Human rights and Japanese bioethics: a report from Japan

The main contentions of this paper are twofold. First, there is a more than century-old Japanese tradition of human rights based on a fusion of Western concepts of natural rights and a radical reinterpretation of Confucianism, the major proponent of which was the Japanese thinker Nakae Chomin. Secondly, this tradition, although a minority view, is crucial for remedying the serious defects in the present Japanese medical system.
In the latter half of the nineteenth century, Nakae Chomin sought to reinterpret Chinese tradition, especially Confucianism, by injecting the concepts of popular sovereignty and democratic equality, drawn from Western sources. The resulting view maintained the Confucian commitment to a moral nexus for society, but replaced hierarchy with egalitarianism.
The pressing need for such an approach to patients' rights in present-day Japan is illustrated by two recent cases: the photographing and commercial exploitation of patients' genitals without serious response by authorities, and the attempt by physicians to manipulate the time of death and, possibly, to improperly pressure family members in order to transplant organs from the brain-dead victim of a criminal assault.
Such problems stem from hierarchy and paternalism, which seem to be a legacy of the rapid, state-sponsored introduction of Western medicine in the mid-nineteenth century, and in particular from the government's adoption of and support for German military medicine as a model for Japan.     

The cholera epidemics and the development of public health in Meiji Japan. 1. Modernity, cholera, and health thought

We present here the beginnings of public health politics in Meiji Japan (1868-1912). Due to a two century isolation of Japan, public health concepts developed in the West from the end of the 18th century were foreign in premodern Japan. Due to its isolation, Japan was also relatively preserved from some acute infectious diseases such as cholera. In this paper, we investigate the role of cholera epidemics in the emergence of public health concepts in the peculiar context of Meiji Japan. We show that chronic diseases such as tuberculosis and leprosy were neglected for a long time and that the Meiji government set priority on acute infectious diseases that were considered as long as they disturbed public order. Nevertheless, some physicians and government officials considered issues of welfare and poverty. We also review some emerging concepts of social medicine. We try to show, that in Japan as well as in Western nations, public health politics were not exempt of contradictions and paradoxes and a permanent tension existed between coercitive policies and conceptions of welfare and rights to health.     

The cholera epidemics and the development of public health in Meiji Japan. 2. Strength and weakness of public health politics

We present here the beginnings of public health politics in Meiji Japan (1868-1912). Due to a two century isolation of Japan, public health concepts developed in the West from the end of the 18th century were foreign in premodern Japan. Due to its isolation, Japan was also relatively preserved from some acute infectious diseases such as cholera. In this paper, we investigate the role of cholera epidemics in the emergence of public health concepts in the peculiar context of Meiji Japan. We show that chronic diseases such as tuberculosis and leprosy were neglected for a long time and that the Meiji government set priority on acute infectious diseases that were considered as long as they disturbed public order. Nevertheless, some physicians and government officials considered issues of welfare and poverty. We also review some emerging concepts of social medicine. We try to show that in Japan as well as in western nations public health politics were not exempt of contradictions and paradoxes and a permanent tension existed between coercitive policies and conceptions of welfare and rights to health.     

Where is the origin of the Japanese gamecocks?

The tradition of cockfighting is widespread throughout the world. There is no doubt that the gamecock has evolved together with the human culture of cockfighting for a long time. In Japan, there is a group of gamecocks called "Shamo" that are used specifically for cockfighting. However, the process of the geographic distribution of cockfighting and the influx route of gamecocks into Japan are totally unclear. The molecular evolutionary study of gamecocks is obviously useful to gain profound insight into the understanding of not only the evolutionary origin of "Shamo" but also the distribution process of cockfighting as a culture. In this study, we collected blood samples of gamecocks from 11 different prefectures in Japan. Then, a phylogenetic tree was constructed using a total of 42 mtDNAs (D-loop, 1100 bp) sequenced. It showed that Japanese Shamo was clearly separated into two different groups: One group contains the samples from the island of Okinawa and the other group is composed of the samples mainly from Kyushu and Honshu of Japan. It suggests that Japanese Shamo must have been brought to Japan from two different origins. Our examination of historical records showed that the results of the phylogenetic analysis is consistent with the view that Japanese Shamo was originated from Southeast Asia and the mainland China independently, but was geographically a bit mixed afterwards.     

