Der Lehrstuhl für Christentumswissenschaft (Kirisutokyōgaku) an der Kaiserlichen Universität Kyoto wurde 1922 als Stiftungslehrstuhl gegründet. Die Gründung der Christentumswissenschaft in Kyoto erfolgte in einer spezifischen bildungspolitischen Konstellation: Es ging um die spannungsreichen Beziehung zwischen staatlichen Hochschulen und den Religionsgemeinschaften sowie um die Ansprüche einer dezidiert nationalen Politik. Der erste Inhaber des Lehrstuhls war einer der prominentesten japanischen Ideenhistoriker und Philosophen, Seiichi Hatano (1877–1950). Für Hatano gab es keinen Unterschied zwischen Theologie und Christentumswissenschaft. Er wandte die historische Methode auf die Forschung (...) zum frühen Christentum an, die er von deutschen Theologen gelernt hatte. Besonders stark hatte ihn die Religionsgeschichtliche Schule beeinflusst. Als Philosoph entwickelte Hatano eine Religionsphilosophie, die auf der Idee der Persönlichkeit basierte. Das starke Interesse am Thema “Persönlichkeit” hatte er auch mit den deutschen Theologen gemeinsam. Andererseits kritisierte Hatano den liberalen Protestantismus in Deutschland scharf. Dennoch wurde seine Haltung, mit der er die Vorgänger und Zeitgenossen “voraussetzungslos” kritisiert hatte, von führenden Vertretern des liberalen Protestantismus in Deutschland angenommen. (shrink)

Why are diagrams sometimes so useful, while other times unhelpful and even misguiding? There are systematic reasons for this. Drawing on modern research in logic, Artificial Intelligence, cognitive psychology, and graphic design, "Semantic Properties of Diagrams and their Cognitive Potentials" shows that diagrams' cognitive functions are rooted in the characteristic ways they carry information about their targets. The analysis leads to an answer for the deeper question of What makes a diagram a diagram?, which is of crucial importance to the (...) foundation of a collective science of diagrams. ". (shrink)

No laws or official guidelines govern medical assistance for dying in Japan. However, over the past several years, cases of assisted suicide or voluntary euthanasia, rarely disclosed until recently, have occurred in close succession. Inspired by these events, ethical, legal, and social debates on a patient’s right to die have arisen in Japan, as it has in many other countries. Several surveys of Japanese people’s attitudes towards voluntary assisted dying suggest that a certain number of Japanese prefer active euthanasia. Against (...) this background, it is important to discuss voluntary assisted dying cases in Japan and the Japanese views on them and to consider their implications. We review three recent Japanese voluntary assisted dying cases and discuss the various objections to voluntary assisted dying that have been published in response to these in various media outlets. Our counterarguments include the double suffering of people who are unable to give up their desire to die, individuality of death, variability of culture, problem of being an annoyance to (burden on) others, a slippery slope argument supporting voluntary assisted dying, and unfair claims about responsibility and excessive burden on people who are unable to give up their desire to die. We also point out the psychocultural and social problems in Japanese society that these objections reflect, and argue that voluntary assisted dying can be ethically acceptable under certain conditions. We conclude that Japanese society must change in order to enable those who sincerely wish to die to do so in a better way. (shrink)

Background: Patients in different countries have different attitudes toward self‐determination and medical information. Little is known how much respect Japanese patients feel should be given for their wishes about medical care and for medical information, and what choices they would make in the face of disagreement. Methods: Ambulatory patients in six clinics of internal medicine at a university hospital were surveyed using a self‐administered questionnaire. Results: A total of 307 patients participated in our survey. Of the respondents, 47% would accept (...) recommendations made by physicians, even if such recommendations were against their wishes; 25% would try to persuade their physician to change their recommendations; and 14% would leave their physician to find a new one. Seventy‐six percent of the respondents thought that physicians should routinely ask patients if they would want to know about a diagnosis of cancer, while 5% disagreed; 59% responded that physicians should inform them of the actual diagnosis, even against the request of their family not to do so, while 24% would want their physician to abide by their family's request and 14% could not decide. One‐third of the respondents who initially said they would want to know the truth would yield to the desires of the family in a case of disagreement. Interpretations: In the face of disagreement regarding medical care and disclosure, Japanese patients tend to respond in a diverse and unpredictable manner. Medical professionals should thus be prudent and ask their patients explicitly what they want regarding medical care and information. (shrink)

