The dilemma of whether and how to disclose a diagnosis of cancer or of any other terminal illness continues to be a subject of worldwide interest. We present the case of a 62-year-old Japanese woman afflicted with advanced gall bladder cancer who had previously expressed a preference not to be told a diagnosis of cancer. The treating physician revealed the diagnosis to the family first, and then told the patient: "You don't have any cancer yet, but if we don't (...) treat you, it will progress to a cancer". In our analysis, we examine the role of family consent, communication patterns (including ambiguous disclosure), and advance directives for cancer disclosure in Japan. Finally, we explore the implications for Edmund Pellegrino's proposal of "something close to autonomy" as a universal good. (shrink)

OBJECTIVES: Life-sustaining treatment at the end of life gives rise to many ethical problems in Japan. Recent surveys of Japanese physicians suggested that they tend to treat terminally ill patients aggressively. We studied why Japanese physicians were reluctant to withhold or withdraw life-support from terminally ill patients and what affected their decisions. DESIGN AND PARTICIPANTS: A qualitative study design was employed, using a focus group interview with seven physicians, to gain an in-depth understanding of attitudes and rationales in (...) Japan regarding medical care at the end of life. RESULTS: Analysis revealed that physicians and patients' family members usually make decisions about life-sustaining treatment, while the patients' wishes are unavailable or not taken into account. Both physicians and family members tend to consider withholding or withdrawing life-sustaining treatment as abandonment or even killing. The strongest reason to start cardiopulmonary resuscitation- and to continue it until patients' family members arrive-seems to be the family members' desire to be at the bedside at the time of death. All physicians participating in our study regarded advance directives that provide information as to patients' wishes about life-sustaining treatment desirable. All expressed concern, however, that it would be difficult to forego or discontinue life-support based on a patient's advance directive, particularly when the patient's family opposed the directive. CONCLUSION: Our group interview suggested several possible barriers to death with dignity and the appropriate use of advance directives in Japan. Further qualitative and quantitative research in this regard is needed. (shrink)

ABSTRACT Objectives: the purpose of this study is to explore laypersons’ attitudes towards and experiences of medical research, and to compare them with those of physicians in Japan. Designs and Participants: fourteen Japanese adults from the general public and seven physicians participated in one of three focus interviews. Setting: Osaka, Japan. Results: trust and distrust in the physician by whom the participants were invited to participate in research played a considerable role in their decisions about participation. That the participants (...) felt an obligation to participate was also expressed. The lay participants perceived medical research as something entirely outside of their world. A greater willingness to volunteer for research was expressed if there were direct benefits to themselves or their families. Research methods such as use of placebos, double blinds, and randomisations seemed to cause negative attitudes to medical research. All physicians were convinced of the need for medical research, including double‐blinded randomised control trials, and its significant role in medical progress. Most physicians thought that the greater awareness of the need for medical research in the community and a better understanding of the psychology of potential research participants were necessary and urgent. Conclusions: there is a good possibility that the lay public and medical professionals have sharply different beliefs about and attitudes towards every aspect of medical research. Building up a better and equal patient‐doctor relationship based on trust is a key issue in medical research, and it is mandatory to fill the gap in perception regarding medical research between them through fully informed debates. (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)

(1996). Access without impact: The mass media in postwar Japanese political culture. The European Legacy: Vol. 1, Fourth International Conference of the International Society for the study of European Ideas, pp. 786-790.

Employing Porter and Kramer’s corporate social responsibility framework, we explored the strategic CSR programs of two Korean and two Japanese electronics multinational enterprises in Indonesia. We observed that the sample MNEs engage in strategic CSR either through investment in competitive context or the transformation of value chain activities. In addition, these firms strongly favor strategic CSR over responsive CSR, not just because of the economic benefits offered by the former, but also its advantages in managing the programs and communicating (...) with stakeholders. Furthermore, they have developed varied organizational methods and tend to manage their key CSR programs centrally to effectively link them to the competitive strategy. Lastly, the results of our analysis suggest that Korean MNEs have customized their strategic CSR programs for emerging countries more actively than Japanese MNEs. In sum, our analysis elucidates several important features of strategic CSR employed by the MNEs in emerging countries. (shrink)

