This article presents a critique of the health promotion policy of Japan, which is based on an examination of the social importance of and justification for health promotion. This is done to suggest the proper direction that the future Japanese policy could take, and to question the adequacy of the term of ‘health promotion’. We find the ‘social progress’ characterization of the ‘Second Term of National Health Promotion Movement in the Twenty-First Century - Health Japan 21 ’ to be problematic. (...) While there are clear restraints found in terms of social costs related to the policy, the aims toward social justice provided by the policy are not clear. Considering the social importance and justification of health promotion, and the present conditions seen in Japan, we believe that it is necessary clearly to position health promotion as a form of social justice. Having said this, the term ‘health promotion’ is in itself misleading and can belie the range of activities required to action these policies. Therefore, we propose considering the selection of a different and more appropriate term for health promotion that concretely defines policies that actively work toward definitive health equity. (shrink)

Progress in artificial intelligence technological innovation raises questions about the role of medical staff and the meaning of medical specialization. This study involved a qualitative survey of medical professionals and ordinary citizens to expand knowledge of this topic. A combination of Neo-Socratic Dialogue and Transfer Dialogue techniques, was used to acquire knowledge related to emerging forms of medical care and changing work demands after the implementation of AI, qualitatively analyzing the TD transcript only. Eleven subjects participated in two surveys. The (...) main points raised during TD were classified into five categories: i) Functions which AI could perform/would find difficult to perform, ii) Changes in medicine caused by AI, iii) Necessary preparations for the application of AI to medicine, iv) Concerns about AI, and v) Others. The survey findings suggest that initiatives to promote the acceptance of each individual in society and appropriate technological development are essential to the process of preparing for the changes in medicine following the implementation of AI. These preparatory conditions cannot be limited to medical professionals, and must extend to workers across all disciplines and to society as a whole. (shrink)

Place and Dialectic presents two essays by Nishida Kitaro, translated into English for the first time by John W.M. Krummel and Shigenori Nagatomo. Nishida is widely regarded as one of the father figures of modern Japanese philosophy and as the founder of the first distinctly Japanese school of philosophy, the Kyoto school, known for its synthesis of western philosophy, Christian theology, and Buddhist thought. The two essays included here are ''Basho'' from 1926/27 and ''Logic and Life'' from 1936/37. (...) Each essay is divided into several sections and each section is preceded by a synopsis added by the translators.The first essay represents the first systematic articulation of Nishida's philosophy of basho, literally meaning ''place,'' a system of thought that came to be known as ''Nishida philosophy.'' In the second essay, Nishida inquires after the pre-logical origin of what we call logic, which he suggests is to be found within the dialectical unfoldings of world history and human society. A substantial introduction by John Krummel considers the significance of Nishida as a thinker, discusses the key components of Nishida's philosophy as a whole and its development throughout his life, and contextualizes the translated essays within his oeuvre. The Introduction also places Nishida and his work within the historical context of his time, and highlights the relevance of his ideas to the global circumstances of our day. The publication of these two essays by Nishida, a major figure in world philosophy and the most important philosopher of twentieth-century Japan, is of significant value to the fields not only of Asian philosophy and East-West comparative philosophy but also of philosophy in general as well as of theology and religious studies. (shrink)

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)

This essay by Nishida Kitarō from 1927, translated into English here for the first time, is from the initial period of what has come to be called “Nishida philosophy” (Nishida tetsugaku), when Nishida was first developing his conception of “place” (basho). Nishida here inquires into the relationship between logic and consciousness in terms of place and implacement in order to overcome the shortcomings of previous philosophical attempts—from the ancient Greeks to the moderns—to dualistically conceive the (...) relationship between being and knowing in terms of subject-object or form-matter. During the course of articulating his novel approach to consciousness and cognition, Nishida discusses what he takes to be the weaknesses of Greek hylomorphism, Kantian (and neo-Kantian) dualism, and Husserlian phenomenology. Dissatisfied with the attribution of mere passivity to placiality, and turning away from consciousness objectified as a subject of statement, Nishida imparts to consciousness qua place a certain logical independence as an active yet un-objectifiable “predicate.” This investigation of consciousness as the unobjectifiable place for objectification leads Nishida to the notion of what precedes consciousness itself, a “place of nothing” (mu no basho) that envelops the dichotomized structures of subject-predicate, being-nothing, subject-object, universal-particular, et cetera. (shrink)

Expressive activity (1925) -- The standpoint of active intuition (1935) -- Human being (1938).

