Ethical principles including autonomy, justice and equality function in the same paradigm of thought, that is, logocentrism - an epistemological predilection that relies on the analytic power of deciphering between binary oppositions. By studying observable behavior with an analytical approach, however, one immediately limits any recognition and possible understanding of modes of thought based on separate epistemologies. This article seeks to reveal an epistemological predilection that diverges from logocentrism yet continues to function as a fundamental component of ethical behavior. The (...) issue of cancer disclosure in Japan is used to exemplify the nature of relative subjectivity (kankeiteki-shukansei), a term I define and believe to be an epistemological predisposition fundamental to ethical behavior. Relative subjectivity denotes an epistemology quintessential to the behavior of individuals who attend to the respective tides of each particular situation, each interpersonal relationship or, in the context of clinical medicine, to the needs and values of each patient. (shrink)

Scientific misconduct can jeopardize scientific progress and destroy the credibility and reputation of academic institutions and their faculty and students; ultimately it can compromise scientific integrity and result in a loss of confidence for the entire scientific community. Only recently in Japan has scientific misconduct become a central public topic. This increased attention to the topic, in turn, has highlighted a paucity of ethical standards within the Japanese scientific community and a lack of an apt process for conflict resolution. In (...) this brief report, we first provide an overview of several high-profile cases of scientific misconduct recently uncovered in Japan. Next we consider how a recent rise in competition within the academic and scientific communities is possibly related to a concurrent increase in reported cases of scientific misconduct. Last, after discussing what actions have already been taken, we recommend further actions needed to deal with the problem of scientific misconduct in Japan. (shrink)

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

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

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

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

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

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

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

This edited collection responds to Richard Kearney's recent work on touch, excarnation, and embodiment, as well as his broader work in carnal hermeneutics, which sets the stage for his return to and retrieval of the senses of the lived body. Here, fourteen scholars engage the breadth and depth of Kearney's work to illuminate our experience of the body. The essays collected within take up a wide variety of subjects, from nature to non-human animals to our experience of the sacred and (...) the demonic, from art's account of touching to the political implications of various types of embodiment. Followed by an inspired new reflection from Kearney himself, in which he lays out his vision for "anacarnation," this volume is an important statement about the centrality of touch and embodiment in our experience, and a reminder that, despite the excarnating tendencies of contemporary life, the lived body remains a touchstone for wisdom in our increasingly complicated and fragile world. Written for scholars and students interested in touch, embodiment, phenomenology, and hermeneutics, this diverse and challenging collection contributes to a growing field of scholarship that recognises and attempts to correct the excarnating trends in philosophy and in culture at large. (shrink)

In the past few years, a second phase of biomedical ethics in Japan has begun to surface with a succession of governmental guidelines and laws regulating biomedical technology. Although this rush of guidelines exemplifies a heightened awareness concerning ethical standards for healthcare research, it also invites several practical, political, and procedural problems.

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

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

Background Ethics committees and their system of research protocol peer-review are currently used worldwide. To ensure an international standard for research ethics and safety, however, data is needed on the quality and function of each nation's ethics committees. The purpose of this study was to describe the characteristics and developments of ethics committees established at medical schools and general hospitals in Japan. Methods This study consisted of four national surveys sent twice over a period of eight years to two separate (...) samples. The first target was the ethics committees of all 80 medical schools and the second target was all general hospitals with over 300 beds in Japan (n = 1457 in 1996 and n = 1491 in 2002). Instruments contained four sections: (1) committee structure, (2) frequency of annual meetings, (3) committee function, and (4) existence of a set of guidelines for the refusal of blood transfusion by Jehovah's Witnesses. Results Committee structure was overall interdisciplinary. Frequency of annual meetings increased significantly for both medical school and hospital ethics committees over the eight years. The primary activities for medical school and hospital ethics committees were research protocol reviews and policy making. Results also showed a significant increase in the use of ethical guidelines, particularly those related to the refusal of blood transfusion by Jehovah's Witnesses, among both medical school and hospital ethics committees. Conclusion Overall findings indicated a greater recognized degree of responsibilities and an increase in workload for Japanese ethics committees. (shrink)

Drawing on interviews and observational work with practicing U.K. plant scientists, this article uses Michel Callon's work as a tool to explore the issue of collaboration between academic science and business, in particular, calls by the Biotechnology and Biological Sciences Research Council for a return to “public good” plant science. In an article titled “Is Science a Public Good?” Callon contributed to the debate about the commercialization of science by suggesting that commercialization and the public good need not be incompatible. (...) Moving away from arguments that center on the effects of business involvement in science, he suggested that analysts use another model, centered on “diversity.” This model allows us to ask what society might want from science, what public good science might look like, and how public good science can be ensured while also recognizing that science cannot be easily separated from the market. (shrink)

