Is there only one bioethics? Is a global bioethics possible? Or, instead, does one encounter a plurality of bioethical approaches shaped by local cultural and national traditions? Some thirty years ago a field of applied ethics emerged under the rubric `bioethics'. Little thought was given at the time to the possibility that this field bore the imprint of a particular American set of moral commitments. This volume explores the plurality of moral perspectives shaping bioethics. It is inspired by Kazumasa (...) class='Hi'>Hoshino's critical reflections on the differences in moral perspectives separating Japanese and American bioethics. The essays include contributions from Hong Kong, China, Japan, Texas, the United States, Germany, Switzerland, and Italy. The volume offers a rich perspective of the range of approaches to bioethics. It brings into question whether there is unambiguously one ethics for bioethics to apply. (shrink)

There are two contrasting views on the decision-making for life-sustaining treatment in advanced stages of dementia when the patient is deemed incompetent. One is to respect the patient's precedent autonomy by adhering to advance directives or using the substituted judgement standard. The other is to use the best-interests standard, particularly if the current judgement on what is best for the incapacitated patient contradicts the instructions from the patient's precedent autonomy. In this paper, I argue that the protracted clinical course of (...) dementia over many years requires the extended perspective of a progressive decision-making process—extended in both social space and time. The ongoing debate between these two competing views has missed this perspective by focussing on an exclusive disjunction between the competent former self and the incompetent current self. Drawing on theories of situated cognition in cognitive science, I will show that the cognition of a demented patient can be viewed as extended and embodied by her supportive social environment. As the disease progresses, the content of the mind of a demented person becomes partially constituted by such external resources along with her diminishing intrinsic mind. With this understanding, medical decision-making for a demented patient can be construed as a temporally and socially extended practice. A collective decision-making body consisting of the patient, her family and surrogates, and the clinician, should make progressive decisions as a whole over years of the disease course. Finally, I will provide a practical example of how this proposal can be applied in clinical practice. (shrink)

BackgroundThis essay provides an ethical and conceptual argument for the use of informed consent prior to the diagnosis of brain death. It is meant to enable the family to make critical end-of-life decisions, particularly withdrawal of life support system and organ donation, before brain death is diagnosed, as opposed to the current practice of making such decisions after the diagnosis of death. The recent tragic case of a 13-year-old brain-dead patient in California who was maintained on a ventilator for over (...) 2 years illustrates how such a consent would have made a crucial difference.MethodsConceptual, philosophical, and ethical analysis.ResultsI first consider a conceptual justification for the use of consent for certain non-beneficial and unwanted medical diagnoses. I suggest that the diagnosis of brain death falls into this category for some patients. Because the diagnostic process of brain death lacks the transparency of traditional death determination, has a unique epistemic structure and a complex risk-benefit profile which differs markedly from case to case, and presents conflicts of interest for physicians and society, I argue that pre-diagnostic counseling and informed consent should be part of the diagnostic process. This approach can be termed as “allow cardiac death”, whose parallel logic with “allow natural death” is discussed. I also discuss potential negative impacts on organ donation and health care cost from this proposal and offer possible mitigation. I show that the pre-diagnostic counseling can improve the possibility for well-thought-out decisions regarding organ donation and terminating life-support system in cases of hopeless prognosis. This approach differs conceptually from the pluralism of the definition of death, such as those in New Jersey and Japan, and it upholds the Uniform Determination of Death Act.ConclusionsMy intention is not to provide an instant panacea for the ongoing impasse of the brain death debate, but to point to a novel conceptual ground for a more pragmatic, and more patient- and family-centered approach. By enabling the family to consent to or decline the diagnostic process of brain death, but not to choose the definition of death, it upholds the current legal definition of death. (shrink)

サイエンス・ウォーズそのものを扱った長編論文。サイエンス・ウォーズという現象が起きた理由を理論的に跡づけるために、その学問的背景に関する分析の試み。そして、ケーススタディという構成。.

The Japanese government took significant steps in making decisions about a newly developing clinical application of gene therapy when, on April 15, 1993, the Government officially accepted the Guidelines for Clinical Research on Gene Therapy submitted by the Health Science Council of the Ministry of Health and Welfare of Japan to the Minister.

Nakamura proposed two three-valued temporal logics. We present two extended Gentzen-type formulations of these logics. Then we prove the soundness as well as the completeness theorem.