Parental refusal of life-saving treatments for adolescents: Chinese familism in medical decision-making re-visited

This paper reports two cases in Hong Kong involving two native Chinese adolescent cancer patients (APs) who were denied their rights to consent to necessary treatments refused by their parents, resulting in serious harm. We argue that the dynamics of the 'AP-physician-family-relationship' and the dominant role Chinese families play in medical decision-making (MDM) are best understood in terms of the tendency to hierarchy and parental authoritarianism in traditional Confucianism. This ethic has been confirmed and endorsed by various Chinese writers from Mainland China and Hong Kong. Rather than giving an unqualified endorsement to this ethic, based more on cultural sentimentalism than rational moral reasoning, we warn that a strong familism in MDM, which deprives 'weak' family members of rights, represents the less desirable elements of this tradition, against which healthcare professionals working in this cultural milieu need to safeguard. Specifically for APs, we suggest that parental authority and family integrity should be re-interpreted in terms of parental responsibility and the enhancement of children's interests respectively, as done in the West. This implies that when parents refuse to consent to necessary treatment and deny their adolescent children's right to consent, doctors, as the only remaining advocates of the APs' interest, have the duty to inform the state, which can override parental refusal to enable the doctors to fulfill their professional and moral obligations. In so doing the state exercises its 'parens patriae' power to defend the defenseless in society and the integrity of the medical profession.     

Reconciling international human rights and cultural relativism: the case of female circumcision

How can we reconcile, in a non-ethnocentric fashion, the enforcement of international, universal human rights standards with the protection of cultural diversity? Examining this question, taking the controversy over female circumcision as a case study, this article will try to bridge the gap between the traditional anthropological view that human rights are non-existent -- or completely relativised to particular cultures -- and the view of Western naturalistic philosophers (including Lockeian philosophers in the natural rights tradition, and Aquinas and neo-Thomists in the natural law tradition) that they are universal -- simply derived from a basic human nature we all share. After briefly defending a universalist conception of human rights, the article will provide a critique of female circumcision as a human rights violation by three principal means: by an internal critique of the practice using the condoning cultures' own functionalist criteria; by identifying supra-national norms the cultures subscribe to which conflict with the practice; and by the identification of traditional and novel values in the cultures, conducive to those norms. Through this analysis, it will be seen that cultural survival, diversity and flourishing need not be incompatible with upholding international, universal human rights standards.     

Western anthropological concepts in stateless societies: A retrospective and introspective look at the Dagaaba

Conclusion Anthropological legal concepts of the so-called primitive societies originally induced by prevailing Western philosophical ideas, political thought and jurisprudence require a serious review. The current emphasis by scholars in the anthropology of law on dispute processes in Africa is fulfilling an important need. Given the constantly transforming and unstable nature of modern African political systems, a clearer understanding of native concepts and fundamental value systems is essential. For instance, concepts such as ownership, property rights in land, legal obligation, individual or collective rights must be thoroughly understood within the framework of history and state transformation to be able to help to mediate and settle major inter and intra ethnic disputes in such areas as land tenure, marriage and succession.It is apparent that among the Dagaaba, the obligation to obey the law of the modern state is seriously complicated by the existing native concept of legal obligation which requires the evaluation of laws. To the extent that coercive sanctions are imposed, obedience may be achieved, but the values embodied in the laws may not be internalized. Thus, the laws of the modern state may simply constitute ordar (plural of ordir), that is, coercive commands with no necessary utility or rationality behind them. Such ordar would then not constitute a solid enough basis for dispute resolution when the modern legal system falters in a political crisis.The importance of continuing legal research in fundamental normative systems, concepts and values of tradition society can be seen from our discussion of legal obligation and the mental requirements for culpable conduct among the Dagaaba. These concepts help explain not only some of the institutional structures of the Dagaaba, but also the Dagaaba vision of their own native reality and the legal choices made. Without such studies, one would have only a partial view of African societies. Such research should employ original language techniques such that the full implications of concepts such as collective rights, individuality, and similar group-based legal rights and duties can be properly analyzed. With particular reference to the Dagaaba, further research should address the full implications of the yir, yiiluu and balu in terms of ownership, use of or access to property, and succession to various types of property. It should also examine the effects of customary, statutory and Christian marriage on the group concepts and the implications for succession to property. Since the Dagaaba appear to have been a male dominated society, it will be important in future work to focus attention on women's rights within the framework of these groups. Finally, to explore more fully the concept of balu and its legal implications fieldwork should include the Dagaaba in Burkina Fasso, where the concept appears to have been developed more functionally.Kojo Yelpaala is Professor of Law at the McGeorge School of Law, University of the Pacific, Sacramento, California.     

