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)

Background Advance care planning (ACP) is a process in which adults engage in an ongoing dialogue about future medical treatment and care. Though ACP is recommended to improve the quality of end-of-life care, the details of the dialogue experience in ACP are unknown. Objective To explore participants’ experiences of dialogue in an ACP educational program that encouraged them to discuss the value of a way of life. Research design This qualitative descriptive study used the focus group interview method. Data were (...) analyzed using qualitative content analysis. Participants and research context A dialogue-based ACP educational program was conducted in four regions in Japan for local citizens to discuss the value of their way of life. A total of 66 individuals (mean age = 55.5 ± 17.2 years; 50 women and 16 men) participated in focus group interviews. Ethical considerations This study was approved by the Ethical Review Committee of Tokyo Women’s Medical University (no. 4723) and Kyoto University (no. R2099). Findings Five main themes were extracted: discussing one’s thoughts with others in a considerate manner, reflecting on one’s way of life through others, feeling a sense of connection with others through storytelling, realizing the difficulties of talking about “what if” topics, and turning one’s eyes toward the future through the dialogue. These themes were interrelated and illustrated the complexity of the experience of discussing values. Conclusions The results suggest that dialogue in ACP is useful in clarifying values. They also indicated the need for dealing with the ethical challenges of discussing value and the importance of caring for the interlocutor to have a safe dialogue. In the ACP process, safety in dialogue may improve readiness in ACP, and health practitioners who support ACP need to address the ethical challenges entailing dialogue about values. (shrink)

Although corruption is ubiquitous, attitudes toward it differ among countries. Until the 1997 OECD Convention, the U.S. had been one of the only two countries with an explicit extraterritorial anti-bribery law, the Foreign Corrupt Practices Act (FCPA) of 1977. The FCPA employs a two-pronged approach to control the supply side of corruption: (1) anti-bribery provisions; and (2) accounting (books and record and internal controls) provisions. I offer evidence, albeit indirect, to show that the FCPA had limited success. The OECD Convention (...) adopts the same two-pronged approach, but, since it is a multilateral treaty, is likely to be more successful provided that enforcement is vigorous enough. The signatory nations effectively form a cartel to reduce the cost of doing business. As with any cartel, however, each multinational corporation has an incentive to deviate. Thus, the mutual enforcement of the agreement is crucial for its success. However, the two-pronged approach is not sufficient, since internal control does not adequately monitor decisions made at the top level. I argue that the two lessons drawn from the U.S. experience are: (1) law enforcement must be credible; and (2) internal controls alone are not sufficient. Stronger and more effective corporate governance within an appropriate regulatory framework is needed to ensure that multinational corporations conduct their business in an ethical manner. (shrink)

Abstract:Pedro Erber discusses with Naoki Sakai the history of Heidegger's influence on philosophy in Japan.

We study how changes in unemployment risk affect firms’ productivity and whether firm-initiated policies can mitigate the moral hazard problem created by increases in unemployment insurance benefits that might decrease workers’ incentives to work hard. We focus on state-specific changes in UIB levels as a quasi-natural experiment. While a large body of research has examined UIBs, including their effect on unemployed workers, few studies investigate whether UIBs have any impact on a firm’s overall productivity. Using data on firm-level total factor (...) productivity and state-level UIBs, we find a negative association between productivity and UIBs. We also find that the negative association is weaker for firms with higher employee-welfare indices than for firms with lower indices, suggesting that the adverse effect of higher UIBs on productivity is mitigated by policies that benefit workers’ welfare. More specifically, we find that among policies that are under the umbrella of corporate social responsibility, a subset of employee-welfare policies are more effective in managing moral hazard problems than other policies. (shrink)

ニヒリズムの輻輳した歴史性を主題化するにあたり著者は、ハイデッガーの「存在歴史的思惟」を手がかりとしつつ、仏教の問題境域において「始源的なもの」がどのように追究されてきたかを論じる。そして“布施”の考 察を通して、仏教の伝統のなかに現代世界の閉塞状況を打破する新たな「自己」の成立が、いま明らかにされる。現代のニヒリズムを解明し、ニヒリズムを引き受けニヒリズムを生き抜く、宗教哲学的思索の書。.

