Why Can’t Japanese People Decide?—Withdrawal of Ventilatory Support in End-of-Life Scenarios and Their Indecisiveness
According to a recently updated survey on end-of-life care conducted by the Ministry of Health, Labour and Welfare (Japan) in 2017, the collective intention regarding end-of-life care has not yet reached a consensus. Within the general public, 66.0% (n = 973) approved of the idea of preparing written advance directives that describe the type of medical care or treatment they wish to receive (or not) if they were to become unable to make a decision. However, 91.3% (n = 642) of these had not actually written out any advance directives (MHLW 2018). In other words, while many Japanese think that it would be good to express their intentions about the end of their lives, most have not actually put this into action. Even when the sample population was limited to elderly over 60 years of age, 85.0% did not have anything in writing, despite agreeing that this would be a good idea (MHLW 2018). These results are fairly consistent with those from a survey conducted in 2013 (MHLW 2014).
This study was supported by Pfizer Health Research Foundation.
Compliance with Ethical Standards
Conflict of Interest
Although AA is President of the Japan Association for Bioethics (JAB), this paper reflects the authors’ personal academic analyses and opinions. It does not represent JAB’s official position on this issue. The other authors have no conflict of interests to declare.
- Doi, Takeo. 1971. The Anatomy of Dependence. Tokyo: Kodansha International.Google Scholar
- Johnson, Frank A. 1993. Dependency and Japanese socialization: psychoanalytic and anthropological investigations into amae. New York, NY: New York University Press.Google Scholar
- Lock, M. 2001. Twice dead: Organ transplants and the reinvention of death. Berkeley, CA: University of California Press. Google Scholar
- MHLW: Ministry of Health, Labour and Welfare (Japan). 2014. Report of the awareness survey on end-of-life medical treatment https://www.mhlw.go.jp/file/05-Shingikai-10801000-Iseikyoku-Soumuka/0000041847_3.pdf. Accessed 11 Nov 2019.
- MHLW: Ministry of Health, Labour and Welfare (Japan). 2018. Report of the awareness survey on end-of-life medical treatment. https://www.mhlw.go.jp/toukei/list/dl/saisyuiryo_a_h29.pdf. Accessed 11 Nov 2019).
- Nakane, Chie. 1970. Japanese society: a practical guide to understanding the Japanese mindset and culture, 80–83. Tokyo: Tuttle Publishing.Google Scholar
- The Mainichi Newspapers. 2018. End-of-life care: emphasis on confirming intention of withdrawal of life-sustaining treatment―Liberal Democratic Party considers new law. 16 September 2018, morning edition. https://mainichi.jp/articles/20180916/ddm/001/040/203000c. Accessed 13 Nov 2019.