This chapter traces the evolution of Japan's systems of household and land registration from c.1600 to the period of early Meiji reforms in the 1870s and 1880s, with due attention to the distinction between a system designed by the state and local forms of registration practice. In the section on the pre-Meiji period, one such local practice of having people ‘disowned’ and its consequence — registerlessness — is examined. The section on the Meiji reforms and the section that follows turn (...) to the issue of continuity and discontinuity, and the question of whether any progress was made by those reforms. In order to illustrate the actual changes that took place at the local level, the chapter begins with an eighteenth-century story about a peasant woman and ends with a case of a family dispute that another village woman brought before the court some 120 years later. (shrink)

This study investigates interpretations of the Japanese initial mora-based minimizer “X.Y...”-_no_ “X”-_no ji-mo_ ‘lit. even the letter “X” of “X.Y...”.’ Although initial mora-based minimizers have a literal interpretation of _ji_ ‘letter’, they have a non-literal interpretation as well. The non-literal interpretation has several distinctive features that are not present in ordinary minimizers. First, it is highly productive in that various expressions can appear in the form “X.Y...”-_no_ “X”-_no ji_. Second, non-literal minimizers typically co-occur with predicates that relate to knowledge, information, (...) concepts, thought, and habituality, as seen in the corpus data (Balanced Corpus of Contemporary Written Japanese [BCCWJ]). I argue that in the non-literal use, X refers to the minimum on the scale of the main predicate concerning “X.Y...”. I suggest that the non-literal use was developed as a result of the conventionalization of the pragmatic inference derived from the literal reading, and that the co-occurrence with predicates related to knowledge, information, knowledge, concepts, thought, or habituality is due to the interpretation of “X.Y...”, which were originally interpreted as letters as an abstract concept. The theoretical implication of this study is that, in addition to a non-compositional (lexically specified) minimizer whose scale is lexically fixed (e.g., _give a damn_, _lift a finger_), there also exists a compositional (lexically unspecified) minimizer in natural language, whose scale is specified via the predicate with which the minimizer co-occurs. The last section of this paper briefly discusses similar/related phenomena in Bosnian/Croatian/Serbian, Korean, and English from a cross-linguistic perspective. (shrink)

Naturalistic teleological accounts of mental content rely on an etiological theory of function. Nanay has raised a new objection to an etiological theory, and proposed an alternative theory of function that attributes modal force to claims about function. The aim of this paper is both to defend and to cast a new light on an etiological theory of function. I argue against Nanay’s “trait type individuation objection,” suggesting that an etiological theory also attributes modal force to claims about function. An (...) etiological theory of function can be thought to analyze claims about function with modal force, not relying on any theory of counterfactuals. (shrink)

This study investigates the meanings of the Japanese low-degree modifiers _kasukani_ ‘faintly’ and _honokani_ ‘approx. faintly’ and the English low-degree modifier _faintly_. I argue that, unlike typical low-degree modifiers such as _sukoshi_ ‘a bit’ in Japanese and _a bit_ in English, they are sense-based in that they not only semantically denote a small degree but also convey that the judge (typically the speaker) measures the degree of predicates based on their own sense (the senses of sight, smell, taste, etc.) at (...) the level of conventional implicature (CI) (e.g., Grice (in: Cole, Morgan (Eds.), Syntax and semantics iii: speech acts, Academic Press, New York, 1975), Potts (The logic of conventional implicatures, Oxford University Press, Oxford, 2005), McCready (Semant Pragmat 3:1–57, 2010. https://doi.org/10.3765/sp.3.8, Sawada (Pragmatic aspects of scalar modifiers. Ph.D. Dissertation, University of Chicago, 2010), Gutzmann (Empir Issues Syntax Semant 8:123–141, 2011)). I will also show that there are variations among the sense-based low-degree modifiers with regard to (i) the kind of sense, (ii) the presence/absence of positive evaluativity, and (iii) the possibility of direct measurement of emotion and will explain the variations in relation to the CI component. A unique feature of sense-based low-degree modifiers is that they can indirectly measure the degree of non-sense-based predicates (e.g., emotion) through sense (e.g., perception). I show that the proposed analysis can also explain the indirect measurement in a unified way. This paper shows that like predicates of personal taste such as _tasty_ (e.g., Pearson (J Semant 30(1):103–154, 2013. https://doi.org/10.1093/jos/ffs001 ), Ninan (Proc Semant Linguist Theory, 24:290–304, 2014. https://doi.org/10.3765/salt.v24i0.2413 ), Willer & Kennedy (Inquiry, 1–37, 2020. https://doi.org/10.1080/0020174X.2020.1850338 )), sense-based low-degree modifiers trigger acquaintance inference. The difference between them is that, unlike predicates of personal taste, sense-based low-degree modifiers co-occur with gradable predicates and their experiential components signal the manner/way in which the degree of the predicate in question is measured. (shrink)