日本伝統の精神文化を考察しつつ、現代におけるそのありようを模索する興味深い論考.

In Kagaku no Sekai to Kokoro no Tetsugaku, Mr.Michio Kobayashi features on Descartes' theory of minds as "subjecitive-active consciousness", and defends it against the materialist movement. I show that Kobayashi's method has a difficulty for defending existence of our minds because Descartes didn't allow the scientific investigation of our mental experience from outside,and so cannot appropriately grasp the significance of other minds.

This article discusses what constituted Japan's conception of the world order, by analyzing political discourse of international order in modern Japan. It has been generally assumed that the Japanese vision of international order in the pre-World War II years was dominated by a belief in the supremacy of the sovereign state. Contrary to the conventional supposition, this paper will argue that modern Japan actually abounded in discourses of transnationalism, and that most of them cannot be seen as the product of (...) liberal ideas but rather the result of an unstable image of the sovereign state system. Surveying the historical development of political discourse of sovereignty and colonial administration in modern Japan, the way in which the ambivalence of Japanese transnationalism had affected the theoretical construction of the international order will be elucidated. Keeping in mind that previous studies on the genealogy of international relations have focused exclusively on the paradigmatic debate over the League of Nations, this article will also pay more attentions to the fact that rearrangement of empire had occupied the significant place in building the image of the world order. Based on the historical considerations mentioned above, the conclusion will offer generalized consideration of what constituteｄ Japan's conception of the world order. (shrink)

「論理」と「合理性」は文化が作る。日・米・仏・イランの思考表現スタイルからその原理を読み解く。.

Translation is an act of articulation that takes place in the social topos of difference or incommensurability. The topos of difference, to which translation is a response, is anterior to the conceptual difference of species or particularities. Yet, translation is often represented as a process of establishing equivalence according to the model of communication. This misapprehension of translation derives from the confusion of the act of translation with its representation. By representing translation that is unrepresentable in itself through the schema (...) of co-figuration, the representation of translation inscribes and re-inscribes the twin figures of languages between which a transfer of information is supposed to have taken place. This whole regime organized around the schema of co-figuration is a historical construct of modernity that has worked powerfully to project national/ethnic languages and the international world, only within which national languages are possible. Our task is to historicize this regime of translation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Journal of Aesthetic Education 37.4 (2003) 114-121 [Access article in PDF] Art as Part of Daily Life - A Cross-cultural Dialogue between Art and People If encounters with art and artists become part of daily life in a small rural community, and if aesthetic experiences are perceived by its local residents as part of their daily lives, what kinds of humanistic, cultural, and social change take place in (...) the community and in the people involved? By living together in a residential community, and by showing and sharing the process of art making, to what extent can aesthetic, cultural, and social issues and concerns expressed by artists be interpreted by local residents? These are the main issues addressed in this essay. 1 The artistic and aesthetic education provided in the community gradually opened up a dialogue not only between foreign artists as guests and Japanese spectators as hosts, but also between art and people, culture and culture, and people and people within the local community. Outline of the Project The Cultural Exchange House, situated in Yamaguchi prefecture, has accommodated about forty artists-in-residence from abroad for over ten years. The forty artists who have stayed there include painters, potters, sculptors, photographers, pianists, musicians, composers, poets, and writers. Artists are responsible for their travel and living expenses. The use of the house is provided without charge and the needs of the artists are met by volunteers. About half of the artists have been German and the rest from Britain, Belgium, United States, Holland, and Australia. Male and female artists have been nearly equally represented.Beginning with three, there are now sixteen volunteers who felt that the creation of a cultural environment, or more specifically the creation of access to the world of art was important for the community. They saw the need for the local community to provide children and adults with aesthetic experiences that could enrich their internal and external worlds. Increasing numbers of children were leaving the community to attend schools and get jobs, with little possibility of returning. The volunteers felt that one of their roles was to educate children and their parents so that they could encounter values different from their own, develop self-confidence, and take pride in the local community which had such cultural opportunities. They assumed that art could open people's minds to the world outside their existing cultural framework, and that it would be valuable to have artists from the outside world as their neighbors and friends. [End Page 114] Benefits of the Project There are already extensive formal grants available to foreign artists in cities such as Tokyo, Nagoya, and Osaka. However, the people who came to Yamaguchi said that they were especially attracted to life in a rural community; they hoped to experience the "real life" of the Japanese. Since the projectcould offer no grants for travel and other daily expenses, the communitydecided that they had little hope of attracting well-known artists. Instead, they invited younger lesser-known artists with potential, who did not mind the limited conditions and who welcomed a new cultural experience which might stimulate or broaden their approach to art. The contract stated that the artists should participate in cultural exchange programs, such as visiting schools and community centers to hold art workshops, and also, at the end of their stay, to share their experiences of the residency in the form of an exhibition or a concert. The degree to which this contract was kept varied. In general, the artists fulfilled the local people's expectations by holding workshops with children and adults, and did not mind having concerts in the town gymnasium or exhibitions at the community center. Foreign artists had an opportunity to reflect in a quiet environment and further their art. They were also stimulated by the encounter with the culture and people, and felt at home in the Cultural Exchange House.The house is relatively large with more than ten rooms; a dining room,kitchen, toilet, an outside bathroom, a separate studio space, and a... (shrink)

