Producing a medical ethics casebook for Japan

本研究的目的是收集关于伦理问题的说明性案例，并为日本医学伦理领域制作一本案例手册样本。该案例手册旨在成为医学伦理学研究或教学人员的标准教科书和研究资源。这本书还将向其他国家的人们解释目前日本的医学伦理。首先，对英文出版的医学伦理学案例书的风格进行了全面审查，然后讨论了最能说明日本当前状况的风格和内容。我们决定以两步的方式呈现病例，即第一部分是基础病例，第二部分是高级病例。我们的互联网主页是在这项资助的第一年建立的，目的是向日本感兴趣的研究人员和医疗专业人员征求他们遇到道德困境的案例经验。最终筛选出14例基础病例和8例晚期病例。基本案例包括简短的案例描述，后跟讨论点，而高级案例包含较长的案例描述，并附有一到两个注释。与这些案例有关的讨论主题包括人工授精、选择性不治疗残疾新生儿、虐待婴儿、实话实说、安乐死和有尊严地死亡、脑死亡、艾滋病毒/艾滋病、不遵守规定、镇静、老年人替代决策和临床试验。最后的版本经过编辑，准备用日文出版。

The purpose of this study was to collect illustrative cases of ethical issues and to produce a sample of casebook for the field of medical ethics in Japan. The proposed casebook aims to be a standard textbook for those who study or teach medical ethics as well as research resource. The book will be also expected to explain current Japanese medical ethics to people in other countries.First, a comprehensive review was conducted of the styles of medical ethics casebooks published in English, following by a discussion of the style and contents that best illustrate current Japanese condition. We decided to present the cases in a two-step manner, namely, basic cases in the first section and advanced cases in the second section. Our internet homepage was established during the first year of this grant in order to solicit from interested researchers and medical professionals in Japan their experience with cases where they encountered ethical dilemmas.As a result, 14 basic cases and eight advanced cases were finally selected. The basic cases include short case descriptions followed by discussion points, while advanced cases contain longer case descriptions with one or two commentaries. Topics discussed in connection with these cases include artificial insemination, selective nontreatment of handicapped newborns, infant abuse, truth-telling, euthanasia and death with dignity, brain death, HIV/AIDS, noncompliance, sedation, surrogate decision making for the elderly and clinical trials. The final version was edited for publication in Japanese.