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  1.  13
    Matters to address prior to introducing new life support technology in Japan: three serious ethical concerns related to the use of left ventricular assist devices as destination therapy and suggested policies to deal with them.Atsushi Asai, Sakiko Masaki, Taketoshi Okita, Aya Enzo & Yasuhiro Kadooka - 2018 - BMC Medical Ethics 19 (1):12.
    Destination therapy is the permanent implantation of a left ventricular assist device in patients with end-stage, severe heart failure who are ineligible for heart transplantation. DT improves both the quality of life and prognosis of patients with end-stage heart failure. However, there are also downsides to DT such as life-threatening complications and the potential for the patient to live beyond their desired length of life following such major complications. Because of deeply ingrained cultural and religious beliefs regarding death and the (...)
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  2.  6
    The Ethics of the Reuse of Disposable Medical Supplies.Anjan Kumar Das, Taketoshi Okita, Aya Enzo & Atsushi Asai - 2020 - Asian Bioethics Review 12 (2):103-116.
    The use of single-use items is now ubiquitous in medical practice. Because of the high costs of these items, the practice of reusing them after sterilisation is also widespread especially in resource-poor economies. However, the ethics of reusing disposable items remain unclear. There are several analogous conditions, which could shed light on the ethics of reuse of disposables. These include the use of restored kidney transplantation and the use of generic drugs etc. The ethical issues include the question of patient (...)
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  3.  21
    Hope for the Best and Prepare for the Worst: Ethical Concerns Related to the Introduction of Healthcare Artificial Intelligence.Atsuchi Asai, Taketoshi Okita, Aya Enzo, Motoki Ohnishi & Seiji Bito - 2019 - Eubios Journal of Asian and International Bioethics 29 (2):64-70.
    Background: The introduction of healthcare AI to society as well as the clinical setting will improve individual health statuses and increase the possible medical choices. AI can be, however, regarded as a double-edged sword that might cause medically and socially undesirable situations. In this paper, we attempt to predict several negative situations that may be faced by healthcare professionals, patients and citizens in the healthcare setting, and our society as a whole. Discussion: We would argue that physicians abuse healthcare AI (...)
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  4.  3
    Grounds for Surrogate Decision-Making in Japanese Clinical Practice: A Qualitative Survey.Atsushi Asai, Taketoshi Okita, Aya Enzo, Kayoko Ohnishi & Masashi Tanaka - 2021 - BMC Medical Ethics 22 (1):1-12.
    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 (...)
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  5.  19
    Matters to Address Prior to Introducing New Life Support Technology in Japan: Three Serious Ethical Concerns Related to the Use of Left Ventricular Assist Devices as Destination Therapy and Suggested Policies to Deal with Them.Atsushi Asai, Sakiko Masaki, Taketoshi Okita, Aya Enzo & Yasuhiro Kadooka - 2018 - BMC Medical Ethics 19 (1):1-8.
    Background Destination therapy is the permanent implantation of a left ventricular assist device in patients with end-stage, severe heart failure who are ineligible for heart transplantation. DT improves both the quality of life and prognosis of patients with end-stage heart failure. However, there are also downsides to DT such as life-threatening complications and the potential for the patient to live beyond their desired length of life following such major complications. Because of deeply ingrained cultural and religious beliefs regarding death and (...)
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  6.  27
    Reexamination of the Concept of ‘Health Promotion’ Through a Critique of the Japanese Health Promotion Policy.Taketoshi Okita, Aya Enzo & Atsushi Asai - 2017 - Public Health Ethics 10 (3):267-275.
    This article presents a critique of the health promotion policy of Japan, which is based on an examination of the social importance of and justification for health promotion. This is done to suggest the proper direction that the future Japanese policy could take, and to question the adequacy of the term of ‘health promotion’. We find the ‘social progress’ characterization of the ‘Second Term of National Health Promotion Movement in the Twenty-First Century - Health Japan 21 ’ to be problematic. (...)
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  7.  22
    What Deserves Our Respect? Reexamination of Respect for Autonomy in the Context of the Management of Chronic Conditions.Aya Enzo, Taketoshi Okita & Atsushi Asai - 2019 - Medicine, Health Care and Philosophy 22 (1):85-94.
    The global increase in patients with chronic conditions has led to increased interest in ethical issues regarding such conditions. A basic biomedical principle—respect for autonomy—is being reexamined more critically in its clinical implications. New accounts of this basic principle are being proposed. While new accounts of respect for autonomy do underpin the design of many public programs and policies worldwide, addressing both chronic disease management and health promotion, the risk of applying such new accounts to clinical setting remain understudied. However, (...)
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  8.  9
    Changing Our Perspective: Is There a Government Obligation to Promote Autonomy Through the Provision of Public Prenatal Screening?Aya Enzo, Taketoshi Okita & Atsushi Asai - 2021 - Bioethics 35 (1):40-46.
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  9.  14
    Conflicting Messages Concerning Current Strategies Against Research Misconduct in Japan: A Call for Ethical Spontaneity.Atsushi Asai, Taketoshi Okita & Aya Enzo - 2016 - Journal of Medical Ethics 42 (8):524-527.
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  10.  5
    Japanese Bioethical Challenges Concerning Self-Management Support For Patients With Chronic Conditions: An Analysis of Quality of Life & Autonomy.Aya Enzo, Taketoshi Okita & Atsushi Asai - 2016 - Eubios Journal of Asian and International Bioethics 26 (5):175-179.
    Prevention and control of chronic conditions are global healthcare challenges. Patient self-management has been deemed essential for treating chronic conditions and improving the quality of patient life. However, the current Japanese system for supporting patient self-management of chronic conditions has received little ethical assessment. The first aim of this article is to provide an ethical analysis of current Japanese support for self-management of chronic conditions with reference to international discussions concerning self-management, developed mainly in western societies such as Europe, the (...)
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  11.  3
    Letter to the Editor: The Challenges of Medical Ethics Educators at a Research University.Atsushi Asai, Taketoshi Okita & Aya Enzo - 2017 - Eubios Journal of Asian and International Bioethics 27 (1):22-22.
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  12.  2
    Cross-Sectional Survey of Surrogate Decision-Making in Japanese Medical Practice.Asai Atsushi, Takethoshi Okita, Aya Enzo, Seiji Bito & Masashi Tanaka - 2021 - BMC Medical Ethics 22 (1):1-11.
    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 (...)
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