In recent years, the global need for clinical ethics consultation services (CECS) has increased to address ethical challenges, dilemmas, and moral distress in clinical environments. In Japan, many hospitals have introduced CECS over the past decade, but few such services work effectively because of the small number of consultations. To address this, we propose two proactive ethics consultation methods: inter-professional ethics rounds and patient note reviews. This paper provides a detailed explanation of these methods, complete with scenarios based on actual (...) cases. These methods can make CECS ‘well-functioning’ by shifting the starting points of consultation from consultees to CECS providers. We then examine the impact and value of proactive ethics consultation as well as four critical factors for its success including attitude, positioning, and competency of proactive consultation teams. We believe our suggestions will provide valuable insights for future clinical ethics consultations and stimulate academic debate about what constitutes a ‘well-functioning’ CECS. (shrink)

This article offers a new interpretation of Plato’s method of collection and division as formulated in the Phaedrus, in light of a detailed examination of the surrounding context. It argues that Socrates carefully distinguishes the characteristic operations of the method from its applications. It shows that collection and division are to be construed independently of one another, and that the collection of F-ness is equivalent to the procedure for the definition of F-ness; and it clarifies three kinds of application that (...) are mentioned in the Phaedrus: simple definition, definition supplemented with division, and scientific analysis. (shrink)

朝鮮史上最も偉大な思想家とされる李退渓(イテゲェ)(1501-70)の知られざる素顔と数々の「謎」を解明する画期的研究。.

ABSTRACT Objectives: the purpose of this study is to explore laypersons’ attitudes towards and experiences of medical research, and to compare them with those of physicians in Japan. Designs and Participants: fourteen Japanese adults from the general public and seven physicians participated in one of three focus interviews. Setting: Osaka, Japan. Results: trust and distrust in the physician by whom the participants were invited to participate in research played a considerable role in their decisions about participation. That the participants felt (...) an obligation to participate was also expressed. The lay participants perceived medical research as something entirely outside of their world. A greater willingness to volunteer for research was expressed if there were direct benefits to themselves or their families. Research methods such as use of placebos, double blinds, and randomisations seemed to cause negative attitudes to medical research. All physicians were convinced of the need for medical research, including double‐blinded randomised control trials, and its significant role in medical progress. Most physicians thought that the greater awareness of the need for medical research in the community and a better understanding of the psychology of potential research participants were necessary and urgent. Conclusions: there is a good possibility that the lay public and medical professionals have sharply different beliefs about and attitudes towards every aspect of medical research. Building up a better and equal patient‐doctor relationship based on trust is a key issue in medical research, and it is mandatory to fill the gap in perception regarding medical research between them through fully informed debates. (shrink)

To consider whether or not we should aim to create a perfect healthy utopia on Earth, we focus on the SF novel Harmony, written by Japanese writer Project Ito, and analyze various issues in the world established in the novel from a bioethical standpoint. In the world depicted in Harmony, preserving health and life is a top priority. Super-medicine is realized through highly advanced medical technologies. Citizens in Harmony are required to strictly control themselves to achieve perfect health and must (...) always disclose their health information to the public and continuously prove their health. From a bioethical standpoint, the world in Harmony is governed by a “healthy longevity supremacy” principle, with being healthy equated to being good and right. Privacy no longer exists, as it is perceived ethical for citizens to openly communicate health-related information to establish one’s credibility. Moreover, there is no room for self-determination concerning healthcare because medical interventions and care are completely routinized, automated, centralized, and instantly provided. This is a situation where the community exhibits extremely powerful and effective paternalism. One can argue that healthy longevity is highly preferred. But is it right to aim for a perfectly healthy society at all costs? Should we sacrifice freedom, privacy, vivid feelings, and personal dignity to achieve such a world? In our view, the answer is no, as this would require the loss of many essential values. We conclude by proposing an alternative governing principle for future healthcare, and refer to it as the “do-everything-in-moderation” principle. (shrink)

