In Japan, where a prominent gap exists in what is considered a patient’s best interest between the medical and patient sides, appropriate decision-making can be difficult to achieve. In Japanese clinical settings, decision-making is considered an act of choice-making from multiple potential options. With many ethical dilemmas still remaining, establishing an appropriate decision-making process is an urgent task in modern Japanese healthcare. This paper examines ethical issues related to shared decision-making (SDM) in clinical settings in modern Japan from the psychocultural-social (...) perspective and discusses the ideal decision-making process in present Japan. Specifically, we discuss how five psychocultural-social tendencies – “surmise (Sontaku),” “self-restraint (Jishuku),” “air (atmosphere or mood, Kuuki),” “peer pressure (or tuning pressure, Docho-Atsuryoku),” and “community (Seken)”—which have often been referred to as characteristics of present-day Japanese people, may affect the ideal practice of SDM in Japanese clinical settings. We conclude that health care professionals must be aware of the possible adverse effects of the above Japanese psychocultural-social tendencies on the implementation of SDM and attempt to promote autonomous decision-making, thereby allowing patients to make treatment choices that sufficiently reflect their individual and personal views of life, experiences, goals, preferences, and values. (shrink)

Madhvācārya’s Bhāgavatatātparyanirṇaya is the oldest Bhāgavata commentary available to us, most probably predating the Advaitic commentary of Śrīdhara. Thus Madhva’s commentary occupies a crucial place in the development of the Bhāgavata tradition. In this paper, I examine Madhva’s commentary on the first verse of the Bhāgavatapurāṇa, focusing on his exegesis. In so doing, I shall point out how Madhva emphasizes what are arguably the two most important doctrines of Dvaita Vedānta, namely, Viṣṇu’s absolute independence and the reality of the world. (...) With this teaching Madhva vehemently rejects absolute monism and the idea that the world is illusory, which, we might say, are the core doctrines of Advaita Vedānta. This paper is also a modest attempt to revise the general perception of Vedānta as ‘the exegetical tradition on the prasthānatraya’. I argue that we need to include commentaries on the purāṇas within our understanding of Vedāntic discourse since, starting with Madhva, the purāṇas such as the Bhāgavata became an important text for Vedānta authors to comment upon. This is evidenced by the proliferation of commentaries on the Bhāgavata in the early modern period. The Bhāgavatapurāṇa attracted commentaries produced not only by Vaiṣṇava authors such as Sanātana, Jīva, Vallabha and Vīrarāghava but also by Advaita authors like Madhusūdana Sarasvatī and Śaivas such as Rāghavānanda. In this connection, toward the end of this paper I will point out Madhva’s influence on the Gauḍīya school that flourished in the early modern period. (shrink)

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. (...) While there are clear restraints found in terms of social costs related to the policy, the aims toward social justice provided by the policy are not clear. Considering the social importance and justification of health promotion, and the present conditions seen in Japan, we believe that it is necessary clearly to position health promotion as a form of social justice. Having said this, the term ‘health promotion’ is in itself misleading and can belie the range of activities required to action these policies. Therefore, we propose considering the selection of a different and more appropriate term for health promotion that concretely defines policies that actively work toward definitive health equity. (shrink)

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 (...) safety and the possibility of infection. It is also important to understand the role of informed consent before reuse of disposables. The widespread practice of reuse may bring down high healthcare costs and also reduce the huge amount of hospital waste that is generated. The reuse of disposables can be justified on various grounds including the safety and the cost effectiveness of this practice. (shrink)

