Jecker and Au’s paper raises important issues concerning health equity in pandemic responses, and the importance of considering the long-term effects of pandemic strategy on population health and well-being.1 We welcome their focus on the experience of Asian countries, including Japan. However, we have some concerns with both the distinction which they draw between elimination and mitigation, and their account of the nature and origins of the Japanese response to the COVID-19 pandemic. First, we believe that the distinction between elimination (...) and mitigation is not fine grained enough to capture the various strategies which countries have taken towards the pandemic. Many of Jecker and Au’s criticisms of the elimination strategy relate to specific policies such as lockdowns, travel restrictions and restrictions on businesses, which have been employed by numerous countries irrespective of their end goal. By contrast to the simple elimination/mitigation dichotomy with which Jecker and Au work, Baker et al have identified five separate COVID-19 strategies, namely: exclusion, elimination, suppression, mitigation and no substantive strategy.2 Baker et al define an elimination strategy as ‘maximum action to exclude disease and eliminate community transmission’ with the goal of reaching ‘zero [disease] transmission in the community’. On this account, Japan’s strategy does …. (shrink)

The purpose of this study was to evaluate the effectiveness of an educational intervention regarding end-of-life discussion directed at older Japanese adults and their attitude to and acceptance of this intervention. A quasi-experimental design was used. A total of 121 older adults, aged 65 years and over, consented to participate. Data from 55 intervention and 57 control participants were used for the analysis. The intervention consisted of an education program comprising a video, a lecture using a handout, and discussion among (...) participants. The control group received only the handout. Both groups were followed up after one month. The intervention group’s attitude became more favorable towards advance directives, especially living wills (P = 0.024). In addition, their expression of preference for life-sustaining treatment by means of artificial nutrition was less at follow up, demonstrating that these older adults had become more autonomous (P = 0.008). There was greater acceptance of the intervention as a whole by the intervention group compared with the control group (P = 0.011). Although few participants overall completed living wills, at follow up twice as many in the intervention group had discussed end-of-life matters with family members and/or their physician. (shrink)

明治の世には、西欧的近代化の流れの中にあっても「日本人としての矜持と風格」といったものがあった。それはいわば凜乎とした倫理意識と、土着的な共同体意識である。それらは漢籍の教養に裏打ちされた至高なる精神 性であったと言ってよい。明治は、思想・文化の面において、日本の精神史上、「豊饒の時代」であった。.

In Japan, terminating life-sustaining treatment in non-terminal patients is legally and ethically problematic given the lack of legal regulations regarding the termination of LST, including dialysis treatment. This article describes an ethically problematic case that happened at a hospital in Tokyo in March 2019, in which a patient died after a physician withdrew kidney dialysis upon the patient’s request. Most national newspapers in Japan reported the case extensively and raised the question of ethical and legal permissibility of withdrawing dialysis treatment (...) from non-terminal patients. In this article, we first examine the case within the current policy framework in Japan and then discuss how Japan can improve its end-of-life practice, focusing specifically on the patient’s right to self-determination and treatment refusal. We recommend that policymakers consider legalizing the termination of LST and the patient’s right to refuse treatment based on the principle of respect for autonomy. (shrink)

BackgroundRegulations on forgoing life-sustaining treatment (LST) have developed in Asian countries including Japan, Korea and Taiwan. However, other countries are relatively unaware of these due to the language barrier. This article aims to describe and compare the relevant regulatory frameworks, using the (more familiar) situation in England as a point of reference. We undertook literature reviews to ascertain the legal and regulatory positions on forgoing LST in Japan, Korea, Taiwan, and England.Main textFindings from a literature review are first presented to (...) describe the development of the regulatory frameworks surrounding the option of forgoing LST in each country. Based on the findings from the four countries, we suggest five ethically important points, reflection on which should help to inform the further development of regulatory frameworks concerning end-of-life care in these countries and beyond. There should be reflection on: (1) the definition of – and reasons for defining – the ‘terminal stage’ and associated criteria for making such judgements; Korea and Taiwan limit forgoing LST to patients in this stage, but there are risks associated with defining this too narrowly or broadly; (2) foregoing LST for patients who arenotin this stage, as is allowed in Japan and England, because here too there are areas of controversy, including (in England) whether the law in this area does enough to respect the autonomy of (now) incapacitated patients; (3) whether ‘foregoing’ LST should encompass withholdingandwithdrawing treatment; this is also an ethically disputed area, particularly in the Asian countries we examine; (4) the family’s role in end-of-life decision-making, particularly as, compared with England, the three Asian countries traditionally place a greater emphasis on families and communities than on individuals; and (5) decision-making with and for those incapacitated patients who lack families, surrogate decision-makers or ADs.ConclusionComparison of, and reflection on, the different legal positions that obtain in Japan, Korea, Taiwan, and England should prove informative and we particularly invite reflection on five areas, in the hope the ensuing discussions will help to establish better end-of-life regulatory frameworks in these countries and elsewhere. (shrink)