Treating Emotion-Related Disorders in Japanese Traditional Medicine: Language, Patients and Doctors

This paper analyses how the conceptual and therapeutic formation of Japanese traditional medicine (Kampo) has been socially constructed through interactions with popular interpretations of illness. Taking the example of emotion-related disorders, this paper focuses on the changing meaning of constraint (utsu) in Kampo medicine. Utsu was once a name for one of the most frequently cited emotion-related disorders and pathological concerns during the Edo period. With the spread of Western medicine in the Meiji period, neurasthenia replaced utsu as the dominant emotion-related disorder in Japanese society. As a result, post-Meiji doctors developed other conceptual tools and strategies to respond to these new disease categories, innovations that continue to influence contemporary practitioners. I begin this history by focusing on Wada Tōkaku, a Japanese doctor of the Edo period who developed a unique theory and treatment strategy for utsu. Secondly, I examine. Yomuto Kyūshin and Mori Dōhaku, Kampo doctors of the early twentieth century, who privileged neurasthenia over utsu in their medical practice. The paper concludes with a discussion of the flexibility and complexity of Kampo medicine, how its theory and practices have been influenced by cross-cultural changes in medicine and society, while incorporating the popular experience of illness as well.     

Introduction

Abstract

Japanese fishing in the coastal waters of China and Korea has often caused serious disputes and was, at times, held by these two countries as a political pawn against Japan. Fishery disputes between Japan and Korea date from the fifteenth century, but culminated in an unprecedented hostility over fourteen years up to 1965. The fisheries agreement of 1965 restored peace between the parties, but is in need of review. Since 1955 fishery relations between China and Japan are regulated by nongovernmental arrangements. Preparations are under way for a formal agreement, whereupon Japan will seek to remove some of the restrictions imposed on its fishermen by China. An ideal method to regulate fishing in such enclosed waters as the Yellow and East China Seas is to conclude a multilateral treaty. Apart from the political relations among the coastal states, the outcome of the Third Law of the Sea Conference may improve the prospect.     

The Dilemma of Science and Morals

The conflicts between science and morals which still continue to arise despite the apparent hegemony of atheistic scientism over traditional Judeo-Christianity in the twentieth century reflect a basic contradiction in the metaphysical foundation of Western lives. As was set forth by Machiavelli, the contradiction inherent in Western ethics is that it is based on the simultaneous belief in both objectively valid moral truths and purely relative values of communal purpose. The achievements of twentieth century science have intensified these contradictions. Modern physics has put in question the validity of its own metaphysical basis, namely the belief in Natural Law, and modern biology has been unable to come to terms with the Cartesian dualism of body and soul. By contrast, Chinese lives are comparatively free of these contradictions, being founded on the philosophies of Confucianism and Taoism, to which the concepts of objectively valid truth or Natural Law are foreign. Recent developments in Western attitudes regarding science and morals can be interpreted as a movement away from the traditional belief in absolute truths towards a Chinese relativism.     

Translational research in immunology: Japanese perspectives

Japan has a formidable tradition in immunological research, starting with Shibasaburo Kitasato (1852-1931), who, after returning to Japan from his studies with Robert Koch, went on to build almost single-handedly a research tradition in investigative medical research, while engaging himself in the fight against infectious diseases. Over the past few decades, Japanese immunologists have been involved in many important discoveries at the forefront of immunological research, yet, when it comes to the translation of new discoveries into clinical innovations and new therapies, Japan's track record seems more modest.     

Tibetan 'wind' and 'wind' illnesses: towards a multicultural approach to health and illness

This article discusses the Tibetan notion of rlung, usually translated as: 'wind', but perhaps better understood as a close equivalent of pneuma in the Greek tradition, or qi in the Chinese tradition. The article focuses on the way rlung provides a useful prism through which concepts of health, illness and disease may be observed in a cross-cultural perspective. An analysis of syndromes linked with rlung in a Tibetan cultural context illuminates some of the ways in which culture determines particular syndromes. The article raises a number of questions which are relevant for a more general multicultural approach to concepts of health, illness and disease. The article argues that notions of rlung/pneuma/wind/ qi constitute a particularly interesting area for an exploration of culture-bound syndromes, as they reside in the meeting point between material and non-material, physical and mental, as well as the psychological, spiritual and religious. They are hence fundamental for a more cross-cultural approach to the mind-body problem. The article also deals with the significance of history of medicine, particularly histories of medicine, which attempt to widen the scope of the traditional Eurocentric narrative of the history of medicine, in dealing with questions such as concepts of health and illness. Allowing alternative narratives-whether narratives of patients, other cultures or historical ones-can enhance our understanding of what health, illness and disease are. Discussing perceptions of the body as culturally defined is not only important from a philosophical or historical point of view, but also has important practical ramifications, which are particularly crucial in our global age.     

