Obtaining informed consent from patients with consciousness disturbance, problems from legal point of view

• Project/Area Number: 25590027
• Research Category: Grant-in-Aid for Challenging Exploratory Research
• Allocation Type: Multi-year Fund
• Research Field: New fields of law
• Research Institution: College of Heathcare Management
• Principal Investigator: chishaki hiroaki 保健医療経営大学, 保健医療学部, 教授 (70607093)
• Co-Investigator(Kenkyū-buntansha): CHISHAKI Akiko 九州大学, 医学部保健学科, 教授 (60216497)
• Project Period (FY): 2013-04-01 – 2016-03-31
• Project Status: Completed (Fiscal Year 2015)
• Budget Amount: ¥3,510,000 (Direct Cost: ¥2,700,000、Indirect Cost: ¥810,000); Fiscal Year 2015: ¥650,000 (Direct Cost: ¥500,000、Indirect Cost: ¥150,000); Fiscal Year 2014: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000); Fiscal Year 2013: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
• Keywords: インフォームドコンセント / 侵襲的医療行為 / 意識障害 / 同意能力 / 医療同意 / 代諾 / 意識障害者 / インフォームド・コンセント / 意思の欠缺 / 救急医療 / 意思能力

Outline of Final Research Achievements

We investigated on obtaining informed consent (IC) from patients in neurosurgical department who had consciousness disturbance. Even before invasive surgery, most of signatures of patients were done by family members as if genuinely performed by the patients. This practice was not in accordance with the right of self-determination supported by the civil law in Japan. And Japanese legal system concerning medical consent seemed premature compared to those of USA and Canada.　We hope early legislative proceedings in this field.

