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The Acceptability of Advance Directives in Japanese Society

Research Project

Project/Area Number 08672579
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Medical sociology
Research InstitutionWaseda University

Principal Investigator

KIMURA Rihito  Waseda University, Professor School of Human Sciences, 人間科学部, 教授 (80195388)

Co-Investigator(Kenkyū-buntansha) AKABAYASHI Akira  The University of Tokyo Assistant Professor, 大学院・医学系研究科, 助手 (70221710)
Project Period (FY) 1996 – 1997
Project Status Completed (Fiscal Year 1997)
Budget Amount *help
¥2,000,000 (Direct Cost: ¥2,000,000)
Fiscal Year 1997: ¥1,000,000 (Direct Cost: ¥1,000,000)
Fiscal Year 1996: ¥1,000,000 (Direct Cost: ¥1,000,000)
Keywordsadvance directive / hospice / crosscultural comparison / questionnaire / living will / ALS / アドバンス・ディレクティブ / 事前指示 / 医師 / ホスピス / ターミナル・ケア / バイオエシックス / リビング・ウイル / 一般健常人 / 質問紙 / 死
Research Abstract

An advance directive, is understood to be a declaration by a person that stipulates the forms of medical treatment to be provided by caregivers and/or designates someone to act as a proxy should the person at some future date lose decision making capacity. In order to investigate the acceptability of advance directives in Japanese society, questionnaire studies were conducted on healthy subjects and health professionals asking about their knowledge, experiences, and attitudes.
Two hundred and ten male subjects who visited two urban general hospitals for their physical check-ups were asked to fill out a self-administered questionnaire. The majority of the respondents wanted to express their preferences about future medical care and wanted to designate their preferences for treatment for incurable diseases such as terminal cancer, brain-death, and persistent vegetative state. More than 80% answered they would give a lot of leeway to surrogates to override their preferences, and did not fe … More el it was necessary for detailed, concrete directives. More than 60% answered that oral statements were enough. As for a surrogate decision maker, 80% answered they would designate "family or relatives", in most cases, a spouse. On the other hand, those who do not want to express their preferences listed reasons against it : psychological resistance to talk about death ; difficulty in imagining the future situation ; and entrusting their family (omakase), etc.
A questionnaire administered to 72 medical doctors in one university hospital revealed that majority of them wanted their patients to leave their preference in advance. They preferred to written documents (not an oral one), however, they did not feel necessity for detailed, concrete directives.
Possible disease-specific advance directives in the palliative care and chronic neurological disease such as ALS were also explored. Written advance directives might be useful in the Japanese settings when 1) a person does not want to give surrogates and/or caregivers a lot of leeway ; 2) where there exists uncertainty and caregivers feel the necessity to ascertain the preference by written documents. Less

Report

(3 results)
  • 1997 Annual Research Report   Final Research Report Summary
  • 1996 Annual Research Report
  • Research Products

    (31 results)

All Other

All Publications (31 results)

  • [Publications] Kimura, R: "Dying and Advance Directwis in Tapan : Socio-Culfurol and Legal Point of Vie" Advance Directive and Sueogate Decision making in Trans cultural Perspective. 印刷中.

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] Volts.R et al: "End-of-life decisions and advance directive in palliatuie care" Jarnal of Pain and Sympton Management. 印刷中.

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] Sass.H. et al: "Advance Health Care Documents in Malficultural Perspective" Ann.Rev.of Low and Ethics. 4. 465-508 (1996)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] Olick.R.S.et al: "Advance Care Planning and the ALS Patient" Ann.Rev.of Law and Ethics. 4. 529-552 (1996)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] 赤林 朗ら: "アドバンスディレクティブ(事前指示)に関する医師の意識調査" 日本医事新報. 3842. 24-29 (1997)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] Kimura.R: "Death and Dying in Japan" Kennedy Institute of Ethics Joumal. 6. 374-378 (1996)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] Kimura, R.: "Dying and Advance Directives in Japan : Socio-Cultural and Legal Points of View." In Advance Directive and Surrogate Decision Making in Transcultural Perspective Baltimore : Johns Hopkins University Press.(in press).

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] Voltz, R., Akabayashi, A., Reese, C., et al.: "End-of-life decisions and advance directives in palliative care : A crosscultural survey of patients and health care professionals." Journal of Pain and Symptom Management. (in press).