A murder case that had some features in common with the Tarasoff case occurred in Sasebo City, Japan, in 2014. A 15-year-old high school girl was murdered and her 16-year-old classmate was arrested on suspicion of homicide. One and a half months before the murder, a psychiatrist who had been examining the girl called a prefectural child consultation centre to warn that she might commit murder, but he did not reveal her name, considering it his professional duty to keep it (...) confidential. Article 134 of the Japanese Criminal Law states that doctors should not disclose patient information obtained in clinical practice without a legitimate reason, but the Japanese Supreme Court has not specified what constitutes a legitimate reason. Mass media and commentators suggested that the murder could have been prevented if the psychiatrist had disclosed the girl's name to the authorities or had isolated her coercively in a psychiatric ward. However, the authors disagree with such claims. This article discusses obligations imposed on concerned individuals and third party members in cases involving ethical dilemmas regarding patient confidentiality and information disclosure. It is concluded that everyone should fulfill their obligations to prevent such tragedies and one should judge the appropriateness of others’ actions based not on the consequences of their actions, but on the processes used to decide on a course of action and their commitment. It is necessary for us to establish a society in which concerned parties can do what they think is ethically best without fearing ungrounded charges. (shrink)

Progress in artificial intelligence technological innovation raises questions about the role of medical staff and the meaning of medical specialization. This study involved a qualitative survey of medical professionals and ordinary citizens to expand knowledge of this topic. A combination of Neo-Socratic Dialogue and Transfer Dialogue techniques, was used to acquire knowledge related to emerging forms of medical care and changing work demands after the implementation of AI, qualitatively analyzing the TD transcript only. Eleven subjects participated in two surveys. The (...) main points raised during TD were classified into five categories: i) Functions which AI could perform/would find difficult to perform, ii) Changes in medicine caused by AI, iii) Necessary preparations for the application of AI to medicine, iv) Concerns about AI, and v) Others. The survey findings suggest that initiatives to promote the acceptance of each individual in society and appropriate technological development are essential to the process of preparing for the changes in medicine following the implementation of AI. These preparatory conditions cannot be limited to medical professionals, and must extend to workers across all disciplines and to society as a whole. (shrink)

While the complexities of interpreting in constrained legal contexts such as trials may gradually be getting better understood by legal professionals, the particular difficulties of interpreting for the Deaf remain largely overlooked, and the recent involvement of citizen judges in Japan’s justice system makes it even more important to raise awareness about this aspect of language disadvantage. This paper focuses on a key feature of Japanese Sign Language: the non-manual markers produced by facial and body movements that accompany hand and (...) finger signs. Research shows such markers to be poorly understood by non-Deaf observers and indeed even sign language interpreters sometimes conflate them with gestures used by hearing people. (shrink)

Basic emotions such as happiness, sadness, and anger are universal, regardless of the human species, and are governed by specific brain regions. A recent report revealed that mentalizing, which is the ability to estimate other individuals’ emotional states via facial expressions, can be preserved with the help of awake surgery. However, it is still questionable whether we can maintain the ability to understand others’ emotions by preserving the positive mapping sites of intraoperative assessment. Here, we demonstrated the cortical regions related (...) to basic emotions via awake surgery for patients with frontal glioma and investigated the usefulness of functional mapping in preserving basic emotion. Of the 56 consecutive patients with right cerebral hemispheric glioma who underwent awake surgery at our hospital, intraoperative assessment of basic emotion could be successfully performed in 22 patients with frontal glioma and were included in our study. During surgery, positive responses were found in 18 points in 12 patients. Of these, 15 points from 11 patients were found at the cortical level, mainly the premotor and posterior part of the prefrontal cortices. Then, we focused on cortical 15 positive mappings with 40 stimulations and investigated the types of emotions that showed errors by every stimulation. There was no specific rule for the region-emotional type, which was beyond our expectations. In the postoperative acute phase, the test score of basic emotion declined in nine patients, and of these, it decreased under the cut-off value in three patients. Although the total score declined significantly just after surgery, it recovered within 3 months postoperatively. Our study revealed that through direct electrical stimulation, the premotor and posterior parts of the prefrontal cortices are related to various kinds of basic emotion, but not a single one. When the region with a positive mapping site is preserved during operation, basic emotion function might be maintained although it declines transiently after surgery. (shrink)

