Harmony is one of the most fundamental Japanese values. It is derived from Confucianism and encompasses a state of mind, an action process and outcomes of the action. This article draws on research data and discusses Japanese nurses’ perceptions of harmony as reflected in their everyday practice. The most important virtues for these nurses were reported as politeness and respect for other persons. The outcome from the nurses’ harmonious practice, it is claimed, benefited patients and created peaceful, harmonious relationships for (...) all. Because of the unique link between harmony and the location of interaction, the ideal ‘workplace harmony’ threatened some nurses’ professional decision making. These nurses confused harmony with conformity by superficial agreement. The Japanese seniority system could be a major factor contributing to this problem. Ethics education that includes traditional values and concepts in Japanese culture is strongly urged. (shrink)

End-of-life issues have become an urgent problem in Japan, where people are among the longest lived in the world and most of them die while connected to high-technology medical equipment. This study examines a sensitive end-of-life ethical issue that concerns patients, families and nurses: the withdrawal of artificial food and fluid from terminally ill patients. A sample of 160 Japanese nurses, who completed a questionnaire that included forced-choice and open-ended questions, supported this act under only two specific conditions: if the (...) patient requested it, and if it relieved the patient’s suffering. They considered that the doctor’s orders, the family’s request, or the patient’s advanced age did not ethically justify this act. A small number of people who had recently lost a relative took part in semistructured interviews focusing on their experiences of their terminally ill relatives being given artificial food and fluid. Ethical, social and cultural factors surrounding this issue are discussed. (shrink)

After ratifying the Convention on the Rights of Persons with Disabilities in 2014, Japan became the focus of an initial review designed to assess the quality of the newly implemented measures. One of the points that particularly caught the attention of UN Commissioners concerned Article 19 on independent living. This paper examines the opportunities and practicalities of independent living for people with disabilities in Japan, particularly those with intellectual disabilities who are still mostly supported by their families. The notion of (...) “independent living” and associated concepts of support emerged in the 1970s under the impetus of a group of people with multiple disabilities. After tracing this development, an overview of the living conditions of disabled people in Japan is presented, based on available statistical data, along with a brief description of the regulatory provisions and services supporting independent living. Finally, the analysis of a qualitative survey conducted people with mental disabilities experiencing independent living highlights the crucial roles of parents who are still often reluctant to their children living independently, underlining the importance of access to information. (shrink)

Two questionnaire surveys are reported describing the attitudes of 127 Japanese nurses towards developing a do not resuscitate (DNR) policy. The background information features the Japanese health care situations: a lack of policies for end-of-life care decisions; frequent life-prolonging treatments initiated without the patient’s knowledge or consent; ethical dilemmas confronting nurses in relation to such treatments; and the public’s growing concern over end-of-life care. A hypothetical DNR policy was used in which a health professional asked patients about their decision regarding (...) DNR. The respondents supported this model DNR policy as an ideal. However, they noted that this policy was at variance with Japanese culture. Recommendations for Japanese nurses emerged from the data. In order to make an impact on end-of-life decision making, nurses should take culturally appropriate actions: (1) teach patients about their rights; and (2) work with physicians to provide patients with accurate information about their condition. (shrink)

This pilot study had two purposes: (1) to review recent Japanese nursing literature on nursing advocacy; and (2) to obtain data from nurses on advocacy. For the second purpose, 24 nurses at a nursing college in Japan responded to a questionnaire. The concept of advocacy, taken from the West, has become an ethical ideal for Japanese nurses but one that they do not always understand, or, if they do, they find it difficult to fulfil. They cite nursing leadership support as (...) necessary to enacting this role. Discussion on the meaning of and the rationale for advocacy in a society where goodness or badness is relative to social situations and its impact may reveal two parallel but overlapping views of morality. Such a situation would not only influence notions of advocacy but also possibly render them more complex. (shrink)

This article explores the potent force of material objects in testimional culture by enacting an encounter with the ‘debris’ of a World War Two internment camp for Japanese Canadians. Pushing beyond the limits of the repetition of linear history, the article moves instead towards a phenomenological analysis of how yielding to remains of the past might allow us to reconnect with the destroyed worlds from which they were removed. Using Michel Taussig's notion of mimesis and Peggy Phelan's work on mimicry, (...) alongside Merleau‐Ponty's work on the habit‐body, this article brings into relief the neglected place of material objects collected by archives and brought to memorials in testimonial culture. (shrink)

Internet services, such as review sites, FAQ sites, online auction sites, online flea markets, and social networking services, are essential to our daily lives. Each Internet service aims to promote information exchange among people who share common interests, activities, or goods. Internet service providers aim to have users of their services actively communicate through their services. Without active interaction, the service falls into disuse. In this study, we consider that an Internet service has a network externality as its main feature, (...) and we model user behavior in the Internet service with network externality as a dynamic game. In particular, we model the diffusion process of users of an ISNE as an infinite-horizon extensive-form game of complete information in which: each user can choose whether or not to use the ISNE in her/his turn and the network effect of the ISNE depends on the history of each player’s actions. We then apply Markov perfect equilibrium to analyze how to increase the number of active users. We derive the necessary and sufficient condition under which the state in which every player is an active user is the unique Markov perfect equilibrium outcome. Moreover, we propose an incentive mechanism that enables the number of active users to increase steadily. (shrink)