In everyday medical settings in Japan, physicians occasionally tell an elderly patient that their symptoms are “due to old age,” and there is some concern that patient care might be negatively impacted as a result. That said, as this phrase can have multiple connotations and meanings, there are certain instances in which the use of this phrase may not necessarily be indicative of ageism, or prejudice against the elderly. One of the goals in medical care is to address pain and (...) suffering that develops with age in elderly individuals, and whether or not aging is a disease is inconsequential. However, assuming that an individualized and thorough examination has been performed, there are some conditions that can be attributed only to age. Accordingly, physicians must acknowledge the merits and drawbacks of using the phrase “due to old age,” and exercise caution when using it. Both physicians and their elderly patients must share a common awareness of the incomplete and limited nature of modern medicine and its scope, and physicians must help their elderly patients accept and live with the aging phenomenon. (shrink)

In medical ethics, an appropriate national healthcare system that meets the requirements of justice in healthcare resource allocation is a major concern. Japan is no exception to this trend, and the pros and cons of introducing a two-tier healthcare system, which permits insured medical care services to be provided along with services not covered by social health insurance, have been the subject of debate for many years. The Supreme Court ruled in 2011 that it was valid for the government to (...) ban mixing medical treatments and both the Ministry of Health, Labour and Welfare and Japanese Medical Association oppose the introduction of such a system. In this paper, we examine the main arguments against the introduction of a two-tier healthcare system and ideas that form their basis, which can be broadly divided into opinions based on the importance of equality and those derived from the logical conclusion that the outcomes would be detrimental. We point out issues and shortcomings of each standpoint and argue that the introduction of the system would not necessarily threaten equality and social solidarity in Japanese society, and that abuses of a self-pay tier would be controllable to a certain extent. Then, the authors—who do not actively promote the introduction of a two-tier healthcare system—conclude that the allegation that is completely devoted to one side and the theory that social healthcare is collapsing, which makes the public excessively nervous, cannot be accepted. (shrink)

A placebo is a substance or intervention believed to be inactive, but is administered by the healthcare professional as if it was an active medication. Unlike standard treatments, clinical use of placebo usually involves deception and is therefore ethically problematic. Our attitudes toward the clinical use of placebo, which inevitably includes deception or withholding information, have a tremendous effect on our practice regarding truth-telling and informed consent. A casual attitude towards it weakens the current practice based on shared decision-making and (...) mutual trust between patients and healthcare professionals. Issues concerning the clinical use of placebo are thus intimately related to patient-provider relationships, the public's trust in medicine, and medical education. A review of recent survey studies suggests that the clinical use of placebo appears to be fairly well accepted among healthcare professionals and is common in clinical settings in various countries. However, we think that an ethical discussion is urgently needed because of its controversial nature. If judged to be ethically wrong, the practice should end. In the present paper, we discuss the ethicality of the clinical use of placebo with deception and argue against it, concluding that it is unethical and should be banned. We will show that most arguments in favor of the clinical use of placebo can be refuted and are therefore incorrect or weak. These arguments will be presented and examined individually. Finally, we will briefly consider issues relevant to the clinical use of placebo without deception. (shrink)

BackgroundIn the coming years, surrogate decision-making is expected to become highly prevalent in Japanese clinical practice. Further, there has been a recent increase in activities promoting advance care planning, which potentially affects the manner in which judgements are made by surrogate decision-makers. This study aims to clarify the grounds on which surrogate decision-makers in Japan base their judgements.MethodsIn this qualitative study, semi-structured interviews were conducted to examine the judgement grounds in surrogate decision-making for critical life-sustaining treatment choices in acute care (...) hospitals.ResultsA total of 228 participants satisfied the inclusion criteria, and 15 were selected for interviews. We qualitatively analysed the content of 14 interview transcripts, excluding one that did not meet the inclusion criteria. Based on this analysis, we extracted 4 core categories, 17 categories, 35 subcategories, and 55 codes regarding judgement grounds in surrogate decision-making. The four core categories were as follows: patient preference-oriented factor (Type 1), patient interest-oriented factor (Type 2), family preference-oriented factor (Type 3), and balanced patient/family preference-oriented factor (Type 4). The Type 4 core category represented attempts to balance the preferences of the patient with those of the surrogate decision-maker.ConclusionsSurrogate decision-makers based their decisions on important aspects related to a patient’s life, and they considered not only the patient’s preferences and best interests but also their own preferences. As the need for surrogate decisions will increase in the future, decision-makers will need to consider judgement grounds from a more diverse perspective. (shrink)