In many countries, prenatal testing for certain fetal abnormalities is offered via publicly funded screening programs. The concept of reproductive autonomy is regarded as providing a justificatory basis for many such programs. The purpose of this study is to re‐examine the normative basis of public prenatal screening for fetal abnormalities by changing our perspective from that of autonomy to obligation. After clarifying the understanding of autonomy adopted in the justification for public prenatal screening programs, we identify two problems concerning this (...) justification: first, the extent to which the government is obliged to meet this demand is not evident; and, second, it is not clear whether the provision of public screening is the most appropriate way to promote autonomy. Next, to tackle these problems, we focus on Onora O’Neill’s argument of rights and obligations. Drawing on this argument, we show that, in addressing the problems above, it is important to change our normative perspective from rights or autonomy to obligation. Our argument will show that since the government does not have an incontrovertibly fundamental obligation to promote autonomy, this obligation needs to be constrained in terms of compatibility with other fundamental obligations. In addition, even if a government is obliged to promote autonomy to some degree, there could be more appropriate means to achieve it than providing public prenatal screening; therefore, it is not necessary for government obligations to extend to the provision of public prenatal screening. (shrink)

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, (...) the application of new accounts of respect for autonomy to clinical settings could support disrespectful attitudes toward or undue interference with patients with chronic conditions. Reconsidering autonomy and respect using Kantian accounts, this paper proposes respect for persons as an alternative basic bioethical principle to respect for autonomy. Unlike the principle of respect for persons in the Belmont Report, our principle involves respecting any patient’s decisions, behaviors, emotions, or life-style regardless of his or her “autonomous” capabilities. Thus, attitudes toward patients should be no different irrespective of the assessment of their decisional or executive capabilities. (shrink)

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 (...) sanctity of life, Japanese society may not be ready to make changes needed to enable patients to have LVADs deactivated under certain circumstances to avoid needless suffering. Western ethical views that permit LVAD deactivation based mainly on respect for autonomy and dignity have not been accepted thus far in Japan and are unlikely to be accepted, given the current Japanese culture and traditional values. Some healthcare professionals might regard patients as ineligible for DT unless they have prepared advance directives. If this were to happen, the right to prepare an advance directive would instead become an obligation to do so. Furthermore, patient selection for DT poses another ethical issue. Given the predominant sanctity of life principle and lack of cost-consciousness regarding medical expenses, medically appropriate exclusion criteria would be ignored and DT could be applied to various patients, including very old patients, the demented, or even patients in persistent vegetative states, through on-site judgment. There is an urgent need for Japan to establish and enact a basic act for patient rights. The act should include: respect for a patient’s right to self-determination; the right to refuse unwanted treatment; the right to prepare legally binding advance directives; the right to decline to prepare such directives; and access to nationally insured healthcare. It should enable those concerned with patient care involving DT to seek ethical advice from ethics committees. Furthermore, it should state that healthcare professionals involved in the discontinuation of life support in a proper manner are immune to any legal action and that they have the right to conscientiously object to LVAD deactivation. (shrink)

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 (...) the sanctity of life, Japanese society may not be ready to make changes needed to enable patients to have LVADs deactivated under certain circumstances to avoid needless suffering. Main text Western ethical views that permit LVAD deactivation based mainly on respect for autonomy and dignity have not been accepted thus far in Japan and are unlikely to be accepted, given the current Japanese culture and traditional values. Some healthcare professionals might regard patients as ineligible for DT unless they have prepared advance directives. If this were to happen, the right to prepare an advance directive would instead become an obligation to do so. Furthermore, patient selection for DT poses another ethical issue. Given the predominant sanctity of life principle and lack of cost-consciousness regarding medical expenses, medically appropriate exclusion criteria would be ignored and DT could be applied to various patients, including very old patients, the demented, or even patients in persistent vegetative states, through on-site judgment. Conclusion There is an urgent need for Japan to establish and enact a basic act for patient rights. The act should include: respect for a patient’s right to self-determination; the right to refuse unwanted treatment; the right to prepare legally binding advance directives; the right to decline to prepare such directives; and access to nationally insured healthcare. It should enable those concerned with patient care involving DT to seek ethical advice from ethics committees. Furthermore, it should state that healthcare professionals involved in the discontinuation of life support in a proper manner are immune to any legal action and that they have the right to conscientiously object to LVAD deactivation. (shrink)