Research Products

• [Journal Article] Body weight reduction results in favorable changes in blood pressure, serum lipids, and blood sugar in middle-aged Japanese persons: A 5-year interval observational study of 26,824 cases. (2015)
  • Author(s): Mandai N, Akazawa K,Hara N, Ide Y, Dazai U, Chishaki A, Chishaki H.
  • Journal Title: Global Journal of Health Science Volume: 7 Issue: 5 Pages: 159-170
  • DOI: 10.5539/gjhs.v7n5p159
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Left Ventricular Ejection Fraction Predicts Severity of Post-traumatic Stress Disorder in Patients with Implantable Cardioverter-defibrillators. (2015)
  • Author(s): 9.Sawatari H, Ohkusa T, Anita Rahamawati, Ishikawa K, Tsuchihashi-Makaya M, Ohtsuka Y, Nakai M, Miyazono M, Hashiguchi N, Chishaki H, Sakurada H, Mukai Y, Inoue S, Sunagawa K, Chishaki A.
  • Journal Title: Clinical Cardiology Volume: 0 Issue: 5 Pages: 263-268
  • DOI: 10.1002/clc.22521
  • Peer Reviewed / Open Access
• [Journal Article] Different physiological and subjective responses to the hyperthermia between young and older adults -basic study for thermal therapy in cardiovascular diseases- (2014)
  • Author(s): Hiroyuki Sawatari, Akiko Chishaki, Mami Miyazono, Nobuko Hashiguchi, Yukari Maeno,Hiroaki Chishaki, Yutaka Tochihara
  • Journal Title: Journal of Gerontology: Medical Sciences Volume: 10 Issue: 7 Pages: 1-5
  • DOI: 10.1093/gerona/glu224
  • Peer Reviewed / Open Access
• [Presentation] Prediction of Cardiovascular Events in Pregnant Women with Congenital Heart Disease. (2016)
  • Author(s): 19.Yamasaki K, Sawatari H,Muneuchi J,Yamamura K, Sakamoto I, Izukura R, Saeki y, Shinbara R, Ohkusa T, Chishaki H, Chishaki A.
  • Organizer: 第80回日本循環器学会学術集会
  • Place of Presentation: 仙台市
  • Year and Date: 2016-03-18
• [Presentation] Post-traumatic Stress Disorder among Patients Receiving Implantable Cardioverter-Defibrillator Shocks. (2016)
  • Author(s): 20.Anita Rahmawati, Chishaki A, Sawatari H, Makaya M, Ohtsuka Y, Nakai M, Miyazono M, Hashiguchi N, Sakurada H, Takemoto M, Mukai Y, Inoue S, Chishaki H.
  • Organizer: 第80回日本循環器学会学術集会
  • Place of Presentation: 仙台市
  • Year and Date: 2016-03-18
• [Presentation] Clinical Indices for Management of Young Adult Congenital Heart Disease Patients in Transitional Stage. (2016)
  • Author(s): 21.Shinabra R, Yamasaki K, Sawatari H, Yamamura S, Sakamoto I, Izukura R, Saeki Y, Ohkusa T, Chishaki H, Muneuchi J, Chishaki A.
  • Organizer: 第80回日本循環器学会学術集会
  • Place of Presentation: 仙台市
  • Year and Date: 2016-03-18
• [Presentation] Perinatal management of adult congenital heart disease patients–Toward anxiety reduction of pregnant women–. (2016)
  • Author(s): 17.Yamasaki K, Sawatari H, Muneuchi J, Yamamura, Sakamoto I, Izukura R, Saeki Y, Shinbara R, Ohkusa T, Chishaki H, Chishaki A.
  • Organizer: 19th EAFONS
  • Place of Presentation: 千葉市
  • Year and Date: 2016-03-14
• [Presentation] Appropriate management of young adult congenital heart disease patients in transitional stage toward preventing cardiac events. (2016)
  • Author(s): 18.Shinbara R, Yamasaki K, Sawatari H, Yamamura K, Sakamoto I, Izukura R, Saeki Y, Ohkusa T, Chishaki H, Muneuchi J, Chishaki A.
  • Organizer: 19th EAFONS
  • Place of Presentation: 千葉市
  • Year and Date: 2016-03-14
• [Presentation] 先天性心疾患をもつ妊婦(初産と経産)の周産期リスクの検討. (2016)
  • Author(s): 7.山﨑啓子、澤渡 浩之 宗内 淳、山村 健一郎 坂本 一郎、伊豆倉 理江子、佐伯 順子、新原 亮史、大草 知子、樗木 浩朗、樗木 晶子.
  • Organizer: 第18回日本成人先天性心疾患学会総会・学術集会
  • Place of Presentation: 大阪府
  • Year and Date: 2016-01-17
• [Presentation] 先天性心疾患をもつ妊婦(初産と経産)の周産期リスクの検討. (2016)
  • Author(s): 15.山﨑啓子、澤渡 浩之、宗内 淳、山村 健一郎、坂本 一郎、伊豆倉 理江子、佐伯 順子、新原 亮史、大草 知子、樗木 浩朗、樗木 晶子.
  • Organizer: 第18回日本成人先天性心疾患学会総会・学術集会
  • Place of Presentation: 大分市
  • Year and Date: 2016-01-17
• [Presentation] Occurrence of cardiovascular events in transitional stage of adult congenital heart disease(ACHD)patients. (2016)
  • Author(s): 16.Shinbara R,Yamasaki K, Sawatari H, Yamamura K, Sakamoto I, Izukura R, Saeki Y, Ohkusa T, Chishaki H, Muneuchi J, Chishaki A.
  • Organizer: 第18回日本成人先天性心疾患学会総会・学術集会
  • Place of Presentation: 大阪府
  • Year and Date: 2016-01-17
• [Presentation] The Accumulated Hypoxemia by Sleep Disordered Breathing Especially in the Patients with Ischemic Cardiac Failure Affects Vascular Endothelial Function (2015)
  • Author(s): Hiroyuki Sawatari, Shin-ichi Ando, Mari Nishizaka, Mami Miyazono, Shujiro Inoue, Takafumi Sakamoto, Tomotake Tokunou, Hiroaki Chishaki, Akiko Chishaki
  • Organizer: The 11th International Congress on Coronary Artery Disease
  • Place of Presentation: Florence Italy
  • Year and Date: 2015-11-29
• [Presentation] 植込型除細動器患者における心機能とうつとの関連. (2015)
  • Author(s): 14.澤渡浩之、樗木浩朗、アニタ・ラハマワティ、真茅みゆき、大塚祐子、仲井盛、 櫻田春水、宮園真美、橋口暢子、向井 靖、井上修二朗、樗木晶子.
  • Organizer: 第72回日本循環器心身医学会総会
  • Place of Presentation: 大分市
  • Year and Date: 2015-11-14
• [Presentation] Psychological Issues in Heart Failure Patients who Received Implantable Cardioverter-defibrillator. (2015)
  • Author(s): 6.Anita Rahmawati, Chishaki A, Ohkusa T, Sawatari H, Miyuki Tsuchihashi-Makaya,Ohtsuka Y, Nakai M, Miyazono m, Hashiguchi N, Sakurada H,Takemoto M, Mukai Y, Inoue S, Chishaki H.
  • Organizer: 第19回日本心不全学会学術集会
  • Place of Presentation: 大阪府
  • Year and Date: 2015-10-17
• [Presentation] Leg Thermal Therapy Improved Sleep Structure as well as Vascular Endothelial Function in Patients with Chronic Heart Failure. (2015)
  • Author(s): 5.Sawatari H, Nisizaka M, Miyazono M , Ando S, I noue S, Takemoto M, Sakamoto T,Anita Rahmawati, Hashiguchi N, Chishaki H, Magota C, Oh kusa T, Sunagawa K, Chishaki A.
  • Organizer: HAKATA Cardiovascular Conference2015
  • Place of Presentation: 福岡市
  • Year and Date: 2015-05-29
• [Presentation] A. Leg Thermal Therapy Improved Sleep Structure as well as Vascular Endothelial Function in Patients with Chronic Heart Failure. (2015)
  • Author(s): 11.Sawatari H, Nisizaka M, Miyazono M , Ando S, I noue S, Takemoto M, Sakamoto T,Anita Rahmawati, Hashiguchi N, Chishaki H, Magota C, Oh kusa T, Sunagawa K, Chishaki
  • Organizer: HAKATA Cardiovascular Conference2015
  • Place of Presentation: 福岡市
  • Year and Date: 2015-05-29
• [Presentation] Anxiety and Worries Among Japanese Patients with Primary and Secondary Prevention Indication Implantable Cardioverter-Defibrillator. (2015)
  • Author(s): 12.AnitaRahmawati1, Chishaki A, Ohkusa T, Sawatari H, Tsuchihashi-Makaya M,Ohtsuka Y, Nakai M, Miyazono M, Hashiguchi N, Sakurada H, Takemoto M, Mukai Y, Inoue S, Sunagawa K, Chishaki H.
  • Organizer: HAKATA Cardiovascular Conference2015
  • Place of Presentation: 福岡市
  • Year and Date: 2015-05-29
• [Presentation] The Left Ventricular Ejection Fraction is Good at Predicting for Depression in Patients with Implantable Cardioverter-Defibrillator. (2015)
  • Author(s): 4.Sawatari H, Chishaki H, AnitaRahamawati, Makaya M, OhtsukaY, Nakai M, Miyazono M, Hashiguchi N, Sakurada H, Mukai Y, Inoue S, SunagawaK, ChishakiA.
  • Organizer: 第79回日本循環器学会学術集会
  • Place of Presentation: 東京都
  • Year and Date: 2015-04-24