Self-determination is a central concept in the field of bioethics and the most critical decision among the myriad of decisions concerning medical care is the decision to choose to die; “self-determination of death.” The purpose of this paper is to clarify the basic positions on self-determination of death held by present Japanese people and we tentatively sorted these positions into 10 arguments. We discuss the problems and implications of these positions revealed within our present review and conclude that a society (...) needs to deny unnecessary intrusion and tolerance for different views might be a keyword in our oncoming society. (shrink)

Background A baby hatch called the “Stork’s Cradle” has been in place at Jikei Hospital in Kumamoto City, Japan, since May 10, 2007. Babyklappes were first established in Germany in 2000, and there are currently more than 90 locations. Attitudes regarding baby hatches are divided in Japan and neither opinions for nor against baby hatches have thus far been overwhelming. To consider the appropriateness of baby hatches, we present and examine the validity of each major objection to establishing baby hatches. (...) Discussion There are various objections to baby hatches as follows: It violates a child’s right to know the identity of his or her biological parents by allowing anonymous birth; it neglects fulfillment of the biological parents’ basic obligation to raise their child and its very availability induces abandonment of infants; some people abuse it for very selfish reasons; it cannot save babies’ lives; the rights of one parent can be ignored if the other surrenders a child without his or her consent; it puts a baby in medical jeopardy; and it has no clear legal basis. The authors would argue that there are many plausible refutations for each objection mainly based on priority of child’s right to life, pregnant women’s vulnerability and necessity of anonymity, social responsibility to protect and raise children, differences between dropping a child off at a baby hatch and child neglect, limited function of social childcare center, inevitability of abuse by a minority of people, necessary distinction between outcomes that occur only because baby hatches exist and those that occur regardless of their existence, important local direct and upmost measures for women in trouble, and difference between ambiguous legality and illegality. Summary We argue that a certain number of baby hatches should continue to be established as a last resort, in a form that can maintain anonymity if the parent dropping the child off so desires. It should be supported if it is initiated with good intentions; if the maximum possible effort is made at said facility to protect the interests, rights, and safety of the child; and if no clear evidence of harm exists. (shrink)

We can easily discriminate self-produced from externally generated sensory signals. Recent studies suggest that the prediction of the sensory consequences of one’s own actions made by forward model can be used to attenuate the sensory effects of self-produced movements, thereby enabling a differentiation of the self-produced sensation from the externally generated one. The present study showed that attenuation of sensation occurred both when participants themselves performed a goal-directed action and when they observed experimenter performing the same action, although they clearly (...) reported that the tones were produced by other during action observation and by themselves during their own action. These results suggest that sensory prediction of action modulates ongoing auditory processing irrespective of who produces the sounds and that the explicit judgment of agency does not necessarily rely on the same mechanisms on which implicit perceptual measures such as sensory attenuation rely. (shrink)

No matter how far medicine advances, incurable disease will inevitably exist; and the dying patient's last resort will likewise look to medical research. In this report, we examine a case concerning the use of experimental medical therapy on a critically ill child. We discuss the ethical argument pertaining to the recommending of experimental medical therapy to the family of a dying patient.Under the circumstances of having to face the impending death of one's own child, parents of a terminally ill child (...) are extremely vulnerable to suggestion and often loose the ability to make a composed decision._Moreover, there exists the possibility of not only patients, but also medical staff and researchers, to fall into therapeutic misconception. Likewise, for the terminal patient and his/her family though, experimental medical therapy is often the only hope, which is, however, always accompanied by a factor of uncertainty and is considered to be merely an unapproximated gamble. The proposing of experimental medical therapy can result in being cruel by shattering the parent's expectations of saving their child._We examine the issues involved in proposing an experimental medical therapy to patients who are in dire need of a last hope; and conclude that, in times of emergency, we must take great consideration in recommending an experimental medical therapy as an "innovative treatment." In extreme circumstances where an individual's life is on the line, doing nothing can be quite trying; yet, what is right is not necessarily doing something, but rather making the right decision. (shrink)