The Institute Vienna Circle held a conference in Vienna in 2003, Cambridge and Vienna – Frank P. Ramsey and the Vienna Circle, to commemorate the philosophical and scientific work of Frank Plumpton Ramsey (1903–1930). This Ramsey conference provided not only historical and biographical perspectives on one of the most gifted thinkers of the Twentieth Century, but also new impulses for further research on at least some of the topics pioneered by Ramsey, whose interest and potential are greater than ever. Ramsey (...) did pioneering work in several fields, practitioners of which rarely know of his important work in other fields: philosophy of logic and theory of language, foundations of mathematics, mathematics, probability theory, methodology of science, philosophy of psychology, and economics. There was a focus on the one topic which was of strongest mutual concern to Ramsey and the Vienna Circle, namely the question of foundations of mathematics, in particular the status of logicism. Although the major scientific connection linking Ramsey with Austria is his work on logic, to which the Vienna Circle dedicated several meetings, certainly the connection which is of greater general interest concerns Ramsey's visits and discussions with Wittgenstein. Ramsey was the only important thinker to actually visit Wittgenstein during his school-teaching career in Puchberg and Ottertal in the 1920s, in Lower Austria; and later, Ramsey was instrumental in getting Wittgenstein positions at Cambridge. (shrink)

"This book is based on new work relating gendered assumptions about rationality to men's mental health. It offers the reader a theoretical exploration of a topically and politically sensitive issue and provides a valuable critique of postmodern theory and theorists. It is relevant to practitioners and activists in the mental health field, will be of interest to profeminist theorists, and is essential reading for academics and students of sociology and allied disciplines."--Jacket.

© 2015, Springer-Verlag Berlin Heidelberg.Genetic studies have identified single nucleotide polymorphisms associated with the risk of prostate cancer. It remains unclear whether such genetic variants are associated with disease aggressiveness. The NCI-SPORE Genetics Working Group retrospectively collected clinicopathologic information and genotype data for 36 SNPs which at the time had been validated to be associated with PC risk from 25,674 cases with PC. Cases were grouped according to race, Gleason score and aggressiveness. Statistical analyses were used to compare the frequency (...) of the SNPs between different disease cohorts. After adjusting for multiple testing, only PC-risk SNP rs2735839 was significantly and inversely associated with aggressive and high-grade disease in European men. Similar associations with aggressive and high-grade disease were documented in African-American subjects. The G allele of rs2735839 was associated with disease aggressiveness even at low PSA levels in both European and African-American men. Our results provide further support that a PC-risk SNP rs2735839 near the KLK3 gene on chromosome 19q13 may be associated with aggressive and high-grade PC. Future prospectively designed, case-case GWAS are needed to identify additional SNPs associated with PC aggressiveness. (shrink)

BackgroundVideo-calls have proven to be useful for older care home residents in improving socialization and reducing loneliness. Nonetheless, to facilitate the acceptability and usability of a new technological intervention, especially among people with dementia, there is a need for user-led design improvements. The current study conducted focus groups with an embedded activity with older people to allow for a person-centered design of a video-call intervention.MethodsTwenty-eight residents across four care homes in the South West of England participated in focus groups to (...) aesthetically personalize and ‘dress-up’ the equipment used in a video-call intervention. Each care home was provided with a ‘Skype on Wheels’ device, a wheelable ‘chassis’ comprising an iPad or tablet for access to Skype, and a telephone handset. During the focus group, residents were encouraged to participate in an activity using colorful materials to ‘dress-up’ SoW. Comments before, during and after the ‘dress up’ activity were audio recorded. Framework analysis was used to analyze the focus group data.ResultsOlder people, including seven with dementia were able to interact with and implement design changes to SoW through aesthetic personalization. Themes arising from the data included estrangement, anthropomorphism, reminiscence, personalization, need for socialization versus fear of socialization and attitudes toward technology. After this brief exposure to SoW, residents expressed the likelihood of using video-calls for socialization in the future.ConclusionCare home residents enjoy engaging with new technologies when given the opportunity to interact with it, to personalize it and to understand its purpose. Low cost aesthetic personalization of technologies can improve their acceptability, usability, and implementation within complex care environments. (shrink)

The phenomenon of multi-used stock photography in the news contradicts the photojournalism professional values of truthful and emotional depictions. This reality echoes other false images increasingly appearing in the media, including deepfakes and artificial intelligence. In the present study, a two (stock and staff photo) by two (positive and negative valence) quasi-experiment is conducted. The dependent variables include: 1) credibility; 2) self-reported arousal level; 3) emotional valence perceptions; 4) fixation duration; and 5) fixation count. Participants viewed staff photos as more (...) credible in both positive and negative valences. Negative photos were perceived as slightly less credible. Stock and staff photos were similarly arousing, received similar valence perceptions, and had similar gaze fixations and durations. Overall, participants perceived the genuine emotion portrayed truthfully in photojournalism as opposed to the faux emotion acted out in stock photos. (shrink)

Nietzsche's use of metaphor has been widely noted but rarely focused to explore specific images in great detail. A Nietzschean Bestiary gathers essays devoted to the most notorious and celebrated beasts in Nietzsche's work. The essays illustrate Nietzsche's ample use of animal imagery, and link it to the dual philosophical purposes of recovering and revivifying human animality, which plays a significant role in his call for de-deifying nature.