The social and cultural causes behind the widespread use and acceptance of robots in Japan are not yet completely understood. This study compares humans and robots in images gathered through Google searches in Japanese and in English. Numerous pictures obtained by the search in Japanese were found to have a human and a robot looking together at something else (“third item”), whereas many of the images acquired by search in English show a human and a robot facing each other. This (...) is similar to the composition of mother and child in paintings: in _ukiyo-e_ that was painted mainly in the Edo period of Japan, the mother and child are often depicted together viewing something other than themselves, whereas this is not the case in Western paintings of mother and child. It has also been pointed out that, in modern Western paintings, the world inside the picture is separated from the outside world, forming an independent microcosmos, whereas the inside and outside are continuous in Japanese paintings. These may indicate that, in Japanese society, robots are to a certain extent regarded as fellow human beings who can share the third item. In Western society, on the other hand, no code is embedded that can fix robots’ superiority or inferiority to humans, which would easily trigger an antagonistic view toward artificial intelligence (AI)/robots as threatening entities, as shown in most of Western literature and movies. We suggest that such cultural characteristics of Japanese society can contribute to enhance coexistence with AI/robots. (shrink)

This paper replies to Nanay’s response to my recent paper. My suggestions are the following. First, “should” or “ought” does not need to be deontic. Second, etiological theories of function, like provability logic, do not need to attribute modal force to their explanans. Third, the explanans of the homological account of trait type individuation does not appeal to a trait’s etiological function, that is, what a trait should or ought to do. Finally, my reference to Cummins’s notion of function was (...) intended to note that the homological account is permitted to use this non-etiological notion of function. (shrink)

This paper investigates the semantics of measure phrases in Japanese. Based on new data, we argue that the interpretation of measure phrases in Japanese is sensitive to scale structure such that (i) measure phrases are introduced by a degree morpheme that selects only for gradable predicates whose scale contains a minimal element (i.e., a lower closed scale) and (ii) violations to this restriction are repaired via coercion, which forces a comparative interpretation with a contextually determined standard and hence a minimal (...) element. We compare the Japanese facts to data in other languages and argue that the requirement of having a minimal element is not specific to Japanese, but universal. We show that languages may vary in how they deal with potential violations of this universal constraint, including coercion of a contextually recoverable derived minimal element (Japanese), ungrammaticality (e.g., Spanish, Korean, Russian), and a hybrid system of ungrammaticality for some adjectives and allowed constraint violation for others (e.g., English, German, Italian). (shrink)

In the half-century history of clinical practice of diagnosing brain death, informed consent has seldom been considered until very recently. Like many other medical diagnoses and ordinary death pronouncements, it has been taken for granted for decades that brain death is diagnosed and death is declared without consideration of the patient’s advance directives or family’s wishes. This essay examines the pros and cons of using informed consent before the diagnosis of brain death from an ethical point of view. As shared (...) decision-making in clinical practice became increasingly indispensable, respect for the patients’ autonomous wishes regarding how to end their lives has a significant role in deciding how death is diagnosed. Brain death, as a fully technologically controlled death, may require a different ethical framework from the old one for traditional cardiac death. With emerging and proliferating options in end-of-life care for those who suffer from catastrophic brain injury, the traditional reasoning that ‘death gives no choice, hence no consent’ requires another examination. Patients facing imminent brain death now have options other than undergoing the diagnostic workup for brain death, such as donation after circulatory death and withdrawal of life-sustaining treatment with maximum comfort measures for death with dignity. Nevertheless, just as in the debate over opt-in versus opt-out organ donation policies, informed consent before the diagnosis of brain death faces fierce opposition from consequentialists urging the expansion of the donor pool. This essay examines these objections and provides constructive replies along with a proposal to accommodate this morally required consent. (shrink)