To consider whether or not we should aim to create a perfect healthy utopia on Earth, we focus on the SF novel Harmony, written by Japanese writer Project Ito, and analyze various issues in the world established in the novel from a bioethical standpoint. In the world depicted in Harmony, preserving health and life is a top priority. Super-medicine is realized through highly advanced medical technologies. Citizens in Harmony are required to strictly control themselves to achieve perfect health and must (...) always disclose their health information to the public and continuously prove their health. From a bioethical standpoint, the world in Harmony is governed by a “healthy longevity supremacy” principle, with being healthy equated to being good and right. Privacy no longer exists, as it is perceived ethical for citizens to openly communicate health-related information to establish one’s credibility. Moreover, there is no room for self-determination concerning healthcare because medical interventions and care are completely routinized, automated, centralized, and instantly provided. This is a situation where the community exhibits extremely powerful and effective paternalism. One can argue that healthy longevity is highly preferred. But is it right to aim for a perfectly healthy society at all costs? Should we sacrifice freedom, privacy, vivid feelings, and personal dignity to achieve such a world? In our view, the answer is no, as this would require the loss of many essential values. We conclude by proposing an alternative governing principle for future healthcare, and refer to it as the “do-everything-in-moderation” principle. (shrink)

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 (...) United States. The second aim is to clarify the challenges faced by Japanese biomedical ethics concerning selfmanagement support by focusing on the ethical concepts of quality of life and autonomy. This article identifies the following two challenges: [1] dispelling conceptual confusion concerning basic ethical concepts such as quality of life and autonomy, and [2] exploring the conceptual relationship between these ethical concepts, as they relate to providing support for chronically ill patients. By addressing these challenges and constructing a theoretical basis for radical change in support mechanisms, bioethics in Japan could contribute to efforts to construct a comprehensive support system for patients with chronic conditions, which organize variety kinds of supports, such as medical professional supports, supports from patient’s groups, local community supports, familial supports, support in patients’ workplace, and supports for patients’ family members as well. (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)

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 (...) through their excessive and dependent use of it, and they will focus only on the AI services in their office and patient medical data and information, and forget to observe the patient in their clinical encounters. In the era of AI introduction, data from the wearable terminal or AI advice will become the primary target of the physician’s interest, and could be regarded as a patient surrogate. Paternalism would be paradoxically resurrected by the introduction of state-of-the-art AI. A physician’s conflict of interest related to AI as a commercial product could strongly influence his or her actions in clinical settings. We also worry that the general public will become uneasy and hypersensitive slaves to information, compulsively and uninterruptedly requesting healthcare information concerning their own health and advice from AI. An AI system capable of expressing proper and timely empathy to suffering patients could deprive healthcare professionals of their roles in terms of hospitality and emotional exchange. Finally, entire societies would soon share and consolidate healthcare sensitive information from all in the general public as part of a totalitarian healthcontrolled society where individual privacy and personal secrets could be neglected. The advent of the healthcontrolled society could lead to the metamorphosis of the concept of privacy itself into something completely different. Conclusion: Although AI which surpasses human healthcare professionals may never appear, hoping for the best and preparing for the worst is the best approach to take. To this end, we present some potential countermeasures including conducting clinical research and social investigations concerning problems surrounding the introduction of AI and developing guidelines for its appropriate use. (shrink)

In medical ethics, an appropriate national healthcare system that meets the requirements of justice in healthcare resource allocation is a major concern. Japan is no exception to this trend, and the pros and cons of introducing a two-tier healthcare system, which permits insured medical care services to be provided along with services not covered by social health insurance, have been the subject of debate for many years. The Supreme Court ruled in 2011 that it was valid for the government to (...) ban mixing medical treatments and both the Ministry of Health, Labour and Welfare and Japanese Medical Association oppose the introduction of such a system. In this paper, we examine the main arguments against the introduction of a two-tier healthcare system and ideas that form their basis, which can be broadly divided into opinions based on the importance of equality and those derived from the logical conclusion that the outcomes would be detrimental. We point out issues and shortcomings of each standpoint and argue that the introduction of the system would not necessarily threaten equality and social solidarity in Japanese society, and that abuses of a self-pay tier would be controllable to a certain extent. Then, the authors—who do not actively promote the introduction of a two-tier healthcare system—conclude that the allegation that is completely devoted to one side and the theory that social healthcare is collapsing, which makes the public excessively nervous, cannot be accepted. (shrink)

