1. Hōriron -- 2. Hōshisō -- 3. Jitteihō no kiso riron.

BackgroundFew comparative studies of clinical ethics consultation practices have been reported. The objective of this study was to explore how American and Japanese experts analyze an Alzheimer's case regarding ethics consultation.MethodsWe presented the case to physicians and ethicists from the US and Japan (one expert from each field from both countries; total = 4) and obtained their responses through a questionnaire and in-depth interviews.ResultsEstablishing a consensus was a common goal among American and Japanese participants. In attempting to achieve consensus, the (...) most significant similarity between Japanese and American ethics consultants was that they both appeared to adopt an "ethics facilitation" approach. Differences were found in recommendation and assessment between the American and Japanese participants. In selecting a surrogate, the American participants chose to contact the grandson before designating the daughter-in-law as the surrogate decision-maker. Conversely the Japanese experts assumed that the daughter-in-law was the surrogate.ConclusionOur findings suggest that consensus building through an "ethics facilitation" approach may be a commonality to the practice of ethics consultation in the US and Japan, while differences emerged in terms of recommendations, surrogate assessment, and assessing treatments. Further research is needed to appreciate differences not only among different nations including, but not limited to, countries in Europe, Asia and the Americas, but also within each country. (shrink)

Collection of texts published previously.

Our aim in this article is to define the difficulties that clinical ethics services encounter when they are asked to demonstrate the value a clinical ethics service (CES) could and should have for an institution and those it serves. The topic emerged out of numerous related presentations at the Un- Conference hosted by the Cleveland Clinic in August 2018 that identified challenges of articulating the value of clinical ethics work for hospital administrators. After a review these talks, it was apparent (...) that the field of clinical ethics may be at a crisis of sorts due to increased pressure to provide explicit measures to healthcare institutions to concretely demonstrate that CESs make a valuable difference in healthcare delivery. In this article, we grapple with how to satisfy the need for demonstrable value in a field in which metrics alone may not capture the scope of clinical ethics practice. We suggest that capturing the value of a CES has been difficult because the benefits of ethics consultation may be overt or attributable to the CES, but are often hidden due to the systems-level and process-oriented nature of clinical ethics work. Part of the difficulty in demonstrating the value of CESs is capturing and conveying all of the ways the integration of a CES throughout an institution positively affects patients, families, visitors, healthcare professionals, administrators, and the institution itself. Our aim is to (1) elucidate the multifaceted value added by a CES, including value that tends to be hidden and (2) suggest how to demonstrate value to others in a way that is not simplistic or reductionistic. (shrink)

Is a genuinely consilient concept of human culture possible? I identify some of the major stumbling blocks that prevent mutual illumination between the humanities and evolutionary sciences. Whereas the sciences are often concerned with predictive averages, the arts draw attention to "outliers" that defy general trends. The solution is not to disregard these outliers, but rather to understand the open-ended processes that, by design, produce startling variations. Such open-endedness is an essential part of the evolutionary story, not an insignificant byproduct. (...) Conversely, humanistic scholars have much to gain by engaging, rather than spurning, the evolutionary framework. (shrink)

Healthcare professionals must make decisions for patients based on ethical considerations. However, they rely on clinical ethics consultations (CEC) to review ethical justifications of their decisions. CEC consultants support the cases reviewed and guide medical care. When both healthcare professionals and CEC consultants face ethical problems in medical care, how is their judgment derived? How do medical judgments differ from the ethical considerations of CECs? This study examines CECs in Japan to identify differences in the ethical judgment of clients and (...) CEC consultants. (shrink)

I have first translated Sein und Zeit in Japanese in 1971 in collaboration with my elder colleague Prof. Hara in Tokyo. But in 1976 both he and Martin Heidegger died, and in 1977 a new edition of Sein und Zeit was published as part of Heidegger’s complete works. This new edition included many marginal notes of Heidegger’s and many textual revisions made by Heidegger himself. Therefore, I have published in 2003, based on the old version of my Japanese translation, a (...) totally revised Japanese translation of Sein und Zeit, in which, as translator, I have written a new introduction, many explicatory notes about Heidegger’s marginal notes and textual modifications and a chronological detailed record of Heidegger’s career. Out of this experience, I would like to detail upon two aspects: first, any nowadays reader of this work must study not only the original text itself, but also, by all means, Heidegger’s marginal notes, in order to correctly grasp a development of his thought on Being. Secondary, a reader must especially pay attention to the difficult problem of the relationship between authenticity and inauthenticity of the Being-in-the-world, because here is the most basic problem of the existence of Dasein and it is here the place where the turning point in Heidegger’s later thought on Being has its origin. (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.

Kōzō to kaishaku -- Ei-Bei tetsugaku nyūmon -- Bākure ni okeru shisō taiken -- Ryōkai ni teuite -- Gendai ni okeru sonzai no mondai.