In Japan, where a prominent gap exists in what is considered a patient’s best interest between the medical and patient sides, appropriate decision-making can be difficult to achieve. In Japanese clinical settings, decision-making is considered an act of choice-making from multiple potential options. With many ethical dilemmas still remaining, establishing an appropriate decision-making process is an urgent task in modern Japanese healthcare. This paper examines ethical issues related to shared decision-making (SDM) in clinical settings in modern Japan from the psychocultural-social (...) perspective and discusses the ideal decision-making process in present Japan. Specifically, we discuss how five psychocultural-social tendencies – “surmise (Sontaku),” “self-restraint (Jishuku),” “air (atmosphere or mood, Kuuki),” “peer pressure (or tuning pressure, Docho-Atsuryoku),” and “community (Seken)”—which have often been referred to as characteristics of present-day Japanese people, may affect the ideal practice of SDM in Japanese clinical settings. We conclude that health care professionals must be aware of the possible adverse effects of the above Japanese psychocultural-social tendencies on the implementation of SDM and attempt to promote autonomous decision-making, thereby allowing patients to make treatment choices that sufficiently reflect their individual and personal views of life, experiences, goals, preferences, and values. (shrink)

His book Some Japanese flowers of 1896. an original copy of which is in the collection of the J. Paul Getty Museum, features handcolored collotypes of flowers native to Japan, including the lotus, several varieties of chrysanthemum and lily ...

Approximately one in two hundred persons in the Marshall Islands have active tuberculosis. We examine the historical antecedents of this situation in order to assign ethical responsibility for the present situation. Examining the antecedents in terms of Galtung’s dialectic of personal versus structural violence, we can identify instances in the history of the Marshall Islands when individual subjects made decisions with large-scale ecologic, social, and health consequences. The roles of medical experimenters, military commanders, captains of the weapons industry in particular, (...) and industrial capitalism in general are examined. In that, together with Lewontin, we also identify industrial capitalism as the cause of tuberculosis, we note that the distinction between personal versus structural violence is difficult to maintain. By identifying the cause of the tuberculosis in the Marshall Islands, we also identify what needs be done to treat and prevent it. (shrink)

Variation in decision-making about end-of-life care among ethnic groups creates clinical conflicts. In order to understand changes in preferences for end-of-life care among Japanese who immigrate to the United States, we conducted 18 focus groups with 122 participants: 65 English-speaking Japanese Americans, 29 Japanese-speaking Japanese Americans and 28 Japanese living in Japan.Negative feelings toward living in adverse health states and receiving life-sustaining treatment in such states permeated all three groups. Fear of being meiwaku, a physical, psychological or financial caregiving burden (...) on loved ones, was a prominent concern. They preferred to die pokkuri (popping off) before they become end stage or physically frail. All groups preferred group-oriented decision-making with family. Although advance directives were generally accepted, Japanese participants saw written directives as intrusive whereas Japanese Americans viewed them mainly as tools to reduce conflict created by dying person's wishes and a family's kazoku no jo– responsibility to sustain the dying patient. These findings suggest that in the United States Japanese cultural values concerning end-of-life care and decision-making process are largely preserved. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Music Teacher Education in Japan:Structure, Problems, and PerspectivesMasafumi OgawaSchool music education in Japan is in a less than ideal situation. In April 2002, the new course of study was implemented by the Ministry of Education, Culture, Sports, Science and Technology (MEXT).1 The total number of music classes in the new curriculum was reduced to 33% of what it had been by the end of 2002. The reduction went from (...) two hours of music classes every week in grades one through nine to one hour in grades five through nine. This inevitably caused many problems. First, it became very difficult to teach music sequentially and instead music classes tended to be fragments of introductory experiences taught as disconnected activities. In this situation, it has been difficult for students to develop musical knowledge and skills. Second, the number of full-time music teachers was reduced greatly. It became common for a music teacher to teach at more than two schools in order to fill a full-time assignment. In some scenarios, many full-time music teachers were replaced with part-time teachers or teachers of other subjects. Music teachers have become disposable.Many music teachers are losing their effectiveness in the classroom. Students consider school music classes as a time to relax compared with other "intellectual subjects."2 They sometimes question music as an essential subject because they [End Page 139] do not value the developing skills that music requires or studying the theory of music. They believe that they can enjoy music outside of school anyway. Consequently, they are quite reluctant to participate in music classes and so behavioral problems arise and classroom management becomes more difficult. Some teachers attempt to force students to obey and force them to order; other teachers totally give up and let students behave as they like in class.3 In either case, teachers and students do not relate well to each other. It is not an exaggeration to say that school music in Japan is at risk of collapsing altogether and disappearing from the curriculum.One of the reasons for this, I believe, is that we have not wrestled with the fundamental problems of school music education until today. We might have intentionally avoided reviewing and criticizing the curriculum, expectations, and purposes of music education because it has been taboo to discuss the national standards, particularly for public school teachers to do so. Social and environmental conditions have changed greatly since the current system of Japanese education was established in 1947. It is obvious that the existing system does not match the new conditions.I strongly feel that it is time to review and reexamine what our pioneers of music education and the government had achieved in the field of music education. If we continue to avoid doing so, music in the schools will face serious consequences. In this paper, I discuss some of the fundamental issues of music teacher education in Japan. There are two reasons for focusing on music teacher education. First, starting with music teacher education is most important because music teachers have the most significant roles in school music education. Second, I have been engaged in music teacher education for seventeen years, and this is not only my research area but also an area in which, as an insider, I can offer direct insights. I will limit this essay to looking at the preparation of teachers in music for elementary and middle schools (grades 7 to 9).StructureThe course of study (COS) is a set of national curriculum standards for kindergarten, elementary, middle, and high school, and schools for the handicapped and is issued by the MEXT.4 All schools, public or private, are required to follow these standards. No other curriculum is allowed. Therefore, in Japan, the COS is law through which the government controls all educational actions. The COS was first issued in 1947 and has been revised seven times.5 The most recent revision was announced in December 1998 for kindergarten, elementary, and middle schools, and in March 1999 for the other levels. All schools in Japan were required to implement the revised COS by April 2002. [End Page 140]The COS of... (shrink)