関東大震災の三年後に始まった戦前昭和とは、審災復興=国家再建の歴史だった。社会主義、議会主義、農本主義、国家社会主義という四つの国家構想が、勃興しては次の構想に移っていく展開の過程として、戦前昭和を再 構成する。.

Originally published as 「明治の哲学界：有機体の哲学とその系譜」in 井上克人編『豊饒なる明治』, Kansai Daigaku Shuppannbu, 2012, 3–22. Translated by Morisato Takeshi. German Idealism was introduced to Japanese intellectuals in the middle of Meiji era and was mainly received from a mystical or religious perspective, as we see in Inoue Tetsujirō’s “harmonious existence,” Inoue Enryō’s “unity of mind and body,” and Kiyozawa Manshi’s “existentialism.” Since these theories envisioned true reality as a unified and living whole, I group them under the label “philosophy of organism” and from (...) there argue that their conviction that “all is truth and truth is all” was shaped in large part by the Awakening of Faith in the Mahayana. The understanding of Buddhist concepts by Meiji philosophers was philosophical in its content, and those who devoted themselves to the study of Western philosophy were encouraged to describe Eastern thought in Western philosophical terms. As a result, the philosophical world of the Meiji era developed an original standpoint that unified Eastern and Western perspectives by means of a logic of “phenomena-in-reality.”. (shrink)

Minerals originated from eastern Democratic Republic of Congo (DRC) are blamed for financing violent conflict in the area over the past decade and have been called conflict minerals. They vividly demonstrate a key human rights issue facing responsible supply chain management. The conflict minerals issue has led to a significant shift in responsible supply chain management in two ways: extending producer responsibility to respect human rights in the total supply chain through establishing traceability and transparency; and developing legally binding supply (...) chain responsibility.This article examines an emerging effort to source conflict‐free minerals using closed‐pipe supply chain in the DRC as a new strategy to respond to the above paradigm shift. By exploring whether this new strategy can contribute to conflict prevention in the DRC, this article argues that the closed‐pipe supply chain allows building long‐term relationship with various stakeholders and has the potential to transform socio‐economic structures in the producing communities, thereby leading to peacebuilding in the long run. (shrink)

The purpose of this paper is to show the plausibility of John Rawls’s treatment of efficiency within the system of justice. While in political philosophy efficiency is often treated as an independent condition for establishing justice, or more precisely, as a necessary condition for establishing justice, Rawls considers efficiency as a non-negligible factor that has normativity in general circumstances. This is similar to the view that efficiency is a presumptive condition for evaluating social arrangements. However, Rawls’s view is salient in (...) a more substantive way. This paper demonstrates the salience of Rawls’s view of efficiency by responding to G. A. Cohen’s Impure Justice Objection to Rawls’s theory of justice. This shows that there is no impure connection between Rawls’s justice and efficiency. Moreover, the combined thesis of Rawls’s justice and efficiency is superior to Cohen’s pluralist theory of justice, making it a fruitful approach. (shrink)

In contemporary political philosophy, reflections on poverty demand careful treatment in the light of key ethical concepts—especially autonomy. While the negative effects of poverty on autonomy are acknowledged, the welfare dependency of the poor is seen as an autonomy-undermining factor, which I call the “autonomy–poverty dilemma.” This chapter discusses contemporary political theories about autonomy and poverty in terms of how they relate to this dilemma. The features and problems of three pertinent theories are addressed in such a way as to (...) resolve the autonomy–poverty dilemma. The first is luck egalitarianism, which weighs individual responsibility in defining just distributions, but may leave some of the incapacitated unattended in order not to annul their personal responsibility and may stigmatize those who are dependent (such as people with mental disabilities) who are not personally responsible. Such stigmatization is also a problem with relational egalitarianism, which bases egalitarian justice on the equal standing of individuals, in that the ideal of socially embedded autonomous agents could be degrading to the dependent. While the capability approach overcomes that problem by providing a powerful buttress for the dependent and allowing them to emerge from poverty, it runs the risk of a paternalistic, perfectionist idealism. In closing, this chapter proposes an alternative view, which I call the “radical pluralist view of egalitarian justice,” based on a consideration of the features and problems of these three key theories. (shrink)