難解な「論理」に潜む西田の「個」の思想を読み解くことで、現代哲学における西田哲学の可能性を明らかにする。.

We study the relationship between the semistationary reflection principle and stationary reflection principles. We show that for all regular cardinals Λ ≥ ω₂ the semistationary reflection principle in the space [Λ](1) implies that every stationary subset of $E_{\omega}^{\lambda}\coloneq \{\alpha \in \lambda \,|\,{\rm cf}(\alpha)=\omega \}$ reflects. We also show that for all cardinals Λ ≥ ω₃ the semistationary reflection principle in [Λ](1) does not imply the stationary reflection principle in [Λ](1).

In searching for an appropriate utility function in the expected utility framework, we formulate four properties that we want the utility function to satisfy. We conduct a search for such a function, and we identify Pareto utility as a function satisfying all four desired properties. Pareto utility is a flexible yet simple and parsimonious two-parameter family. It exhibits decreasing absolute risk aversion and increasing but bounded relative risk aversion. It is applicable irrespective of the probability distribution relevant to the prospect (...) to be evaluated. Pareto utility is therefore particularly suited for catastrophic risk analysis. A new and related class of generalized exponential (gexpo) utility functions is also studied. This class is particularly relevant in situations where absolute risk tolerance is thought to be concave rather than linear. (shrink)

Minami–Sakai :883–898, 2016) investigated the cofinal types of the Katětov and the Katětov–Blass orders on the family of all \ ideals. In this paper we discuss these orders on analytic P-ideals and Borel ideals. We prove the following:The family of all analytic P-ideals has the largest element with respect to the Katětov and the Katětov–Blass orders.The family of all Borel ideals is countably upward directed with respect to the Katětov and the Katětov–Blass orders. In the course of the proof (...) of the latter result, we also prove that for any analytic ideal \ there is a Borel ideal \ with \. (shrink)

