Commentary on Bunch

- Masahiro Morioka
CIAS, Osaka Prefecture University,
Gakuencho, Sakai, Osaka, 599-8531 Japan
International Network for Life Studies (

Eubios Journal of Asian and International Bioethics 10 (2000), 40.
The descriptions of how nurses think in clinical settings were very interesting. The author says that "the drama of the unit is hidden behind quiet voices and the hissing of the respirators," but once we understand the code of interpretation behind the silence, we are open to their real ethical dilemmas and their unspoken premises. I believe research of this sort should be encouraged in each country and tradition, then, we will be able to learn more from each other's experiences. The author says doctors and nurses respect each other in Norway. If this is really true, I envy this, because in Japan many nurses have severe frustration and a kind of grudge toward physicians. There are very few male nurses here. A magazine once published a special report on the status of nurses in Japan, and the title of that report was "Caste system in hospitals." This clearly shows the sentiment among nurses and paramedicals.

By the way, the drama is often observed between medical staff and the family members. This drama is sometimes performed with shouts, weeps, cries, or angers; but sometimes in a silent and hidden manner. I can not help asking the author this point. What kinds of drama were observed between them in your hospital? And what kind of attitude does the staff show to them? I am very interested in this because the emotional dimension of human relationships is to be analyzed in our clinical ethics. This has been one of my major points in recent years, but I want to emphasize again. If we are going to provide a good medical care, we will have to keep sound communication between the medial staff and the patient, and in the case of severely damaged patients, between the medical staff and the family members.

Glaser and Strauss, whom the author cites in her paper, did an intensive research on communications among the medical staff, patients, and the family in 1960s USA. Their strategy is effective even today. Research on contemporary medicine from the perspectives of social sciences, especially based on qualitative methods, is needed for us. Comparative study among different countries and co-operation between bioethics and social sciences are required. We do not have to stick to bioethics as discipline. I believe interdisciplinary "human relationship oriented research" should be encouraged, because quality of life of a patient heavily depends on the relationship he/she is involved in. As I did in my book, "Brain Dead Person" (1989), we should place more emphasis on "human relationship oriented research" in bioethics.

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