In any focus on an aesthetic experience one may find both sensational and cognitive qualities, referred to as the scene and scenario respectively. Hence, an experiencer tries to decipher the scenario —a narration—by sensing the scene —space—through the spatial atmosphere. Thus, space starts to transform into a poetic experience. Japanese architecture, on account of a number of inherent qualities, has the capability to convey such narrations in spaces. In Japanese examples, an experiencer tries to derive the narration that (...) emanates from explicit qualities—sensational, such as textual, visual, audial, or tactile phenomena—with his/her implicit qualities—cognitive/intellectual abilities. The article examines the layer of narration of Japanese architectural structure through haiku 俳句 and haiga 俳画 examples, in doing so, utilizes the layers proposed on behalf of the explicit and implicit qualities: nature-based and feeling-based. (shrink)

This work analyses the complex and contentious issues of mutual affection and codependency in relationships between Korean ‘comfort women’ and Japanese soldiers during World War II. Drawing on a combination of interviews and published resources, it explores the groups’ perceptions of one another within the framework of ‘traumatic bonding’. Despite traumatic violence and stark inequalities, this article finds nuanced contributions from the parties involved. For the soldiers, the relationships provided a form of emotional relief from the violence of war (...) and from the oppression they themselves were subjected to by those of superior rank within the military hierarchy, while the women often sought kindness and protection from the military men with whom they had formed relationships. However, underneath the yearning for human connection, these relationships were highly complex and deeply affected by the overarching power dynamics of gender and the racialised colonial hierarchy. (shrink)

The present study examines the interactional phenomenon of enactment, wherein conversation participants act out themselves or others by utilizing both linguistic and non-linguistic resources and demonstrate certain ideas rather than describe them. While past research has revealed that people, based on their first- or second-hand experiences, frequently use enactment during storytelling activities to depict what story characters said and/or did, this article explores cases in which participants in Japanese conversations enact based on what co-participants have experienced. In such cases, (...) producers of enactment are recipients of the enacted information provided by co-participants. This study refers to interactants who originally provide certain information as “tellers,” and it refers to interactants who enact the received information as “recipients”. Employing Conversation Analysis as an analytical framework, the present study investigates how recipients’ enactments are utilized as a resource to demonstrate their understanding of information given at the moment of their interaction in Japanese. (shrink)

In the preface to his new monograph, Tragic Beauty in Whitehead and Japanese Aesthetics, Steve Odin proposes to do two things: better understand Alfred N. Whitehead's "poetic vision of tragic beauty" through comparison with Japanese aesthetics, and thereby also suggest a "new religio-aesthetic vision of tragic beauty and its resolution in the supreme ecstasy of peace". He does more than that, though. Besides thoroughly discussing Whitehead's aesthetics throughout the latter's works, from An Enquiry Concerning the Principles of Natural (...) Knowledge to Modes of Thought, he enriches this aesthetics by discussing similar themes in American philosophy and literature, including Charles Peirce, John... (shrink)

This study introduces an enigmatic construction in Japanese called chūshakuteki nibun-renchi ‘annotative dual-clause juxtaposition’ (ADCJ), exemplified below: Hiro wa, dare ni au no ka, resutoran o yoyakushita. top who dat meet nmlz int restaurant acc reserved Lit. ‘Hiro, (I wonder) who (he) will meet, reserved a restaurant.’ This construction is ubiquitous and yet little known even in Japanese linguistics circles. Because the matrix predicate of ADCJ cannot semantically accommodate such a component as dare ni au no ka ‘who (...) (he) will meet’ above, this paper argues that ADCJ is parenthetical, a construct that should be recognized as an essential element of verbal communication and, in turn, a determining factor in how utterances are to be formed and interpreted. This construction is dissimilar to any other type of parentheticals hitherto reported in the literature. What is so special about it is its merger of portraying two situations through abduction and expressing the entire circumstance in a single communicative unit. For example, in the above example, the parenthetical element explains why the speaker wishes to convey the matrix statement. From an interactional perspective, the primary function of ADCJ is to highlight the speaker’s intellectual and communicative involvement in the depicted scene. This style of communication, when compared with an ‘objective’ and apathetic description, is likely to induce more earnest reactions from the hearer or reader and, consequently, promote a more favorable continuation of the conversation or reading. This paper advocates a wide-ranging examination of thetical grammar (Kaltenböck et al. 2011), for which detailed analyses of constructions such as ADCJ that traditional syntactic/semantic theories cannot capture are indispensable. (shrink)

