Letter from Kyoto - Bioethics in an aging society

- Masahiro Morioka,

International Research Center for Japanese Studies, Nishikyo, Kyoto, Japan 610-11.


Eubios Ethics Institute Newsletter 4 (May, 1994) 30.

In the year 2025, one fourth of Japanese are estimated to be more than 65 years old. In the same year, one fifth of people in many European countries and the United States will be over 65. In the mid-21century people in the advanced countries will be faced with difficult problems arising from various facets of the aging society.

This means that bioethics in the 21 century in the advanced countries must change into "bioethics in an aging society." Bioethics in the 70s was conceived of by healthy middle-aged academicians in the United States as something where people hate old and ugly age, and even the elderly try to pretend to be young wearing colourful Aloha shirts living independently apart from their relatives.

Open the contents pages of typical American bioethics readings, Beauchamp and Walters' Contemporary Issues in Bioethics (third edition,1989). You cannot find any entries concerning ethical problems in an aging society. These well known readings have kept ignoring those issues from the first edition published in 1978 to the latest one. If bioethics is ethics concerning our own health problems in our society, it must include papers or essays which deal with those issues from an ethical point of view.

Of course, in the 80s many academic works appeared which discussed "ethics and an aging society." Health professionals have come to be aware of the future crisis of manpower (women's power?). For example Japan's birthrate dropped to 1.50 per a woman in 1992; it is clear from this that the number of people who take care of the old will become smaller and smaller compared with the number of the old appeared in the 21 century. This will surely create many difficult ethical problems in Japanese society.

I believe "ethics in an aging society" must be the core of the coming 21st century's bioethics in the advanced countries. We will have to discuss who has an obligation to take care of the aged; whether we have freedom not to take care of the aged in our family if we have enough money to hire someone else to care for them. We will have to think what is the best model for future aging society, for example, North European welfare society, society of equal opportunity as the United States, or family based society as China and Korea.

Japan will probably employ foreign Asian young workers as assistants for caring and nursing jobs by Japanese health specialists. Many Asian workers are now staying in Japan to make their living, and send money to their family waiting in their own country. In the near future, those foreign workers will come into health care fields and do "dirty and hard" jobs behind the scene. Is it really acceptable to hire foreign people for "dirty and hard" health care jobs? This has been a law of civilization. Europe and the United States have already experienced this.

Does ethics have no power before this firm and indisputable historical fact? I don't know. But I believe bioethics must think about this seriously,and put this issue in the forefront of today's bioethical thinking.

To think about aging society is to think about the South-North problem. The South-North problem in the global community, and the south-north problem hiding deeply in our own heart.


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