Letter from Kyoto - The Paradigm of the U.S.- Japan Bioethics Congress

- Masahiro Morioka,

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

Eubios Ethics Institute Newsletter 4 (September, 1994) 58.

September 2-4 we had the U.S.-Japan Bioethics Conference at Sophia University, Tokyo. The lectures and discussions were interesting. After hearing most of them, I came back to Kyoto and caught a cold. And I was thinking about this bioethics conference for several days in bed.

One of the points we discussed was whether American bioethics is or ought to be "universal." Some American bioethicists seemed to believe that bioethics, especially the concept of "informed consent," should be universal, hence it should be applied in Japan as well. In contrast, some Japanese scholars stressed that American style individualism does not work well here in Japan, so that informed consent has to be applied not as a doctor-patient contract, but as a mutual agreement among patient, doctor, and patient's family.

Dr.Engelhardt Jr.'s comment was interesting. He said that every culture has two aspects, traditional and modernized. The U.S. and Japan are no exception. However, people sometimes try to compare the modernized aspect of American culture and the traditional aspect of Japanese culture. And this kind of comparison is apt to lead us to nonsense. I am not sure about American culture, but concerning Japanese culture his comment is right. Japanese society is rapidly changing from traditional to modernized one. Over the past ten years young people have become "individualistic" and adults have repeatedly lamented their children's individualism.

Yes, Japan is changing. But what about the United States? Is individualism still almighty in the U.S.? Some American bioethicists talked about "virtue" and "caring" in that conference. Some of my friends who have studied ethics in the U.S. said to me that for years principle-based bioethics has been severely attacked from physicians and clinical ethicists. Does this mean American bioethics shifted its centre of gravity toward contextual and communitarian ethics? If so, sometime in the 21st century American bioethics and Japanese might become similar, and a kind of "universalism" might be attained between them. Suffering fever in bed such a day dream came to my mind. Universalism between two industrialized North countries. Probably the paradigm of the U.S.-Japan bioethics conference aims at this beautiful dream. However, poor third world countries are put aside out of this paradigm. A Japanese professor asked what value informed consent have in countries where people have scarce medical resources, and they fear war, cholera, and starvation. This question may seem to be rhetorical, but I must say the comparison between rich two countries, for example the U.S. and Japan, is no longer fruitful. The U.S. and Japan have already had very similar infrastructure of modern civilization. The differences are small. We enjoy MTV, and Americans enjoy "Lion King", a parody of a classic Japanese cartoon "the King of Jungle."

We have to have international perspective, and look at this planet from various angles. The United States sells a great deal of weapon to third world countries. Does the U.S. get informed consent from those countries when she sells weapon to them? Is that consent "free" and "equal" one? This must be an important topic in international bioethics. And this is the point we will have to concentrate on.

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