This essay retrieves the meaning and importance of renga, or linking poetry. Long forgotten, even in Japan, it was the form of which the great Bashō was the mater (not haiku as is now believed). When examining renga poetry, one can see that it is based not on authorial vision, but rather the trans-subjective mood that guides the different links made by the various poets who collaborate in the “rolling” of a renga. The radical implications of this form for both (...) aesthetics and ethics will be considered. (shrink)

In this paper, we develop an organization method of page information agents for adaptive interface between a user and a Web search engine. Though a Web search engine indicates a hit list of Web pages to user’s query using a large database, they includes many useless ones. Thus a user has to select useful Web pages from them with page information indicated on the hit list, and actually fetch the Web page for investigating the relevance. Unfortunately, since the page information (...) on a hit list is neither sufficient nor necessary for a user, the adequate information is necessary for valid selection. However which information is adequate depends on a user and a task. Hence we propose adaptive interface AOAI in which different page information agents are organized through man-machine interaction. In AOAI, the page information agents indicating different page information on a hit list like the file-size, network traffic and a page title are prepared at first. A user evaluates them through searching with a search engine, and the agents are organized based on the evaluation. As results, different organizations are achieved depending on a user and a task. Finally we make experiments with subjects and find out AOAI is promising for adaptive interface between a user and a search engine. (shrink)

This paper describes an automatic monitoring system that constantly checks partial update in Web pages and notifies them to a user. While one of the most important advantages of the WWW is update of Web pages, we need to constantly check them out and this task takes much cognitive load. Thus applications to automatically check update of Web pages have been developed, however they can not deal with partial update like update in a particular cell in a table in a (...) Web page. Hence we developed a automatic monitoring system that checks such partial update. A user can give a system regions in which he/she wants to know the update in a Web page as training examples, and it is able to learn rules to identify the partial update by classification learning. By this learning, a user do not need to directly describe the rules. We implemented our system and some executed examples were presented. (shrink)