This paper examines the use and meaning of the body-part terms or quasi-body part terms associated with Japanese emotions. The terms analyzed are kokoro, mune, hara, ki, and mushi. In Japanese kokoro is regarded as the seat of emotions. Mune (roughly, ‘chest’) is the place where Japanese believe kokoro is located. Hara (roughly, ‘belly’) can be used to refer to the seat of ‘thinking’, for example in expression of anger-like feelings which entail a prior cognitive appraisal. The (...) term ki (roughly, ‘breath’) is also used for expressions dealing with emotions, temperament, and behaviour; among these, ki is mostly frequently used for referring to mental activity. Mushi — literally, a ‘worm’ which exists in the hara ‘belly’ — is also used for referring to specific emotion expressions. The tool for semantic analysis employed in this paper is the “Natural Semantic Metalanguage” method developed by Anna Wierzbicka and colleagues. This metalanguage enables us to explicate concepts by means of simple words and grammar (easily translated across languages), and clarifies the similarities and dissimilarities between the components involved in semantically similar terms. The data used for analysis are from various sources; published literature both in Japanese and English, newspaper/magazine articles, film scripts, comic books, advertisements, dictionaries, and popular songs. (shrink)

This article evaluates Japanese foreign aid policy in light of the World Commission on Environment and Development's concept of sustainable development by focusing on Japanese official development assistance (ODA) to energy sectors in the global South. The analysis reported here finds two fundamental weaknesses in Japanese ODA policy on the energy sector: first, its premise of the compatibility of economic growth with environmental sustainability and, second, its heavy reliance on modern science. As an alternative, this article suggests (...) a policy of promoting small and decentralized renewable energy technology. (shrink)

This study investigates Japanese compliments produced at a distinct sequential position and how the complimentees treat the compliments. In ordinary conversation, speakers sometimes talk about their accomplishments. Drawing on Conversation Analysis and multimodal interaction analysis, the study demonstrates how telling recipients deploy compliments at the possible completion of such tellings of accomplishment. The analysis also shows how the tellers deal with the complimentary telling responses, taking into consideration the design of tellings and the possibility of engaging in self-praise. The (...) study illuminates a context-sensitive nature of complimenting activity and managing two conflicting preferences by illustrating a specific interactional pattern of compliment sequences in Japanese ordinary conversation. (shrink)

Similar to its old history, Japan has a rich traditional and ethical Architecture. Based on these tenets and ethics, different concepts and spaces are formed through the time, as now Japan's ethical and traditional design ideas has its standard principles. Linking the present and the past has always been a momentous criterion in the countries with an old rich Architecture. This fact is indeed important in Japan due to the blend of ethics and religions with peoples` life. Through this idea, (...) three Japanese Architects, Kenzo Tange, Fumihiko Maki and Tadao Ando-who are the only Japanese pritzker prize winners-have well, noticed the need for linking the country's traditional and ethical Architecture criteria with the contemporary Architecture. So, analyzing such projects of these architects prepares a good basis to find out the quality of how traditional and ethical design ideas crystallize in the works of contemporary Japanese architects. The research method for this article is a comparative analysis between the architects` particular projects and Japan's ethical and traditional design ideas, formed through the history of architecture in this country. The contents of this article rely heavily on three bases: 1) study of the historical documents concerning the ethical and traditional design concepts in Japan. 2) The consultancy of leading experts on Asian traditional constructions and ethical architecture specialists from Azad Universities in Tehran. 3) Comparative analysis between the ethical concepts applied in different contemporary works. The results show that the contemporary architects have had good bases for presenting the traditional design concepts as standard principles are all formed in the architecture of Japan today. Meanwhile, it seems that Maki and Ando are more likely to have a conceptual look at Japan's traditions while Tange has a more formal viewpoint. Chronological analysis of the architects` projects shows that despite, all the three architects were impressed by the works of le Corbusier, they were successful to keep contacts with Japan's traditional design concepts. (shrink)

: Eastern Learning, which is an important part of modern new learning, refers to the Western natural science and socio-political thought that was assimilated by Japan from the end of 19th century to the beginning of 20th century. From the end of Ming Dynasty to the period before and after the revolution of 1911, China’s intake of new learning went through four stages. In the first three stages, a large number of Western books translated into Chinese were also introduced into (...) Japan, which became the basic literature and language medium of Japanese Dutch studies, English Studies and later the whole foreign studies. At the beginning of the 20th century, exiles, students studying in Japan and Japanese teachers introduced Eastern Learning into China, which had a profound impact on China’s modernization process. Eastern Learning is a new learning system with East Asian characteristics constructed by China and Japan in the process of Western Learning spreading to the East. (shrink)