This article, written from research data, focuses on the possible meaning of the data rather than on detailed statistical reporting. It defines whistleblowing as an act of the international nursing ethical ideal of advocacy, and places it in the larger context of professional responsibility. The experiences, actions, and ethical positions of 24 Japanese nurses regarding whistleblowing or reporting a colleague for wrongdoing provide the data. Of these respondents, similar in age, educational level and clinical experience, 10 had previously reported another (...) nurse and 12 had reported a physician for a wrongful act. These data raise questions about overt actions to expose a colleague in a culture that values group loyalty and saving face. Additional research is needed for an in-depth understanding of whistleblowing, patient advocacy and professional responsibility across cultures, especially those that value group loyalty, saving face and similar concepts to the Japanese Ishin Denshin, where the value is on implicit understanding requiring indirect communication. Usually, being direct and openly discussing sensitive topics is not valued in Japan because such behavior disrupts the most fundamental value, harmony (wa). (shrink)

Despite increasing interests and urgent needs for quality end-of-life care, there is no exact definition of what is the interval referred to as end of life or what end-of-life care is. The purpose of this article is to report our examination of terms related to end-of-life care and define end-of-life care from nursing ethics perspectives. Current terms related to end-of-life care, such as terminal care, hospice care, and palliative care, are based on a medical model and are restrictive in terms (...) of diagnosis and prognosis. Using codes of ethics for nurses as a framework, we attempt to identify people to whom nurses are responsible to provide end-of-life care and develop a definition of end-of-life care that is more inclusive and applicable to a broader range of people who would benefit from end-of-life care by nurses and other health-care providers. (shrink)

Drawing upon the findings of a grounded theory study, this article addresses how sunao-sa influences intercultural communication and the process of building and developing trust between Japanese expatriate managers and Australian supervisors working in subsidiaries of Japanese multinationals in Australia. The authors argue that sunao is related to other concepts in business ethics and virtue literature such as character and its constituents, empathy and concern for others. How sunao as a value, influences the process of interpreting intercultural behaviour in relation (...) to providing accounts, excuses or apologies in situations where a breach of some norm has occurred, is also explained. Although sunao has a particular role in hierarchical relationships between manager and subordinate, the paper concludes that becoming mutually sunao is crucial in learning and understanding the perspectives and expectations of a counterpart so that trust can deepen and flourish. The study makes an original contribution in an area that to date does not appear to have been researched from a management perspective and purports that sunao as character is an important factor in the culture of Japanese multinational organizations and indeed, international management in that context. (shrink)

This research explored the ethical issues that nurses reported in the process of elaboration and further disclosure after an initial diagnosis of a terminal illness had been given. One hundred and six hospice nurses in Norway and Denmark completed a questionnaire containing 45 items of forced-choice and open-ended questions. This questionnaire was tested and used in three countries prior to this study; for this research it was tested on Danish and Norwegian nurses. All respondents supported the ethics of ongoing disclosure (...) to terminally ill patients based on ethical principles embedded in their country’s Patients’ Rights Acts. Truth, as an intrinsic value, proved foundational to patient autonomy, the most frequent ethical principle these nurses reported to justify their ethical position on information disclosure to terminally ill people. Telling the truth about a diagnosis was not the end of ethics in hospice care, but rather the beginning because what occurs ethically in dealing with prognosis issues became central to these hospice nurses, the patients and their families. Coupled with truth-telling, compassionate interaction and care become extensions of patients’ rights. (shrink)

This study examines public health nurses’ perceptions and concerns about the implications of Japan’s new long-term care insurance law concerning care provision for elderly people and their families. Respondents voiced their primary concern about this law as access to services for all elderly people needing care, and defined their major responsibility as strengthening health promotion and illness prevention programmes. Although wanting to expand their roles to meet the health care, social and public policy advocacy needs of elderly persons and their (...) families, respondents also stated their concern for the possible lack of enough resources for this expansion to support family caregivers adequately. They viewed their first function as developing collaborative relationships with local government officials to help to assure sufficient resources to provide the necessary foundation for long-term care programmes to deliver services to all those in need. These concerns fall within the larger ethical issue of distributive justice in a society based on the obligations of the state to citizens and the family to its members, especially elderly relatives, who, according to traditional Japanese values, retain respect. (shrink)

