Contemporary issues concerning informed consent in Japan based on a review of court decisions and characteristics of Japanese culture.
Contemporary issues concerning informed consent in Japan based on a review of court decisions and characteristics of Japanese culture.
复制标题
DOI：
10.1186/1472-6939-15-8
复制
发表时间：
2014-02-04
影响因子：
2.7
通讯作者：
Asai A
中科院分区：
文献类型：
--
作者：
Masaki S;Ishimoto H;Asai A
由于日本采用了西方的知情同意的概念，在日本的临床环境中，患者的不适当的收购一直在继续，部分原因是文化方面。在这里，我们讨论了日本知情同意的现状和当代问题，以及这些问题如何受到日本文化的影响。日本目前关于知情同意和信息披露的法律的规范不明确。例如，在日本，医生没有法律的义务将癌症诊断告知患者。为了更好地了解这些问题，我们提出了五个有关知情同意和信息披露的法院判决。然后，我们讨论日本文化，通过审查已发表的意见和评论，文化如何影响决策和获得知情同意。我们专注于两个当代的问题，涉及知情同意和相关问题在临床环境中：滥用知情同意和持久性在获得同意。就前一个问题而言，“知情同意”一词通常用来表示有机会披露医疗条件和建议的治疗选择。随意使用“知情同意”一词可能反映了根深蒂固的文化影响。对于后一个问题，医生可能会不择手段地试图获得签名，缺乏对重要伦理原则的深刻理解，例如保护人类尊严，为患者的最佳利益服务，以及在决策中不伤害患者。显然，日本医疗保健专业人员对知情同意的概念存在误解，对伦理原则缺乏完整的理解。虽然在某些方面类似于知情同意，因为它起源于美国，我们的审查清楚地表明，日本的知情同意有明显的特点。日本的医疗保健专业人员应该致力于了解知情同意的基本性质，无论他们对个人主义，自由主义和患者自决的态度如何。如果他们认为知情同意的概念在日本临床环境中是重要和必不可少的，则应努力以适当的方式获得知情同意。
Since Japan adopted the concept of informed consent from the West, its inappropriate acquisition from patients in the Japanese clinical setting has continued, due in part to cultural aspects. Here, we discuss the current status of and contemporary issues surrounding informed consent in Japan, and how these are influenced by Japanese culture. Current legal norms towards informed consent and information disclosure are obscure in Japan. For instance, physicians in Japan do not have a legal duty to inform patients of a cancer diagnosis. To gain a better understanding of these issues, we present five court decisions related to informed consent and information disclosure. We then discuss Japanese culture through reviews of published opinions and commentaries regarding how culture affects decision making and obtaining informed consent. We focus on two contemporary problems involving informed consent and relevant issues in clinical settings: the misuse of informed consent and persistence in obtaining consent. For the former issue, the phrase "informed consent" is often used to express an opportunity to disclose medical conditions and recommended treatment choices. The casual use of the expression "informed consent" likely reflects deep-rooted cultural influences. For the latter issue, physicians may try to obtain a signature by doing whatever it takes, lacking a deep understanding of important ethical principles, such as protecting human dignity, serving the patient’s best interest, and doing no harm in decision-making for patients. There is clearly a misunderstanding of the concept of informed consent and a lack of complete understanding of ethical principles among Japanese healthcare professionals. Although similar in some respects to informed consent as it originated in the United States, our review makes it clear that informed consent in Japan has clear distinguishing features. Japanese healthcare professionals should aim to understand the basic nature of informed consent, irrespective of their attitudes about individualism, liberalism, and patient self-determination. If they believe that the concept of informed consent is important and essential in Japanese clinical settings, efforts should be made to obtain informed consent in an appropriate manner.
影响因子：
50.5
作者：
Miyashita, M.;Sanjo, M.;Uchitomi, Y.
通讯作者：
Uchitomi, Y.
影响因子：
13.4
作者：
Akabayashi, A;Slingsby, BT
通讯作者：
Slingsby, BT
影响因子：
2.2
作者：
Tanida, N
通讯作者：
Tanida, N