An ethics of dwelling and a politics of world‐building: a critical response to ordinary ethics

In this essay I provide a critical reading of so‐called ‘ordinary ethics’ in order to disclose how it ultimately undoes two of the three major contributions of the anthropology of moralities and ethics: that is, ordinary ethics ultimately equates morality/ethics with all social activity and at the same time only accounts for morality/ethics in terms of the moral concepts already provided by the Western moral philosophical tradition. In the second part of this essay I provide an ethnographic example from anti‐drug war political activism that shows how a critical hermeneutics provides a theoretical‐analytical framework for the radical rethinking of both the moral tradition and the social and political worlds that mobilize the concepts and assumptions of this tradition.     

Morals,suicide, and psychiatry: a view from Japan

In this paper, I argue that within the Japanese social context, the act of suicide is a positive moral act because the values underpinning it are directly related to a socially pervasive moral belief that any act of self–sacrifice is a worthy pursuit. The philosophical basis for this view of the self and its relation to society goes back to the writings of Confucius who advocated a life of propriety in which being dutiful, obedient, and loyal to one's group takes precedence over the desires of the individual selves that make up the group. I argue that this philosophical perspective poses formidable challenges to Japanese psychiatry (which accepts a contrary western perspective) because, as western psychiatry is based on the concept of autonomous individuality, the Japanese conceive of the self as socially embedded. Because suicide in Japan is viewed as a potentially honorable, virtuous, and even beautiful act of self–sacrifice expressing one's duty to one's group, the western perspective is quite foreign to the Japanese self–conceptual framework. Therefore, since Japanese psychiatry and law have embraced the western medical tradition of viewing suicide as a non–rational response to mental illness, which runs counter to the cultural view that suicide is a moral (and rational) act, I argue that western explanations of suicide present significant cross–cultural problems for Japanese psychiatry.     

An Unusual Xylotheque with Plant Illustrations from Early Meiji Japan

An Unusual Xylotheque with Plant Illustrations from Early Meiji Japan. Two unusual wood collections, reported previously in the collections of the Botanical Museum at Berlin-Dahlem and the Royal Botanic Gardens, Kew, take the form of framed plant illustrations painted on boards made from the wood of the species illustrated. We present new finds of very similar wood collections in the Economic Botany Collection of the Harvard University Herbaria, a private collection in the U.K. (Loudon collection), and at the Koishikawa Botanical Garden of the University of Tokyo. A stamp on the reverse of the boards links all five collections to Chikusai Kato, an artist working at Tokyo University (now the University of Tokyo) in early Meiji Japan, under the direction of the preeminent nineteenth century Japanese botanist Keisuke Ito. New evidence from contemporary historical accounts indicates that more than 100 boards were ordered in June 1878 by Hiroyuki Katō, the first president of Tokyo University, most likely to support the early teaching of Western-influenced botanical science in Japan. However, while the boards had clear value for teaching, especially about useful plants, their unusual fusion of Western and Japanese influences also made them desirable craft objects that were collected and given as gifts during the early Meiji era.     

The Firefly and the Trout: Recent Shifts Regarding the Relationship Between People and other Animals in Japanese Culture

ABSTRACT

Scholars of Japan like to point out that the Japanese are interested in tamed (miniature trees, ikebana, gardens) as opposed to wild nature, and that for the Japanese, culture and nature are not mutually exclusive concepts. Moreover, there hardly seems to be any direct relationship between the Japanese sensitivity to nature and Japanese environmental behaviour. Bearing these general assumptions in mind, this paper analyzes the changes in the relationship between the Japanese and animals through two recent movements in Japan: firefly protection and fly fishing.