In everyday medical settings in Japan, physicians occasionally tell an elderly patient that their symptoms are “due to old age,” and there is some concern that patient care might be negatively impacted as a result. That said, as this phrase can have multiple connotations and meanings, there are certain instances in which the use of this phrase may not necessarily be indicative of ageism, or prejudice against the elderly. One of the goals in medical care is to address pain and (...) suffering that develops with age in elderly individuals, and whether or not aging is a disease is inconsequential. However, assuming that an individualized and thorough examination has been performed, there are some conditions that can be attributed only to age. Accordingly, physicians must acknowledge the merits and drawbacks of using the phrase “due to old age,” and exercise caution when using it. Both physicians and their elderly patients must share a common awareness of the incomplete and limited nature of modern medicine and its scope, and physicians must help their elderly patients accept and live with the aging phenomenon. (shrink)

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 (...) and surrogate decision-makers, extent of involvement of the various parties in the surrogate decision-making process, judgement grounds for surrogate decision-making, and frequency of involvement in the surrogate decision-making process.ResultsOf the participants, 70.5% were male and 48.3% were eldest sons. Only 7.6% of the patients had left a written record of their preferences and 48.8% of the surrogates reported no knowledge of the patient having expressed their prior intentions regarding medical care in any form. Respondents indicated that their family meetings with healthcare professionals mostly included the information recommended by guidelines in a surrogate decision-making meeting in Japan. Most participants reported a good understanding of the meeting content. Although many participants based their decisions on multiple grounds, surrogates’ considerations may not adequately reflect respect for patient autonomy in Japan. Specifically, the eldest son considered his own preference more frequently than that of the other surrogate decision-makers. In 26.1% of the cases, either zero or one family meeting with healthcare professionals was held. In these cases, significantly fewer decisions involved the participation of healthcare professionals other than the doctor compared to cases with multiple meetings.ConclusionsSurrogate decisions in Japan are most commonly made by eldest sons and may not frequently consider the perspectives of other surrogates. The finding that patient preferences were rarely known suggests a role for increased advance care planning. (shrink)

BackgroundNo laws or official guidelines govern voluntary assisted dying (VAD) in Japan. A legislative bill on the termination of life-sustaining measures has yet to be sent to deliberations for legislation, due to strong opposition that has prevented it from being submitted to the Diet. However, Japan has recently witnessed several cases involving VAD.Main textAgainst this backdrop, we argue that Japan should begin discussion on VAD legislation, referring to the Voluntary Assisted Dying Act 2017 (VADA2017), which was established in 2017 in (...) Victoria, Australia. VADA2017 puts in place a wide range of stringent safeguards and is considered worldwide to be the safest and most conservative policy on a physician offering assisted dying based on the patient’s premeditated request. We consider what opposing opinions from society would arise in response to the VADA2017. Among these will include arguments against VAD itself, those against the validation of this act, and opinions that oppose even the initiation of the dialogue on VAD.ConclusionsWe conclude that to protect the right to life among those placed in vulnerable positions and, at the same time, to respect decision-making of those who wish for immediate death due to unbearable suffering, the dialogue must immediately begin with that on introducing a policy more conservative than that of the VADA2017, which solidly considers arguments against VAD. (shrink)

世界を騒がせた、理化学研究所のSTAP細胞事件。この背後には、日本の歪んだ科学行政があった。外圧によってもたらされた、分子生物学・再生医療分野の盛況と、潤沢すぎる研究資金。大学の独立行政法人化により伝 統と研究の自由を蹂躙され、政府・産業界の使用人と化した大学研究者たち。学術雑誌の正体と商業主義など、研究者を論文捏造に走らせる原因の数々を、筆者ならではの視点から、科学史を交えつつ鋭く指摘する。研究者 の自由を取り戻し、論文捏造を根絶するための提言も行なう。.