Objectives: This study aimed to conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) to improve subjective well-being (SWB), including evaluative, hedonic, and eudemonic well-being, and the mental component of quality of life (QOL) of working population. Methods: A literature search was conducted, using PubMed, Embase, PsycINFO, and PsycARTICLES. Eligible studies included those that were RCTs of any intervention, conducted among healthy workers, measured SWB as a primary outcome, and original articles in English. Study characteristics, intervention, outcomes, and (...) results on SWB outcomes were extracted by the investigators independently. After a brief narrative summarizing and classifying the contents of the interventions, the included outcomes were categorized into each aspect of SWB (evaluative, hedonic, and eudemonic well-being, and the mental component of QOL). Finally, the characteristics of the effective interventions for increasing each aspect were summarized, and the pooled effect of interventions on SWB was investigated by a meta-analysis. Publication bias was investigated by drawing a funnel plot and conducting Egger's test. Results: From the 5,450 articles found, 39 met the inclusion criteria for the systematic review. The interventions included in this review were classified into six categories (physical activity, ergonomics, psychological, environmental, multicomponent intervention, and others). The meta-analysis from 31 studies showed that the pooled effect of included interventions on SWB was significantly positive (standardized mean difference (SMD) = 0.51; standard error (SE) = 0.10). A funnel plot showed there were extremely large or small SMDs, and Egger's test was significant. Thus, we conducted sensitivity analysis, excluding these extreme SMDs, and confirmed that the estimated pooled effect was also significantly positive. Subgroup analyses for separate types of interventions showed the effects of psychological interventions (e.g., mindfulness, cognitive behavioral based approach, and other psychological interventions) were also significantly positive. Conclusion: The current study revealed the effectiveness of interventions for increasing SWB. Specifically, psychological interventions (e.g., mindfulness, cognitive behavioral based approach, and other psychological interventions) may be useful for improving SWB. (shrink)

The purpose of this article is to initiate a philosophical discussion about the ethical component of professional competence in nursing from the perspective of Brazilian nurses. Specifically, this article discusses professional competence in nursing practice in the Brazilian health context, based on two different conceptual frameworks. The first framework is derived from the idealistic and traditional approach while the second views professional competence through the lens of historical and dialectical materialism theory. The philosophical analyses show that the idealistic view of (...) professional competence differs greatly from practice. Combining nursing professional competence with philosophical perspectives becomes a challenge when ideals are opposed by the reality and implications of everyday nursing practice. (shrink)

Although applauding Pickering & Garrod's (P&G's) attempt to ground language use in the ideomotor perception-action link, which provides an of embodied social interaction, we suggest that it needs to be complemented by an additional control mechanism that modulates its operation in the service of the language users' communicative intentions. Implications for intergroup relationships and intercultural communication are discussed.

This article reports a survey of nurses in different cultural settings to reveal their perceptions of ethical role responsibilities relevant to nursing practice. Drawing on the Confucian theory of ethics, the first section attempts to understand nursing ethics in the context of multiple role relationships. The second section reports the administration of the Role Responsibilities Questionnaire (RRQ) to a sample of nurses in China (n = 413), the USA (n = 163), and Japan (n = 667). Multidimensional preference analysis revealed (...) the patterns of rankings given by the nurses to the statements they considered as important ethical responsibilities. The Chinese nurses were more virtue based in their perception of ethical responsibilities, the American nurses were more principle based, and the Japanese nurses were more care based. The findings indicate that the RRQ is a sensitive instrument for outlining the embedded sociocultural factors that influence nurses’ perceptions of ethical responsibilities in the realities of nursing practice. This study could be important in the fostering of partnerships in international nursing ethics. (shrink)

The paper is devoted to the issue of warfare between science and religion. The author describes various positions at this issue, analyzing their faults and merits. He concludes that two most popular ones — of the two books (the Bible, book of Revelation, and the book of Nature), and of complete separated, non-overlapping magisteria (so-called bomb-shelter theology) — are untenable. He proposes a new conception instead of them — the conception of punctuated, or interrupted, discordism — according to which science (...) and religion are predominantly in real conflict which though dangerous is not fatal to both sides of the conflict. It is so because science is ever-changing set of hypothetical claims in comparison to religious claims which are dogmatic and unchangeable. (shrink)

In the past years, food has found itself a central focus of creativity in contemporary culture and a pinnacle of this trend has been the kind of culinary creativity displayed at Noma in Copenhagen. But what is culinary creativity? And what is distinctive about the kind of culinary creativity displayed at places like Noma? In this paper, I attempt to answer these two questions. Building up on pioneering work on creativity by Margaret Boden, I argue that creativity is (...) a matter of adding new valuable things to the world. I then distinguish three different ways a recipe can be creative, building up on different culinary trends. I then focus on the specific case of Noma and argue that what is specific about the kind of culinary creativity displayed at Noma is that it emphasizes the role that recipes can play in mediating our relation to the environment. (shrink)

El presente artículo aborda el análisis curricular de la Lic. en Psicología de la UAQ. Valora elementos que se consideran por parte de los organismos evaluadores y acreditadores, y se recuperan los principales que deben ser atendidos en la evaluación curricular y el rediseño de las áreas de la licenciatura. Palabras clave: Análisis curricular, psicología, organismos evaluadores, organismos acreditadores, evaluación curricular.