_An Inquiry into the Good_ represented the foundation of Nishida’s philosophy—reflecting both his deep study of Zen Buddhism and his thorough analysis of Western philosophy—and established its author as the foremost Japanese philosopher of this century. In this important new translation, two scholars—one Japanese and one American—have worked together to present a lucid and accurate rendition of Nishida’s ideas. "The translators do an admirable job of adhering to the cadence of the original while avoiding unidiomatic, verbatim constructions."—John C. (...) Maraldo, _Philosophy East and West_ __ __ "More accurate and critical than the first translation into English of Nishida's earliest book.... An important addition to library collections of twentieth-century philosophy, Japanese intellectual history, and contemporary Buddhist thought."—_Choice_ "A welcome new translation of a work by probably the most original and influential of modern Japanese philosophers."—Hidé Ishiguro, _Times Literary Supplement_ "Undoubtedly the most important work for anyone in the West interested in understanding modern Japanese thought. This work premiered Japanese philosophy as modern but has also shown unusual staying power. In the late twentieth century Japanese thinkers, both religious and secular, insist on its importance and relevance."—William R. La Fleur, University of Pennsylvania. (shrink)

« L’autodétermination du maintenant éternel» est un essai central portant sur une question qui ne cessa de préoccuper Nishida tout au long de sa carrière, celle du temps et, corrélativement, celle du soi véritable. L’analyse de la temporalité à laquelle il procède constitue l’un des apports majeurs de sa philosophie sur la scène de la philosophie contemporaine. L’inspiration platonicienne et le rapport constant à Augustin sur ce sujet conduisirent Nishida à approfondir considérablement sa «logique du basho» ou du (...) lieu et à réinterpréter en retour de manière «englobante» la temporalité. Pour lui, tout ce qui est se situe dans le temps, forme fondamentale de la réalité. Or, le temps se situe dans le présent. À partir de cet acquis, Nishida élargit encore plus sa perspective en établissant que le présent lui-même se situe dans le soi. En réalité, le véritable soi n’est autre que le soi présent. Le stade suivant, le plus englobant de tous, est celui du maintenant éternel, dans lequel tourne le temps. Il résulte de la temporalité «englobante» de Nishida une conception du présent qui met l’accent sur le rapport à l’histoire, sur un soi plus fondamental et éthique, de même que sur le thème de l’altérité. (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)

The exocyst is a conserved octameric complex that physically tethers a vesicle to the plasma membrane, prior to membrane fusion. It is important not only for secretion and membrane delivery but also, in mammalian cells, for cytokinesis, ciliogenesis, autophagy, tumorigenesis, and host defense. The combination of genome editing and advanced light microscopy of exocyst subunits in living cells has recently shown the complex to be much more dynamic than previously appreciated, and exposed how little we still know about its function (...) and regulation. (shrink)

The following essay, “The Unsolved Issue of Consciousness” (Torinokosaretaru ishiki no mondai 取残されたる意識の問題), by Nishida Kitarō 西田幾多郎 from 1927 is significant in regard to the development of what has come to be called “Nishida philosophy” (Nishida tetsugaku 西田哲学). In what follows, in addition to providing some commentary on the important points of his essay, I would like to show its relevance or significance not only for those who would like to study Nishida’s thought but also for (...) philosophy in general, especially in the contemporary setting. It was first published in 1927 by Iwanami Publishers in a collection of essays by different authors, Philosophical Essays in Commemoration of the Sixtieth Birthday of Dr. .. (shrink)

This comment discusses work by Aylett and Paiva (2012) which describes a synthetic approach to building a virtual world inhabited by synthetic characters where the user can experience subjective culture, that is, the experience of social reality, and learn how to empathetically communicate with people in other cultures. It provides a computational theory for integrating recent findings on emotion and cultural sensitivities into an interactive drama played by interacting characters with varying personalities. The FAtiMA-PSI, the implementation of their theory, has (...) advanced a critical step towards basing affective intelligence on a firmer ground. Future challenges include building an empathic agent on the simulated physiology level that can be recognized as an independent ego with its own personality and presence. (shrink)

A murder case that had some features in common with the Tarasoff case occurred in Sasebo City, Japan, in 2014. A 15-year-old high school girl was murdered and her 16-year-old classmate was arrested on suspicion of homicide. One and a half months before the murder, a psychiatrist who had been examining the girl called a prefectural child consultation centre to warn that she might commit murder, but he did not reveal her name, considering it his professional duty to keep it (...) confidential. Article 134 of the Japanese Criminal Law states that doctors should not disclose patient information obtained in clinical practice without a legitimate reason, but the Japanese Supreme Court has not specified what constitutes a legitimate reason. Mass media and commentators suggested that the murder could have been prevented if the psychiatrist had disclosed the girl's name to the authorities or had isolated her coercively in a psychiatric ward. However, the authors disagree with such claims. This article discusses obligations imposed on concerned individuals and third party members in cases involving ethical dilemmas regarding patient confidentiality and information disclosure. It is concluded that everyone should fulfill their obligations to prevent such tragedies and one should judge the appropriateness of others’ actions based not on the consequences of their actions, but on the processes used to decide on a course of action and their commitment. It is necessary for us to establish a society in which concerned parties can do what they think is ethically best without fearing ungrounded charges. (shrink)