世界を騒がせた、理化学研究所のSTAP細胞事件。この背後には、日本の歪んだ科学行政があった。外圧によってもたらされた、分子生物学・再生医療分野の盛況と、潤沢すぎる研究資金。大学の独立行政法人化により伝 統と研究の自由を蹂躙され、政府・産業界の使用人と化した大学研究者たち。学術雑誌の正体と商業主義など、研究者を論文捏造に走らせる原因の数々を、筆者ならではの視点から、科学史を交えつつ鋭く指摘する。研究者 の自由を取り戻し、論文捏造を根絶するための提言も行なう。.

Immerse yourself in the world of the Samurai with this classic text. Code of the Samurai is the 350-year-old summary of the rules and expectations embodied in Bushido-the ancient Japanese "Way of the Warrior." Written by Taira Shigesuke, a Samurai and prominent teacher of military techniques, it was published posthumously in 1834. This influential book was intended as a training manual for young Samurai, outlining personal and professional standards. This accessible and enjoyable translation is by Thomas Cleary, the foremost (...) translator of Asian martial classics, accompanied by the powerful line drawings of master illustrator Oscar Ratti. A new foreword by Alexander Bennett, a leading expert on Samurai history, explains the lasting importance of this classic work and its place within the canon of Japanese literature. (shrink)

Hindu Theology in Early Modern South Asia: The Rise of Devotionalism and the Politics of Genealogy. By KiIyokazu Okita. Oxford: Oxford University Press, 2014. Pp. vii + 284. $99.

This article demonstrates that Fujiwara no Toshinori composed the text of the National Treasure Heike nokyo ganmon, which has usually been attributed to Taira no Kiyomori. First, the article establishes that Toshinori was a prolific author of the ganmon genre, which required skill in composing elaborate parallel prose and a profound knowledge of Buddhist doctrine and Chinese history. It then documents the existence of many, overlooked works written by Toshinori and reveals that certain passages found in them match passages (...) in the Heike nokyo ganmon, thus proving Toshinori’s authorship. It focuses in conclusion on Toshinori’s role in producing a picture scroll for the imperial court, a task precisely analogous to that carried out by his brother, the monk Joken, and suggests that Toshinori and his family may have been responsible for a good deal of the art created in the milieu of the retired emperor Goshirakawa. (shrink)

Ce livre interroge les passages entre dire et chanter, leurs usages, leurs contraintes, les multiples façons dont ils sont nommés et mis en oeuvre, leurs enjeux esthétiques, poétiques, dramaturgiques ou anthropologiques. Il rassemble dix-sept essais comme autant d'études de cas, autour de quatre axes: " Le chant des mots "; " Représentations de la parole et enjeux dramaturgiques "; " Du souffle au cri "; " Voix plurielles et identité ". De multiples états du dit/chanté sont abordés: des manifestations du (...) parlé sur la scène de l'opéra au me siècle au retour actuel de la mélodie parlante orchestrale, des formes vocales exploratoires des années soixante aux modes du chant en poésie, de l'extra-vocalité provocatrice des XXe et XXIe siècles aux musiques rituelles où il n'est plus seulement question de chanter mais aussi de servir avec sa voix. L'ouvrage tient ensemble musicologie, ethnomusicologie et poétique. Il rend compte de structures, de pratiques et de typologies. Les oeuvres étudiées sont entre autres celles de Bernd Aloïs Zimmermann, Jonathan Harvey, Paul Valéry, Jules Massenet, Alban Berg, Claude Debussy, Manuel de Falla, Francis Poulenc, Jean Cocteau, les Beatles, les Pink Floyd, les Who, Helmut Lachenman, Yoshihisa Taïra, Jean-Christophe Marti, Franz Koglmann et aussi des chants liturgiques coptes de Haute-Egypte, de l'Eglise apostolique arménienne d'Istanbul ou encore la musique carnatique d'Inde du Sud. (shrink)