This study is based on interviews and participant observation among several firefly protection groups in the Kansai area from 1989 to 1997, among fly-fishing fishermen, and in fishing cooperatives of Gifu prefecture since 1997. In order to ascertain tendencies regarding new shifts in attitudes toward animals, specific observations regarding each of these issues will be disregarded so as to deal only with the commonalities. The similarities between the movements are indeed striking. Traditionally caught by the thousands, and released in houses and gardens for people's enjoyment, fireflies play a role in linking humans with what the Japanese call “close nature.” The firefly image is also very conspicuous in poetry and art. But the firefly population declined in the 1950s, and they are now being protected through drastic legal and social policies, partly influenced by Western environmentalism. The issue of firefly protection is entangled in a criss-cross of interests involving environmental concerns, urban renewal policies and the revival of depopulated rural areas, for which the firefly has become a widely used symbol. At the same time, the movement for firefly protection is highly critical of the traditional ways of dealing with fireflies. Similarly, despite the existence of a traditional Japanese method of “fly-fishing” (tenkara), the recent fly fishing boom seems to be the result of environmental trends such as the “outdoor boom,” and the “catch and release” method.

The introduction of a new fishing technique and the emergence of a consciousness and a commitment to protect fauna and flora disrupted the complex traditional relationship between humans and certain species of animals in both cases. And in both cases, the new approach to nature provoked a strong “cultural resistance” to the loss of the specific Japanese way of dealing with animals. Like “woodpigeon hunting” in southern France, or the whaling issue in other cultural areas, these phenomena appear to be symptomatic of the opposition between tradition(al culture) and environmental concerns. Indeed, the objectification of nature that underscores environmental concern is only possible through a distancing from nature, in which people differentiate and disassociate themselves from other animals… a very “un-Japanese” idea.     

Perceptions and uses of Chinese medicine among the chinese in Hong Kong

The present paper was based on both qualitative observations and quantitative survey data. Major findings are as follows: (1) The sacred or magical-religious tradition of Chinese medicine is accepted by a relatively small portion (roughly one-fifth) of the ordinary Chinese people in urban Hong Kong, and is relatively more popular among women or less educated people. (2) Both the classical-professional and the local-empirical traditions of secular medicine are resorted to by many Chinese people (over one half) either for treating diseases or for strengthening their constitution. The acceptance of secular Chinese medicine does not vary significantly among different sex, age, education, or income groups. It should be noted that secular Chinese medicine is often used in addition to or in combination with modern Western medicine. (3) It appears that most people are more confident in the Chinese medical tradition than in Chinese-style practitioners in Hong Kong, and that people's confidence in secular Chinese medicine has been increasing in recent years. (4) There are reasons for the confidence in secular Chinese medicine. Chinese medicine is generally perceived to be better than or as good as Western, scientific medicine in some ways, such as for tonic care, for fewer side effects, for curing the cause (not symptoms) of diseases, and for treating certain diseases. Therefore, to ordinary Chinese people, Chinese and Western medicine may perform either equivalent or complementary functions. (5) As regards the process of seeking medical care, most people seem to follow the pattern of moving from self-medication, using Chinese and/or Western home remedies, to Western-style doctors, to Chinese-style practitioners, and finally to a Western medical hospital. Policy and theoretical implications of these findings are discussed.     

Study on the ethical concepts of the Japanese writer Yukio Mishima, ultra-nationalist

After WWII, ultra-nationalism, which was the leading ideology of wartime Japan, seemed to have lost its power to inspire the Japanese. In the 1960s, when the Japanese began to enjoy economic prosperity, Yukio Mishima, deploring that the Japanese were losing the traditional spirit and morality of the nation, was one of those citizens who felt a strong nostalgia for wartime Japan. In an attempt to revive the spiritual exaltation of wartime Japan, Mishima took radical action as an ultra-nationalist, and killed himself by Hara-kiri. Mishima's ethical concepts, which center on the ethos of warriors who dedicate themselves to the defense of their commune, have structural similarities to the ethical structure of the Kanun, which may be called the ethics of "blood". Mishima's theory of ultra-nationalism has a paradoxical logic, which seems to be related to the ethical concepts of a society without state power.     

The Production of Tradition and Culture in the Japanese Wedding Enterprise

In this article I examine the production of culture in the contemporary commercial Japanese wedding. This is analyzed in relation to the theoretical discourse of ‘the invention of tradition’. However, while this ‘invention’ is usually related to political motivations, I discuss the invention of tradition and of culture for economic motivations. I offer a broader perspective of tradition and culture and show how flexible these two may be as they are manufactured, played with or imagined. The contemporary wedding consists of both ‘traditional-Japanese’ and ‘Western’ inventions. These are regarded here as cultural constructs which both play a significant role in the construction of contemporary Japanese cultural identity.