The use of single-use items is now ubiquitous in medical practice. Because of the high costs of these items, the practice of reusing them after sterilisation is also widespread especially in resource-poor economies. However, the ethics of reusing disposable items remain unclear. There are several analogous conditions, which could shed light on the ethics of reuse of disposables. These include the use of restored kidney transplantation and the use of generic drugs etc. The ethical issues include the question of patient (...) safety and the possibility of infection. It is also important to understand the role of informed consent before reuse of disposables. The widespread practice of reuse may bring down high healthcare costs and also reduce the huge amount of hospital waste that is generated. The reuse of disposables can be justified on various grounds including the safety and the cost effectiveness of this practice. (shrink)

A new reprint of Nishida Kitarō’s maiden philosophical classic, 善の研究 (An inquiry into the Good), cross-referenced to the pagination of the older (1946) and newer (2003) editions of the Complete Works of Nishida Kitarō, vol. 1, as well as to translations in English, Chinese, German, Italian, Korean, Romanian, and Spanish. This is the second volume of "Classics of Philosophy in Japan," a series of books dedicated to the dissemination of important philosophical texts at an affordable price.

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)

This English translation of Intuition and Reflection in Self-Consciousness evokes the movement and flavor of the original, clarifies its obscurities, and eliminates the repetitions.

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 1919, Nishida Kitarō delivered a speech at Ōtani University discussing the relationship between Nicolaus of Cusa’s coincidentia oppositorum and love. The address, given within weeks of a disabling injury suffered by Nishida’s wife, Kotomi, gives evidence of how severe personal crisis would come to influence his philosophical work, and highlights several themes that would dominate the writings of the last twenty-five years of his life.

In questa sua ultima opera Nishida Kitarō, padre indiscusso della moderna filosofia giapponese, si concentra sul sentimento religioso, analizzandolo attraverso una logica imperniata sul suo concetto di Nulla Assoluto, luogo ultimo in cui emergono realtà e ragione, mondo e uomo. Dialogando sulla soglia che unisce e separa la tradizione buddhista e quella cristiana, Nishida invita a pensare una religione della “trascendenza immanente”, del Dio che si svuota della sua divinità per donarla alle sue creature, del Buddha che sempre (...) è impresso nel cuore dell’uomo. Nella sua dettagliata introduzione, il traduttore, Tiziano Tosolini, ripercorre i concetti fondamentali che Nishida ha sviluppato lungo gli anni tentando di capire il retroscena filosofico che ha portato l’autore alla stesura de La logica del luogo e la visione religiosa del mondo. L’introduzione serve così da guida al lettore perché lo scritto di Nishida possa essere accolto come un testo su cui meditare, interrogarsi ed interagire. Solo così le parole di Nishida, il suo spirito indagatore e religioso, potranno risuonare in tutti coloro che si lasciano affascinare da un pensiero che ha avuto come suo unico e vero confine non tanto quello di una cultura e tradizione filosofica, ma quello più universale ed umano della ragione e della fede. (shrink)

_Ontology of Production_ presents three essays by the influential Japanese philosopher Nishida Kitarō, translated for the first time into English by William Haver. While previous translations of his writings have framed Nishida within Asian or Oriental philosophical traditions, Haver's introduction and approach to the texts rightly situate the work within Nishida's own commitment to Western philosophy. In particular, Haver focuses on Nishida's sustained and rigorous engagement with Marx's conception of production. Agreeing with Marx that ontology is (...) production and production is ontology, Nishida in these three essays—"Expressive Activity", "The Standpoint of Active Intuition", and "Human Being" —addresses sense and reason, language and thought, intuition and appropriation, ultimately arguing that in this concept of production, ideality and materiality are neither mutually exclusive nor oppositional but, rather, coimmanent. Nishida's forceful articulation of the radical nature of Marx's theory of production is, Haver contends, particularly timely in today's speculation-driven global economy. Nishida's reading of Marx, which points to the inseparability of immaterial intellectual labor and material manual labor, provokes a reconsideration of Marxism's utility for making sense of—and resisting—the logic of contemporary capitalism. (shrink)