For almost 700 years shoguns ruled Japan. These "gentleman warriors" developed a dedicated system of honor and strict guidlelines of behavior that Taira Shigesuke first brought together in his 16th century book—Bushido Shoshinshu. Present to a modern audience in clear, easy-to-read English, this new translation captures the majesty of the higher principles as well as the usefulness of the daily advice. From principles such as "a samurai should keep foremost in his mind the fact that he must die" to (...) rules regarding duty, personal obligation and even money management, this book sets out the guidelines that defined Japan's "way of the warrior." Honor and obligation are emphasised above all to the reader, who is taught that a samurai is expected to be indifferenet to pain, unquestioningly loyal, and an expert in his training. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Awesome Nightfall: The Life, Times, and Poetry of SaigyōMichiko YusaAwesome Nightfall: The Life, Times, and Poetry of Saigyō. By William R. LaFleur. Boston: Wisdom Publications, 2003. Pp. ix + 173. Paper $14.95.A quarter of a century ago William LaFleur published his book on Saigyō, Mirror for the Moon, which the present work, Awesome Nightfall: The Life, Times, and Poetry of Saigyō, thoughtfully and masterfully supersedes. In this connection (...) I may mention the philosopher, Nishida Kitarō, whose Zen no kenkyū (An inquiry into the good) was reprinted in 1936, twenty-five years after its first publication. On that occasion Nishida, deeply moved by the thought that his earliest work was still being read, expressed his sentiment by quoting the last two lines of one of Saigyō's poems: [End Page 270]Toshitaketemata koyubeshitoomoikiyaInochi narikeriSaya no NakayamaDid I ever imagineIn my advanced ageI should cross once againThis mountain pass of Saya-no-Nakayama?Ah, it is all thanks to having lived a long life!1(Saigyō composed this poem on going for the second time to Mutsu, the northern region of Japan, forty-two years after his first visit there.)As LaFleur notes, a number of important works on Saigyō's life and his times have been published in Japan in the last two decades, which these offer us more complete sketches of his life and allow an appreciation of his poetry to a greater depth. In the first part of the book, "The Life and Times of Saigyō," the author succinctly incorporates many of these findings and relates Saigyō's poems both to historical events and to his personal life experience (pp. 1-70). The second half of the book contains LaFleur's translation of over 150 poems by Saigyō, all of which appear to be taken from his earlier book (pp. 73-152).LaFleur shows how Saigyō's life (1118-1190) was closely linked to the historical context. The time was fast changing from the insei system (political administration run by the court of the retired emperor) to the Hōgen and Heiji Disturbances, the fierce power struggle between the Taira and the Minamoto military clans, with the dramatic demise of the former and the end of the Heian period. Saigyō's path crossed with such eminent political figures as Taira no Kiyomori in 1172 and Minamoto no Yoritomo in 1186. By juxtaposing historical events with Saigyō's poems, which often bear headnotes describing the circumstances under which he composed them, a full-fledged biography of Saigyō promises to be in the offing.In the present work, LaFleur sketches Saigyō's life in bold strokes and introduces new findings for the English-reading audience, such as the homoeroticism that dominated the court of the retired Emperor Toba (1103-1156)—although Saigyō himself does not appear to have been a member of this coterie.2 LaFleur also draws our attention to the fact that Saigyō practiced religious austerities at Mt. Kōya and Ōmine (pp. 20-21). Going beyond a rather two-dimensional image of Saigyō as a nature-loving poet of the moon and the flowers, the present study presents a picture of a man caught in an impossible love affair; a highly skilled equestrian, archer, and kemari (a sort of kickball) player; and a man who caused a sensation by renouncing the world at the young age of twenty-three despite his promising career as an imperial guard. Saigyō's mental and physical strength, honed by his mountain asceticism, no doubt was essential in his making extensive journeys far and wide. We also see that the distance Saigyō created from the political arena by becoming a monk gave him a keener eye to assess the fundamental political changes that were then taking [End Page 271] place. The full import of his poems, dealing with warfare, emperors, and the court, cannot be understood when separated from the political events of the day, although Saigyō himself maintained his cool objectivity and distanced himself from them.The tantalizing speculation that Saigyō was infatuated with Empress Taikenmon'in, Emperor Toba's consort and Emperor Sutoku's mother, is highly probable... (shrink)