Abstract

This paper outlines ethical problems with the regional quota systems used in Japanese medical schools from the perspective of the autonomous choice of doctors and medical students. “Regional quotas” have been established in university medical schools in Japan to cultivate doctors for rural areas, and the percentage of such quotas has been significantly increasing in recent years. This study mainly focuses on the regional quota systems for medical schools whereby medical students receive scholarships on the condition that they work in community medicine for a certain period after graduating and are exempt from repaying the scholarship depending on the fulfillment of their obligations. In many cases, the regional quota systems impose penalties on those who leave to prevent withdrawal, and some claim that it is morally impermissible to withdraw from the contract. Thus, the study reviews regional quota systems and argues that these systems contain contracts that restrict the signatory’s freedom of residence and professional choice for more than a decade, and that it is difficult to withdraw from the contract because of the penalties. Consequently, it demonstrates that these contracts are morally unjust as they severely restrict the autonomous choice of doctors and medical students. In conclusion, the current regional quota systems are morally impermissible and local authorities should recruit new doctors without using such systems.