Prevention and control of chronic conditions are global healthcare challenges. Patient self-management has been deemed essential for treating chronic conditions and improving the quality of patient life. However, the current Japanese system for supporting patient self-management of chronic conditions has received little ethical assessment. The first aim of this article is to provide an ethical analysis of current Japanese support for self-management of chronic conditions with reference to international discussions concerning self-management, developed mainly in western societies such as Europe, the (...) United States. The second aim is to clarify the challenges faced by Japanese biomedical ethics concerning selfmanagement support by focusing on the ethical concepts of quality of life and autonomy. This article identifies the following two challenges: [1] dispelling conceptual confusion concerning basic ethical concepts such as quality of life and autonomy, and [2] exploring the conceptual relationship between these ethical concepts, as they relate to providing support for chronically ill patients. By addressing these challenges and constructing a theoretical basis for radical change in support mechanisms, bioethics in Japan could contribute to efforts to construct a comprehensive support system for patients with chronic conditions, which organize variety kinds of supports, such as medical professional supports, supports from patient’s groups, local community supports, familial supports, support in patients’ workplace, and supports for patients’ family members as well. (shrink)

A system for analyzing concerns of people from Weblog articles is proposed. The system called KANSHIN analyzes concerns of people by collecting Japanese, Chinese, and Korean Weblog articles. Users can find concerns of people in each language. Users can also compare differences of concerns between Japanese, Chinese, and Korean language communities. We describe several analysis results: (1) patterns of social concerns, (2) change of focuses on a problem along with the time, (3) differences of concerns on a problem between Japanese, (...) Chinese, and Korean Weblog sites, and (4) relation between words in Weblog articles and real world natural phenomenon. (shrink)

In the near future, our life will normally be surrounded with fairly complicated artifacts, enabled by the autonomous robot and brain–machine interface technologies. In this paper, we argue that what we call the responsibility flaw problem and the inappropriate use problem need to be overcome in order for us to benefit from complicated artifacts. In order to solve these problems, we propose an approach to endowing artifacts with an ability of socially communicating with other agents based on the artifact-as-a-half-mirror metaphor. (...) The idea is to have future artifacts behave according to the hybrid intention composed of the owner’s intention and the social rules. We outline the approach and discuss its feasibility together with preliminary work. (shrink)

In many countries, prenatal testing for certain fetal abnormalities is offered via publicly funded screening programs. The concept of reproductive autonomy is regarded as providing a justificatory basis for many such programs. The purpose of this study is to re‐examine the normative basis of public prenatal screening for fetal abnormalities by changing our perspective from that of autonomy to obligation. After clarifying the understanding of autonomy adopted in the justification for public prenatal screening programs, we identify two problems concerning this (...) justification: first, the extent to which the government is obliged to meet this demand is not evident; and, second, it is not clear whether the provision of public screening is the most appropriate way to promote autonomy. Next, to tackle these problems, we focus on Onora O’Neill’s argument of rights and obligations. Drawing on this argument, we show that, in addressing the problems above, it is important to change our normative perspective from rights or autonomy to obligation. Our argument will show that since the government does not have an incontrovertibly fundamental obligation to promote autonomy, this obligation needs to be constrained in terms of compatibility with other fundamental obligations. In addition, even if a government is obliged to promote autonomy to some degree, there could be more appropriate means to achieve it than providing public prenatal screening; therefore, it is not necessary for government obligations to extend to the provision of public prenatal screening. (shrink)

Early animal embryos are patterned by localized egg cytoplasmic factors and cell interactions. In invertebrate chordate ascidians, larval tail muscle originates from the posterior marginal zone of the early embryo. It has recently been demonstrated that maternal macho‐1 mRNA encoding transcription factor acts as a localized muscle determinant. Other mesodermal tissues such as notochord and mesenchyme are also derived from the vegetal marginal zone. In contrast, formation of these tissues requires induction from endoderm precursors at the 32‐cell stage. FGF–Ras–MAPK signaling (...) is involved in the induction of both tissues. The responsiveness for induction to notochord or mesenchyme depends on the inheritance of localized egg cytoplasmic factors. Previous studies also point to critical roles of directed signaling in polarization of induced cells and in subsequent asymmetric divisions resulting in the formation of two daughter cells with distinct fates. One cell adopts an induced fate, while the other assumes a default fate. A simple model of mesoderm patterning in ascidian embryos is proposed in comparison with that of vertebrates. BioEssays 24:613–624, 2002. © 2002 Wiley Periodicals, Inc. (shrink)