The weakly compact reflection principle\\) states that \ is a weakly compact cardinal and every weakly compact subset of \ has a weakly compact proper initial segment. The weakly compact reflection principle at \ implies that \ is an \-weakly compact cardinal. In this article we show that the weakly compact reflection principle does not imply that \ is \\)-weakly compact. Moreover, we show that if the weakly compact reflection principle holds at \ then there is a forcing extension preserving (...) this in which \ is the least \-weakly compact cardinal. Along the way we generalize the well-known result which states that if \ is a regular cardinal then in any forcing extension by \-c.c. forcing the nonstationary ideal equals the ideal generated by the ground model nonstationary ideal; our generalization states that if \ is a weakly compact cardinal then after forcing with a ‘typical’ Easton-support iteration of length \ the weakly compact ideal equals the ideal generated by the ground model weakly compact ideal. (shrink)

It is known that there is a close relation between Prikry forcing and the iteration of ultrapowers: If U is a normal ultrafilter on a measurable cardinal κ and 〈Mn, jm,n | m ≤ n ≤ ω〉 is the iteration of ultrapowers of V by U, then the sequence of critical points 〈j0,n | n ∈ ω〉 is a Prikry generic sequence over Mω. In this paper we generalize this for normal precipitous filters.

メタ倫理学、規範倫理学、応用倫理学を体系的に概説した入門書。大学における倫理学教育のミニマム・エッセンスを体系的に学べるユニークなテキスト。.

Japanese nationalism after World War II emerged out of the U. S. occupation of Japan. Rather than oppressing nationalist sentiment, the U. S. occupation administration nurtured the sense of national uniqueness and continuity in Japan and helped absolve Japanese colonial guilt and war responsibility. This U S. strategy toward Japan is best symbolized by the way the emperor system was reconstructed as part of the American reign in East Asia. Although it sometimes reveals its anti-American emotion, Japanese nationalism is in (...) complicity with the US. hegemony in East Asia, in such a way that Japan’s subjugation to US. policies is further intensified as its nationalism manifests more jingoistic tendencies. Perhaps we should find an intimation of today’s global complicity of the peripheral state with the super-state in this entanglement. (shrink)

About Japan at the beginning of the postmodernity, through the reading of David Pollack’s Fracture of Meaning and the comment of positions on is history of two young Japanese philosophers : Kôyama Iwao and Kôsaka Masaaki, Naoki Sakai problematise relations between universalism and particulartism. The identity of Japan which dialectise with which of China, exists only as Jar as Japan break loose as a particular object in the Occidental field. The criticism of the West and of modern expressed in (...) its denunciation of the monistic history reveals that all the rhetoric of the anti-modernity is a coverage without principles of all which is modern. Because world is mainly a sphere of heterogeneity and plurality, history has to be interpreted as a synthesis of time and internationalized spaces. (shrink)

Today in Japan psychoactive drugs are widely prescribed for various psychiatric disorders including so-called ‘functional’ disorders. They are undoubtedly effective in relieving various psychological and behavioral symptoms. However, Japan has yet to address some basic questions: (1) uncertainty concerning the cause of various psychiatric functional disorders; (2) unknown factors that affect the function of psychotropic drugs in patients; (3) the difficulty in obtaining objective data concerning the effects of these medications * both on the brain and the psychological symptoms (behavior); (...) and most importantly, (4) due to both the behavioral and organic (brain and CNS) effects of psychoactive drugs, the difficulty in evaluating the risk/benefit ratio between the behavioral (primary) effect and the organic (side) effect. In addition, there are bioethical problems, since these uncertainties tend to permit too broad a range of intention and too many modes of intervention in (a) prescribing and (b) taking psychoactive drugs on the part of therapists and patients, respectively. Though the increased risk of the inappropriate use of these drugs – the non-therapeutic uses, and their over-prescription – has been indicated in other industrialized countries, it has not yet been fully recognized and adequately discussed in Japan. Moreover, it is necessary to establish a sound basis for the ‘somato-psychic’ evaluation of these effects in the context of the physician-patient relationship, including the patient's family and even the broader society. Keywords: bioethics, pharmacological treatment, primary and secondary effects, psychiatric-functional disorders, risk/benefit ratio CiteULike Connotea Del.icio.us What's this? (shrink)