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The Future of BioethicsInternational Dialogues$
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Akira Akabayashi

Print publication date: 2014

Print ISBN-13: 9780199682676

Published to Oxford Scholarship Online: January 2014

DOI: 10.1093/acprof:oso/9780199682676.001.0001

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Barriers to Clinical Ethics Mediation in Contemporary Japan

(p.712) 20.2 Commentary
The Future of Bioethics

Atsushi Asai

Yasuhiro Kadooka

Oxford University Press

Here, the authors argue that it is unclear how clinical ethics mediation impacts clinical ethics consultation and education in the Japanese system. Activities to support clinical ethics are not authoritatively powerful enough to affect the final decision-making in clinical cases in Japan. In addition, no ethical or legal safeguards currently exist concerning decisions generated in the clinical ethics mediation process. As such, this process could fail to respect and protect the best interest and dignity of the patient in a family-centered atmosphere. Respect for the principle of harmony through conference and negotiation in unequal human relationships could yield imposition of collective decisions on unwilling individuals. Furthermore, the closed and exclusive tendency of the healthcare society, time constraints, and financial difficulty could obscure the effective and practical use of clinical ethics mediation. Some questions are also discussed here from the ethical standpoint.

Keywords:   Barriers, Confucianism, family-centered atmosphere, neutrality, ethical advice, ethical disagreement

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