Background Evidence concerning how Japanese physicians think and behave in specific clinical situations that involve withholding or withdrawal of medical interventions for end-of-life or frail elderly patients is yet insufficient. Methods To analyze decisions and actions concerning the withholding/withdrawal of life-support care by Japanese physicians, we conducted cross-sectional web-based internet survey presenting three scenarios involving an elderly comatose patient following a severe stroke. Volunteer physicians were recruited for the survey through mailing lists and medical journals. The respondents answered questions concerning (...) attitudes and behaviors regarding decision-making for the withholding/withdrawal of life-support care, namely, the initiation/withdrawal of tube feeding and respirator attachment. Results Of the 304 responses analyzed, a majority felt that tube feeding should be initiated in these scenarios. Only 18% felt that a respirator should be attached when the patient had severe pneumonia and respiratory failure. Over half the respondents felt that tube feeding should not be withdrawn when the coma extended beyond 6 months. Only 11% responded that they actually withdrew tube feeding. Half the respondents perceived tube feeding in such a patient as a "life-sustaining treatment," whereas the other half disagreed. Physicians seeking clinical ethics consultation supported the withdrawal of tube feeding (OR, 6.4; 95% CI, 2.5–16.3; P < 0.001). Conclusion Physicians tend to harbor greater negative attitudes toward the withdrawal of life-support care than its withholding. On the other hand, they favor withholding invasive life-sustaining treatments such as the attachment of a respirator over less invasive and long-term treatments such as tube feeding. Discrepancies were demonstrated between attitudes and actual behaviors. Physicians may need systematic support for appropriate decision-making for end-of-life care. (shrink)

This paper considers a monthly pattern in government spending. I have found that public spending increases at the end of the fiscal year for both the Japanese central government and the US federal government and that the effects are stronger in recent years than in the past. I then propose two hypotheses that would explain why public spending increases at the end of the fiscal year.

This paper explores preferences and attitudes related to fiscal federalism held by the ASEAN people in the context of environmental issues. Fiscal federalism would predict that local environmental problems will be handled more efficiently by local governments, while national environmental problems will be solved more efficiently by the national government. But it is not obvious whether citizens consider in the same way as economics theory predicts. To unveil this point, I address questions of whether those who have higher consciousness toward (...) environmental issues at the neighbor or local level prefer local governments to decide environment policies, whether those who have more consciousness about environmental issues at the national level prefer the national government to decide the policies, and whether those who have higher consciousness toward environmental problems at global level prefer higher levels government such as the United Nations to decide the policies. By fitting multi-level probit regressions to cross-national survey data collected in ASEAN countries, I found the results supporting the hypotheses. The country analyses show the results which support the hypotheses in Brunei, Indonesia, and the Philippines. (shrink)

This paper considers the efficiency of the political market in the California State legislature. I analyzed the property tax limitation voter initiative, Proposition 13. I found that districts which supported Proposition 13 more strongly were more likely to oppose the incumbents regardless of whether the incumbents had the different preferences for property taxes from their districts. I also studied how legislators voted on the bills adopted after the passage of Proposition 13 to finance local governments. I found that legislators tended (...) to follow the constituents tax-cutting message expressed by the passage of Proposition 13. (shrink)

실학의 개념을 설명하고 유교와 실학의 관계 등 실학 의 제이론을 분석한 저서.

Philosophy is global, insofar as it is a relation of a human being towards its world and as such a thinking of the »betweenness«, of logos and of structure, as they disclose themselves in the relations between the Ego and the world, between the beginning and the end, between the Ego and the others. e theme of »the relational thinking« transcends boundedness to a particular cultural sphere. e transcendence is possible because of the insight into the identity of structures in (...) every culture, which is founded on the performance of a deliberation upon a repeated analysis of the most fundamental issues. e thinking of the relation is the heart of philosophy. (shrink)

東アジア共通の知の基盤を創った99人。日本・中国・韓国の3か国から各33名、近世の代表的思想家を紹介。単なる技術の学ではなく、儒学を基調として、自己修養や自然への畏敬など「心」を重んじる実心実学思想は 、東アジア世界の独自かつ共通の知的達成であった。近代以降を席巻した西洋の知的体系が大きな見直しを迫られるいま、東アジア独自の知の源泉を再認識する。.

文献的知識の皮相ではなく、内部にひそむ日本独特の悲哀の感情を読む梅原日本学。縁故をもつ著者達が回顧しつつ思想的意義を説く。.