A dialectical contradiction can be appropriately described within the framework of classical formal logic. It is in harmony with the law of noncontradiction. According to our definition, two theories make up a dialectical contradiction if each of them is consistent and their union is inconsistent. It can happen that each of these two theories has an intended model. Plenty of examples are to be found in the history of science.

BackgroundFinancial interactions between pharmaceutical companies and physicians lead to conflicts of interest. This study examines the extent and trends of non-research payments made by pharmaceutical companies to board-certified allergists in Japan between 2016 and 2020.MethodsA retrospective analysis of disclosed payment data from pharmaceutical companies affiliated with the Japanese Pharmaceutical Manufacturers Association was conducted. The study focused on non-research payments for lecturing, consulting, and manuscript drafting made to board-certified allergists from 2016 to 2020. We performed descriptive analyses on payment data. Trends (...) were analyzed using generalized estimating equation models.ResultsOf the 3,943 board-certified allergists, 2,398 (60.8%) received non-research payments totaling $43.4 million over five years. Lecturing fees comprised 85.7% ($37.2 million) of the total payment amounts. For allergists who received at least one payment, the median amount per allergist was $3,106 (interquartile range: $966 – $12,124), in contrast to a mean of $18,092 (standard deviation: $49,233) over the five-year span. The top 1% and 10% of these allergists accounted for 20.8% and 68.8% of all non-research payments, respectively. The annual payment amounts significantly increased by 7.2% annual increase (95% CI: 4.4 – 10.0%, p < 0.001) each year until 2019, but saw a significant decrease in 2020 amid the COVID-19 pandemic.ConclusionThe majority of allergists received non-research payments, with a notable concentration among a small group. Payments increased annually until the pandemic’s onset, which coincided with a substantial decrease. Further research is needed to explore the implications of these financial interactions on clinical practice and patient care in Japan. (shrink)

朝鮮史上最も偉大な思想家とされる李退渓(イテゲェ)(1501-70)の知られざる素顔と数々の「謎」を解明する画期的研究。.

In Matter and Memory, Bergson identifies a problem with perception and resolves it by arguing that matter is an aggregate of images. However, it is unclear whether and how Bergson justifies this thesis, and interpreters differ considerably on this question. This paper formulates and analyzes Bergson’s arguments for this thesis in Chapter 1 of Matter and Memory. Bergson presents five arguments, some of which echo arguments in early modern philosophy. They jointly compose a substantive, well-structured defense of his thesis. This (...) paper also illuminates an aspect of Bergson’s method that departs from his famous reliance on intuition and is grounded in his conception of the clarity required in philosophy. (shrink)

It is often argued that relational egalitarianism has a fundamental problem with intergenerational justice when compared to other theories of justice such as utilitarianism, prioritarianism, and luck egalitarianism. Recently, Timothy Sommers argued that there is no such comparative disadvantage for relational egalitarianism. His argument is quite modest: it merely aims to reject the claim that there could be no way to extend relational egalitarianism to intergenerational justice. This may be called the ‘No Comparative Disadvantage Thesis’. The present article challenges Sommers’s (...) argument in two ways. First, I show that Sommers fails to provide a reasonable constraint on causal efficacy, which is crucial to his argument for our relation (not relationship) to future generations. Second, I show that the chain-relatedness problem casts a shadow over Sommers’s argument for the No Comparative Disadvantage Thesis. More specifically, compared to the other theories of justice, relational egalitarianism (as it stands) can less easily justify that present persons have duties to future others. This is because relational egalitarianism cannot appeal to a specific principle in regard to the duties in question, because its principle is sensitive to current context and practice. I conclude that the No Comparative Disadvantage Thesis does not hold much promise. (shrink)

動物にとどまらず、あらゆる存在の解放をめざす包括的正義の理論へと至った批判的動物研究を初めて本格的に紹介。.