This volume addresses the intriguing issue of indirect reports from an interdisciplinary perspective. The contributors include philosophers, theoretical linguists, socio-pragmaticians, and cognitive scientists. The book is divided into four sections following the provenance of the authors. Combining the voices from leading and emerging authors in the field, it offers a detailed picture of indirect reports in the world’s languages and their significance for theoretical linguistics. Building on the previous book on indirect reports in this series, this volume adds an empirical (...) and cross-linguistic approach that covers an impressive range of languages, such as Cantonese, Japanese, Hebrew, Persian, Dutch, Spanish, Catalan, Armenian, Italian, English, Hungarian, German, Rumanian, and Basque. (shrink)

All major western countries today contain groups that differ in their religious beliefs, customary practices or ideas about the right way in which to live. How should public policy respond to this diversity? In this important new work, Brian Barry challenges the currently orthodox answer and develops a powerful restatement of an egalitarian liberalism for the twenty-first century. Until recently it was assumed without much question that cultural diversity could best be accommodated by leaving cultural minorities free to associate (...) in pursuit of their distinctive ends within the limits imposed by a common framework of laws. This solution is rejected by an influential school of political theorists, among whom some of the best known are William Galston, Will Kymlicka, Bhikhu Parekh, Charles Taylor and Iris Marion Young. According to them, this 'difference-blind' conception of liberal equality fails to deliver either liberty or equal treatment. In its place, they propose that the state should 'recognize' group identities, by granting groups exemptions from certain laws, publicly 'affirming' their value, and by providing them with special privileges or subsidies. In Culture and Equality, Barry offers an incisive critique of these arguments and suggests that theorists of multiculturism tend to misdiagnose the problems of minority groups. Often, these are not rooted in culture, and multiculturalist policies may actually stand in the way of universalistic measures that would be genuinely beneficial. (shrink)

All major western countries today contain groups that differ in their religious beliefs, customary practices or ideas about the right way in which to live. How should public policy respond to this diversity? In this important new work, Brian Barry challenges the currently orthodox answer and develops a powerful restatement of an egalitarian liberalism for the twenty-first century. Until recently it was assumed without much question that cultural diversity could best be accommodated by leaving cultural minorities free to associate (...) in pursuit of their distinctive ends within the limits imposed by a common framework of laws. This solution is rejected by an influential school of political theorists, among whom some of the best known are William Galston, Will Kymlicka, Bhikhu Parekh, Charles Taylor and Iris Marion Young. According to them, this 'difference-blind' conception of liberal equality fails to deliver either liberty or equal treatment. In its place, they propose that the state should 'recognize' group identities, by granting groups exemptions from certain laws, publicly 'affirming' their value, and by providing them with special privileges or subsidies. In Culture and Equality, Barry offers an incisive critique of these arguments and suggests that theorists of multiculturism tend to misdiagnose the problems of minority groups. Often, these are not rooted in culture, and multiculturalist policies may actually stand in the way of universalistic measures that would be genuinely beneficial. (shrink)

All major western countries today contain groups that differ in their religious beliefs, customary practices or ideas about the right way in which to live. How should public policy respond to this diversity? In this important new work, Brian Barry challenges the currently orthodox answer and develops a powerful restatement of an egalitarian liberalism for the twenty-first century. Until recently it was assumed without much question that cultural diversity could best be accommodated by leaving cultural minorities free to associate (...) in pursuit of their distinctive ends within the limits imposed by a common framework of laws. This solution is rejected by an influential school of political theorists, among whom some of the best known are William Galston, Will Kymlicka, Bhikhu Parekh, Charles Taylor and Iris Marion Young. According to them, this 'difference-blind' conception of liberal equality fails to deliver either liberty or equal treatment. In its place, they propose that the state should 'recognize' group identities, by granting groups exemptions from certain laws, publicly 'affirming' their value, and by providing them with special privileges or subsidies. In Culture and Equality, Barry offers an incisive critique of these arguments and suggests that theorists of multiculturism tend to misdiagnose the problems of minority groups. Often, these are not rooted in culture, and multiculturalist policies may actually stand in the way of universalistic measures that would be genuinely beneficial. (shrink)