One of the ethical principles of medical research involving human subjects is obtaining proper informed consent (IC). However, if the participants’ actual awareness of medical research terminology is lower than the researchers’ prediction of that awareness, it may cause difficulty obtaining proper IC. Therefore, this study aims to clarify the presence of “perception gaps” and then discuss IC-related issues and measures based on the insights obtained. We conducted two online surveys: a “public survey” to understand the Japanese public’s awareness of (...) 11 medical research terms and a “physicians’ survey” to investigate physicians’ predictions regarding public awareness. In the “public survey,” for each term, respondents were instructed to select their situation from “understand,” “have heard,” or “have never heard.” In the “physicians’ survey,” respondents were asked to estimate the proportions of the general public who would “have understood,” “have heard,” or “have never heard” by using an 11-step scale. We analyzed separately in two age groups to understand the age-related difference. We received 1002 valid responses for the “public survey” and 275 for the “physicians’ survey.” Of the public respondents, more than 80% had never heard of terms such as interventional study, prospective clinical study, cohort study, Phase I clinical trial, or double-blind study. Concurrently, physicians overestimated general public awareness of the terms placebo, cohort study, double-blind study, and randomized clinical trial (in the group of people under 60). The results revealed the perception gap between the general public and physicians which raise serious concerns about obtaining proper IC from clinical research participants. (shrink)

As of 2008, surrogacy is legal and openly practised in various places; Japan, however, has no regulations or laws regarding surrogacy. This paper reports the situation of surrogacy in Japan and in five other regions to clarify the pros and cons of prohibiting surrogacy, along with the problems and issues relating to surrogacy compensation.Not only in a country such as France that completely prohibits surrogacy within the country, but also in a country such as the UK that allows non-commercial surrogacy, (...) infertile couples travel overseas for the purpose of surrogacy. In addition, some couples might seek underground surrogacy if the government prohibits surrogacy. If an intended parent couple and a surrogate make an agreement among themselves and then a problem occurs, they cannot ask for support from professionals or bring a case to court, as can be observed in South Korea and Taiwan.We also conclude that there is little difference between commercial surrogacy and non-commercial surrogacy in the absence of a clear definition of ‘reasonable expenses.’ In the UK, the law does not allow surrogates to receive compensation. However, in reality, there may be little difference between the amounts paid to surrogates for profit in the US and those paid to surrogates for reasonable expenses in the UK. We conclude that the issue of surrogacy demands further discussion in Japan. (shrink)