great contributions to understand the mechanism underlying piRNA biogenesis in particular. In this review, we highlight the recent progress in biochemical and structural biology. (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)

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)

While the world rushed to develop treatments for COVID-19, some turned hopefully to drug repurposing. However, little study has addressed issues of drug repurposing in emergency situations from a broader perspective, taking into account the social and ethical ramifications. When drug repurposing is employed in emergency situations, the fairness of resource distribution becomes an issue that requires careful ethical consideration.This paper examines the drug repurposing in emergency situations focusing on the fairness using Japanese cases. Ethical issues under these circumstances addressed (...) by the authors include: maintaining the evidence level, integrity of clinical research ethics, and voluntary consent by original indication patients. In order to address these issues, they argue that rapid accumulation of ethically and scientifically valid evidence is required, as is obtaining information on resource quantity. (shrink)

In April 2018, Japan’s first law regulating clinical research went into effect. The law aimed to strengthen regulations on research integrity and conflicts of interest, which had been limited under existing administrative guidelines; the law also provided stipulations for legal penalties. The scope of the new regulations, however, is limited entirely to studies that evaluate unapproved drugs or the off-label use of approved drugs, and those that receive funding from companies. On the other hand, the law’s application brings numerous complications, (...) including the establishment of new review committees, troublesome procedures for transitioning studies that are currently underway, and ambiguities about the scope of what constitutes best efforts. Thus, the change has led to substantial strain and confusion in the field. This paper offers an overview of the law and its background, and discusses its future prospects from the practical standpoint of managing ethics committees and providing research ethics support in the field. (shrink)

In the January edition of the Journal of Medical Ethics, Fujita and Tabuchi responded that we misunderstood the ‘facts’ in our previous article. Our article’s method was twofold. First, it appealed to normative analysis and publicly accessible materials, and second, it targeted a policy-making approach to public funding. We specifically did not focus on the Center for iPS Cell Research and Application or induced pluripotent stem stock projects. The Authors raised five criticisms, including transparency of our interpretation of public funding (...) policy. We reply to these criticisms by clarifying facts, and demonstrating new data, and asking the Authors what qualifies as a ‘good fact’ in medical ethics. We note that in some cases, it might be possible to examine to what extent facts are ‘true’, while in other cases, ‘facts’ are laden with ‘values’, which cannot be confirmed or falsified with observation alone. The level of ‘good’ implicit in a fact is a challenging issue that goes well beyond science and makes metaethical assumptions about the relationships between facts and values more broadly. (shrink)

In recent years, research in robotics and artificial intelligence (AI) has made rapid progress. It is expected that robots and AI will play a part in the field of nursing and their role might broaden in the future. However, there are areas of nursing practice that cannot or should not be entrusted to robots and AI, because nursing is a highly humane practice, and therefore, there would, perhaps, be some practices that should not be replicated by robots or AI. Therefore, (...) this paper focuses on several ethical concepts (advocacy, accountability, cooperation, and caring) that are considered important in nursing practice, and examines whether it is possible to implement these ethical concepts in robots and AI by analyzing the concepts and the current state of robotics and AI technology. Advocacy: Among the components of advocacy, safeguarding and apprising can be more easily implemented, while elements that require emotional communication with patients, such as valuing and mediating, are difficult to implement. Accountability: Robotic nurses with explainable AI have a certain level of accountability. However, the concept of explanation has problems of infinite regression and attribution of responsibility. Cooperation: If robot nurses are recognized as members of a community, they require the same cooperation as human nurses. Caring: More difficulties are expected in care-receiving than in caregiving. However, the concept of caring itself is ambiguous and should be explored further. Accordingly, our analysis suggests that, although some difficulties can be expected in each of these concepts, it cannot be said that it is impossible to implement them in robots and AI. However, even if it were possible to implement these functions in the future, further study is needed to determine whether such robots or AI should be used for nursing care. In such discussions, it will be necessary to involve not only ethicists and nurses but also an array of society members. (shrink)

BackgroundSolitary death (kodokushi) has recently become recognized as a social issue in Japan. The social isolation of older people leads to death without dignity. With the outbreak of COVID-19, efforts to eliminate solitary death need to be adjusted in line with changes in lifestyle and accompanying changes in social structure. Health monitoring services that utilize wearable devices may contribute to this end. Our goals are to outline how wearable devices might be used to (1) detect emergency situations involving solitary older (...) people and swiftly connect them with medical treatment, to (2) reduce the frequency of deaths that remain undiscovered and (3) to reduce social isolation by promoting social interaction. MethodsTheoretical and philosophical approaches were adopted to examine ethical issues surrounding the application of wearable devices and cloud-based information processing systems to prevent solitary death in the world with/after COVID-19.Main body(1) Technology cannot replace social connections; without social support necessary to foster understanding of the benefits of health management through wearable devices among older adults, such devices may remain unused, or not used properly. (2) Maturity of the technology; systems face the difficult task of detecting and responding to a wide range of health conditions and life-threatening events in time to avert avoidable morbidity and mortality. (3) Autonomy and personhood; promoting the voluntary use of wearable devices that are a part of larger efforts to connect isolated individuals to a community or social services might be effective. Legal force should be avoided if possible. There is some concern that landlords may require an older person to sign a contract agreeing to wear a device. The autonomy of solitary older people should be respected. (4) Governance: policies must be developed to limit access to data from wearables and the purposes for which data can be used.ConclusionIf thoughtfully deployed under proper policy constraints, wearable devices offer a way to connect solitary older people to health services and could reduce cases of solitary death while respecting the personhood of the user. (shrink)