This paper examines the movement for independent living among the Japanese with disabilities from the perspective of multiculturalism and human rights. The IL movement questions the conventional idea, widely held by Japanese without disabilities, that disabled people are in need of special care and cannot live independently in ordinary communities. The IL movement advocates: 1) the reinterpretation of “disability” as mere “difference”, 2) the equal right to autonomy and social participation for the disabled, and 3) the unique right (...) to care and support that enable the disabled to be autonomous. The IL movement thus projects a new “disability culture” that assigns different meanings to disability and calls for radical change in social relationships. The IL movement then is one of many forces that celebrates diversity and advocates pluralism in Japanese society in defiance of the myth of a “homogeneous monocultural” Japan. The IL movement highlights the right to care as a basic human right which is a precondition for the right to autonomy. Consequently, the IL movement reinterprets the notion of autonomy and enriches the concept of “human rights.”. (shrink)

Return to the ordinary as extraordinary has become the signature motif for the Emersonian perfectionism of Stanley Cavell in contemporary American philosophy. In this article I develop Cavell's notion of “the ordinary” as an intercultural theme for exploring aspects of traditional Chinese philosophy, especially Confucianism and Chan Buddhism. I further use Cavell's philosophy of the ordinary to examine Sino-Japanese thought as found in the Zen tradition of Japan and its reformulation by Nishida Kitarô in modern Japanese philosophy. It (...) will be seen how for both Cavell and Sino-Japanese philosophy, perfection is achieved not by transcendence of the ordinary, but through continuous return to and affirmation of the ordinary as extraordinary. I thus endeavor to illuminate the quotidian as articulated by Cavell, Chinese philosophy, and the Sino-Japanese tradition. (shrink)

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

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)

What is culture? What can we learn from art, architecture, and fashion about how people relate? Can cultures embody ethical and moral ideals? These are just some of the questions addressed in this book on the cultural philosophy of three preeminent Japanese philosophers of the early twentieth century, Nishida Kitarō, Watsuji Tetsurō and Kuki Shūzō.

An overview of Japanese philosophy from the seventh century to the present.

No Moonlight in My Cup: Sinitic Poetry from the Japanese Court, Eighth to the Twelfth Centuries. Edited and translated by Judith N. Rabinovitch and Timothy R. BradstocK. East Asian Comparative Literature and Culture, vol. 10. Leiden: Brill, 2019. Pp. xxvi + 474. $232.

This paper examines how Japanese multinational companies manage corporate social responsibility (CSR). It considers how the concept has come to be framed within Japanese business, which is increasingly globalized and internationally focused, yet continues to exhibit strong cultural specificities. The discussion is based on interviews with managers who deal with CSR issues and strategy on a day-to-day basis from 13 multinational companies. In looking at how CSR practice has been adopted and adapted by Japanese corporations, we can (...) begin to see what implications arise from the fact that CSR is a Western-led concept, so opening up critical questions about the future development and evolution of CSR practice within a global context. In being exposed to the concept of CSR as practiced vigilantly in western countries, Japanese multinational company managers have certainly come to re-evaluate aspects of business likely to need rectifying (with potential concerns being gender inequalities, discrepancies in employee conditions, and issues over human rights and supply chains). Japan can be thought to be lagging behind in its understanding and adoption of CSR, in part because corporations do not necessarily state their policies as formally as might be expected. Yet, by analyzing more deeply the kinds of responses gained from CSR managers in Japan (and by placing their remarks within a broader context of Japanese culture and business practices) a far more subtle and revealing picture becomes apparent, not least a more complex picture of the local/global interaction of the frames of reference of corporate responsibility. (shrink)

I will argue that Japanese liberalism is distinct from its Western counterparts by adopting Maruyama Masao’s description of how the development of Japanese liberalism has been continuously influenced by the ethical and political thought of the Yamazaki Ansai school. I will use Maruyama’s description of the relationship between the two to demonstrate that the distinctiveness of Japanese liberalism from its Western counterparts in the current period provides us with one of the manifestations of the inconsistencies of communitarianism. (...) I will show that it is an inconsistent position since it is still bound by the association of consciousness and rationality. To be more explicit, my argument against communitarianism will emphasize that Japan’s adoption of liberalism as the basis for the legitimacy of rule in its nation-state is best understood in the context of liberalism’s emphasis on the association of consciousness, rationality, and their respective roles in the creation of social reality. (shrink)