Mikami H, Terazawa K
Department of Legal Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Hokkaido Igaku Zasshi. 1994 Sep;69(5):1096-101.
We attended the 11th Liaison Society of Ethics Committees in Medical Schools in Japan. Three symposiums were held under the themes of quality of life (QOL), stopping medical cure and the Japanese bioethics. Symposists were medical practitioners, teaching staffs in universities and a person of religion. In the first symposium, the definition of QOL, the usage of the term and the method of its evaluation were discussed. In the second symposium, an internist and a neonatologist reported several cases and stated problems and countermeasures in terminal care in cases that they could not maintain QOL. A person of religion made his opinion on the problems. In the final symposium were stated Japanese bioethics from the aspects of ethics and cultural anthropology. They emphasized differences in bioethical view between the Japanese and the Europeans and Americans, and a need to reform medical education in Japan. It is difficult to define QOL and to care patients at terminal stage, because present-day persons have various senses of value. Especially, Japanese have taken Western culture into our traditional social structures with its original style. Therefore, we have dual culture, as recognized in communication. Although it is very important to communicate sufficiently between patients and doctors, we consider that the dual communication has interrupted their mutual understandings. Incidentally, Western medicine had originally dual structure of art and technology. But we have taken only the technological aspect. That is probably the reason why human relations have been getting worse. It would be necessary for us to attend to these two dual structures in order to solve bioethical problems in Japan.
我们参加了日本医学院校伦理委员会联络协会第11届会议。会议举办了三场以生活质量(QOL)、停止医疗救治和日本生物伦理学为主题的研讨会。参会人员包括医学从业者、大学教师和一位宗教人士。在第一场研讨会上,讨论了生活质量的定义、该术语的用法及其评估方法。在第二场研讨会上,一名内科医生和一名新生儿科医生报告了几起病例,并阐述了在无法维持生活质量的终末期护理中的问题及应对措施。一位宗教人士就这些问题发表了看法。在最后一场研讨会上,从伦理学和文化人类学的角度阐述了日本生物伦理学。他们强调了日本与欧美在生物伦理观念上的差异,以及日本医学教育改革的必要性。由于当代人有各种各样的价值观,所以很难定义生活质量并照顾末期患者。特别是,日本人将西方文化融入了我们原有的传统社会结构中。因此,正如在交流中所认识到的,我们拥有双重文化。虽然患者与医生之间充分沟通非常重要,但我们认为这种双重沟通阻碍了他们之间的相互理解。顺便说一下,西医原本具有艺术和技术的双重结构。但我们只采纳了技术方面。这可能就是人际关系变得越来越糟糕的原因。为了解决日本的生物伦理问题,我们有必要关注这两种双重结构。