The aim of the present paper is to evaluate the role of a patient’s religious and non-religious beliefs in making decisions about medical care. Faith exerts a profound influence on our spiritual lives and on our daily actions, including ethical decisions. Religion determines the believer’s fundamental worldview, view of humanity, perspective on life and death, and values. In this paper, we investigated the treatment of medical decisions based on religious or non-religious beliefs. To understand this issue, it is necessary to (...) assess the uniqueness and validity of religious beliefs, as well as the rationality of beliefs. We concluded that decisions based on religious and non-religious beliefs shouldbe treated in the same way and that the distinguishing features of valid beliefs are deeply held and do not cause harm to others. In addition, we stated that the root beliefs we hold, whether religious or secular, cannot necessarily be explained logically, and that patient decisions should be judged by the logical consistency of their reasoning with their beliefs as starting points. (shrink)

Novel functions, which emerge by reusing existing resources formerly adapted to other original usages, cannot be anticipated before the need eventually arises. Simple reuse must be accidental. However, to survive the evolutionary race, one cannot merely keep hoping for a string of good fortune. So, successful species might be gifted with and biological mechanisms to prepare for future reuse. Neural reuse must be extrapolated from such mechanisms.

Der Aufsatz behandelt das Konzept der „Christentumswissenschaft“ (Kirisutokyo gaku) Tetsutarō Arigas, der der erste Dekan der Theologischen Fakultät an Doshisha Universität gewesen war und nach dem zweiten Weltkrieg auf den Lehrstuhl für Christentumswissenschaft an der Kyoto Universität berufen wurde. Ariga stammte aus einer „monotheistischen“ Familie mit einem muslimischen Vater und einer christlichen Mutter. Nachdem er an der Doshisha Universität graduierte, studierte er am Union Theological Seminary in the City of New York. Es ist zu vermuten, dass Ariga aufgrund seiner liberalen (...) demokratischen Gesinnung auf den Lehrstuhl an der Kyoto Universität berufen wurde. In der Einleitung in die Christentumswissenschaft unterschied Ariga zwischen der Christentumswissenschaft an der nationalen Universität und der Theologie an den privaten Universitäten. Ariga als Christentumswissenschaftler hat ohne die kirchlichen Autoritäten historisch-kritisch das Christentum erforscht, während er als Theologe sich mit pragmatischen Aufgaben, z. B. Ökumenismus, beschäftigt hat. Aus der Spannung zwischen der Christentumswissenschaft und der Theologie erzeugte er seine reichen wissenschaftlichen Leistungen. (shrink)

Humans have great locomotor adaptability to environmental demands, which has been investigated using a split-belt treadmill with belts on both the left and right sides. Thus far, neuromuscular control in split-belt locomotor adaptation has been evaluated by analyzing muscle activities at the individual muscle level. Meanwhile, in the motor control field, the muscle synergy concept has been proposed. Muscle synergies are considered the fundamental building blocks of movement and are groups of coactive muscles and time-varying activation patterns, thereby, reflecting the (...) neurophysiological characteristics of movement. To date, it remains unclear how such muscle synergies change during the adaptation and de-adaptation processes on the split-belt treadmill. Hence, we chronologically extracted muscle synergies while walking on the split-belt treadmill and examined changes in the number, muscle weightings, and temporal activation patterns of muscle synergies. Twelve healthy young males participated, and surface electromyography signals were recorded bilaterally from 13 lower-limb muscles. Muscle synergies were extracted by applying non-negative matrix factorization to the EMG data of each leg. We found that during split-belt walking, the number of synergies in the slow leg increased while an extra synergy appeared and disappeared in the fast leg. Additionally, the areas under the temporal activation patterns in several synergies in both legs decreased. When both belts returned to the same speed, a decrease in the number of synergies and an increase in the areas under the temporal activation patterns of several synergies were temporally shown in each leg. Subsequently, the number of synergies and the areas under the temporal activation patterns returned to those of normal walking before split-belt walking. Thus, changes in the number, muscle weightings, and temporal activation patterns of synergies were noted in the split-belt locomotor adaptation, suggesting that the adaptation and de-adaptation occurred at the muscle synergy level. (shrink)