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] Akabayashi, A.: "Female circumcision-A health issue or a human rights issue." Health Care Analysis. (in press).

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] Kimura, R.: "Verbrechen gegen die Menschlichkeit. Die vergessene Geschichte Japans." In Ethik und Medizin 1947-1997, Wallstein Verlag, Gottingen. 161-170 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] Kimura, R.: "The need for new images." World Health Forum. 18. 137-138 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] Akabayashi, A.: "Finally done-Japan's final decision on organ transplantation." The Hastings Center Report Sep-Oct. 1997. 47 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] Akabayashi, A.: "Questions raised over release of side-effects data in Japan." The Lancet. 350. 9071-124 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] Akabayashi, A.: "Japan's parliament passes brain-death law." The Lancet. 349. 9069-1895 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] Akabayashi, A.: "The concept of happiness in oriental thought and its significance in clinical medicine." Japanese and Western Bioethics, Hoshino, K.ed., Philosophy & Medicine Series 54, Kluwer Academic Publishers. 161-164 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] Voltz, R., Akabayashi, A., Reese, C., et al.: "Organization and patients' perception of palliative care : A crosscultural comparison." Palliative Medicine. 11. 351-357 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] Akabayashi, A., Kai, I., Itoh, K., Tsukui, K.: "Acceptability of advance directive in Japanese Society : A questionnaire study for healthy people in the physical check-up settings. (in Japanese)" J Japan Association for Bioethics. 7 (1). 31-40 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] Akabayashi, A., Kai, I., Kawakami, N.et al.: "Attitudes and knowledge of physicians about advance directive. (in Jananese)" Japan Medical Journal. 3842. 24-29 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] Sass, H., Bonkovsky, F., Akabayashi, A.et al.: "Advance Health Care Documents in Multicultural Perspective." Ann.Rev.of Law and Ethics Band. 4. 465-508 (1996)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] Olick, R.S., Kimura, R., Kielstein, J.T.et al.: "Advance Care Planning and the ALS Patient : A Cross-culutural Perspective on Advance Directives." Ann.Rev.of Law and Ethics Band. 4. 529-552 (1996)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] Kimura, R.: "Death and Dying in Japan." Kennedy Institute of Ethics Journal. 6. 374-378 (1996)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1997 Final Research Report Summary
  • [Publications] Kimura, R.: "The need for new images" World Health Forum. 18. 137-138 (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] Kimura, R.: "Verbrechen gegen die Menschlichkeit Dievergessene Geshichte Japan" Ethik und Medizin 1947-1997. (161-170)

    • Related Report
      1997 Annual Research Report
  • [Publications] 木村利人: "医の倫理の課題と展望" 最新内科学大系1. 別冊. 23-31 (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] 木村利人: "健康のイメージと伝統医療" 全日本鍼灸学会雑誌. 47(3). 93-100 (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] 赤林朗ら: "アドバンスディレクティブ(事前指示)に関する医師の意識調査" 日本医事新報. 3842. 24-29 (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] Voltz, R. et al: "Organization and patients perception of palliative care : a cross cultura comparison" Palliatuie Medicene. 11. 351-357 (1997)

    • Related Report
      1997 Annual Research Report
  • [Publications] Kimura,Rihito: "Death and Dying in Japan" Kennedy Iaftitute of Ethics Journal. Vol6.904. 374-378 (1996)

    • Related Report
      1996 Annual Research Report
  • [Publications] Sass,Bokowsky,Akabayashi: "Advance Health Care Documents in Multiwltural Perspective" Annual Review of Law and Ethics. 4. 465-508 (1996)

    • Related Report
      1996 Annual Research Report
  • [Publications] Kimura,Rihito: "Death,Dying and Advance Directives in Japan" in Kimura et.al eds."Advance Direchives Sanogate Decisim Making in Txnscultural Perspectill" Joho (Hopk) U.Drey. (in press). (1997)

    • Related Report
      1996 Annual Research Report
  • [Publications] Akabayashi,Akira: "The Concept of Happiness in Oriental Thought and It's Significance in Clinical Medicine" Japanese and Western Bioethics (Philosorhy Medicine). 54. 161-164 (1997)

    • Related Report
      1996 Annual Research Report

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Published: 1996-04-01   Modified: 2016-04-21  

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