Challenges of Japanese Doctors' human experimentation in China for East-Asian and Chinese bioethics: Commentary on Tsuchiya

Jing-Bao Nie, MD (tcm), PhD
Lecturer, Bioethics Centre,
University of Otago, P.O. Box 813, Dunedin, New Zealand

Eubios Journal of Asian and International Bioethics 11 (2001), 3-7.

Introduction I must have heard about the phrase “Japanese doctors’ human experimentations in China” in the course “History of Chinese Communist Party” (with “Marxist Philosophy” and “Political Economy,” a universally required course for college and university students in China then). The phrase, however, did not make much sense to me until sometime in the early 1980s when I watched, together with my fellow medical students, a movie titled “The Black Sun 731” at the assembly hall of Hunan College of Chinese Medicine in Changsha. I cannot remember where the movie was originally made, but not in Mainland China for sure. Horrible images in the movie had given me nightmares for a few nights. Even today I still remember a half-naked frozen Chinese man being checked by a Japanese doctor with a stick in a freezing field of ice and snow. I was horrified, angered, and puzzled. Nevertheless, the most natural question seemed never to occur to me: “How medical doctors who are supposed to relieve human sufferings and save lives can do such things to other human beings?” The whole education we received up to that point had taught that Japanese soldiers, including military doctors, are guizi (devils or monsters), not only enemies of Chinese people but also not really fellow human beings. Like other “class enemies,” they were no more than cruel beasts, belonging to a totally different category.

In spite of some initial intense reactions to the movie, the horror, anger and perplexity that resulted from watching it did not last long. That movie and those feelings soon elapsed into the deep memory and slept soundly there. They appeared to be completely out of my consciousness as I was immersed in the business of ordinary life. I did not come across the subject again until the middle 1990s. First, while studying medical humanities at Galveston, Texas, I noticed how significant the Nuremberg Trial on Nazi doctors’ human experimentation and the Nuremberg Code was for the birth and development of bioethics in the West. I also happened to notice the existence of two book-length studies in the English language on the topic—Peter Williams’ and David Wallace’s Unit 731: Japan’s Secret Biological Warfare in World War II (The Free Press, 1989) and Sheldon Harris’ Factories of Death: Japanese Biological Warfare 1932-45 and the American Cover-up (Routledge, 1994).

Later, I met the Japanese philosopher Takashi Tsuchiya in person for the first time in 1997 while accompanying a team of Chinese scholars to visit some major bioethics programs in the USA. At that time, he was a visiting scholar at the Kennedy Institute of Ethics in Georgetown University. In our meeting with him, Prof Tsuchiya sincerely apologized to us for what Japanese doctors had done in China half a century ago. He also informed us that he was conducting research on the topic and offered some preliminary, but stimulating, ideas. I have always been a zealous admirer of Japanese culture, especially the great capacity Japanese people have in absorbing and integrating the good elements of other civilizations, such as Chinese and Western, to create their own. Tsuchiya’s apology made me admire Japanese people even more because it confirmed and assured me once again on the bright and great side of Japan.

What Shirio Ishii, the surgeon general in charge of inhuman human experimentation in China, and his followers represented is, (no matter how dark it is,) only one part of Japanese civilization. In fact, to a great degree, what Ishii and his followers represented is not specifically Japanese, but the evil force universally existing among human beings, something that has been called the “basic evil human nature” in the moral philosophy of the ancient Chinese thinker Xun Zi (Hsun Tzu) or the “original sin” in Judeo-Christianity or the “death instinct” in Freud’s psychology. Among many others, Tsuchiya’s apology urged me, a Chinese, to ask myself: Ought not China and Chinese people apologize to Vietnamese for invading Vietnam in 1979 and destroying lives and properties there, to Cambodians for supporting the Khmer Rouge in its regime more than two millions of innocent Cambodians were killed or died for un-natural reasons, and to Northern Koreans for supporting the government whose misgoverning resulted in disasters for thousands and thousands Korean people?

Therefore, it was with great interest that I read Tsuchiya’s significant article “Why Japanese doctors performed human experiments in China 1933-1945”, EJAIB 10 (2000), 179-80, and Professor Masahiro Morioka’s brief but thought-provoking commentary. In his article Tsuchiya first lists four major types of inhuman human experiments conducted by Japanese doctors: vivisections on Chinese prisoners for training newly employed army surgeons intentional infection of many diseases such as plague, cholera and typhoid trials of unusual and non-established “treatments” and studies on the tolerance of the human body for extraordinary circumstances. He also gives four explanations as to how the mass murder could have happened: the belief that in wartime everything is justifiable for the purpose of winning the war the deep and widespread prejudice of Japanese against Chinese and other Asian people as well as the fear of communism the idea of not wasting those arrested suspected spies or resisters who would be executed, usually without trial, anyway and the loss of common sense of humanity among researchers when the experimentation was performed secretly. Moreover, he discusses three factors why the doctors who were formally normal academic researchers did not avoid participating in the mass murdering: the prevailing pressure from a fascist society over the individual the authoritarian and hierarchical structure of Japanese medical schools and the attraction of “luxurious” research facilities and resources in factories of death like the most infamous Unit 731. He concludes that in order to forever prevent the kind of outrageous enterprise, it is necessary to critically examine the absolute authoritarian feature of the medical system in Japan and the authoritarian character of Japanese and East-Asian values, which, according to Tsuchiya, constitute the socio-cultural basis of the atrocities committed by Japanese doctors.

I have learnt a lot from Tsuchiya in talking with him and reading his article. Tsuchiya’s moral courage to break a taboo topic in his own country has deeply moved me. The question he raised and attempted to answer, “Why Japanese doctors and scientists conducted inhuman human experimentations in China?,” is absolutely important and extremely challenging. His historical-social analysis is incisive. The conclusions he has reached are insightful as well as provocative. Japanese doctors’ human experimentation is a subject that should have been widely and deeply discussed in the circles of Asian, especially Chinese and Japanese, medical ethics. Unfortunately and sadly, this has never happened. Finally, in the last years of the 20th century, Tsuchiya and Morioka have initiated serious moral and ethical reflections on a human-made tragedy occurred in Asia in the early-middle of the century.

Bioethics is attracting more and more attention in East Asia including Japan and China. Bioethics is certainly alive in East Asia, but is it well? A salient sign to tell whether or not East-Asian bioethics is healthy is how the subject of Japanese doctors’ human experimentation has been treated. If the topic is by and large ignored or very much marginalized in East-Asian bioethics, one has reasons to doubt whether bioethics in East Asia has truly started. The topic “Japanese doctors’ inhuman human experimentation in China,” I believe, has many-sided and multi-level theoretical and practical implications for medical ethics in today’s Japan as well as China in particular, and bioethics in general.

Nazi and Japanese Doctors’ Human Experimentation: Same Atrocities with Different Historical Consequences Experimentation on human beings is probably as old as medicine since medicine has always been a business of trials and errors. Human experimentation can be very ethical, such as that Shennong (the Legendary Farmer) tested all plants on his own body to discover their therapeutical effects, or very unethical. Medical experimentation conducted by Japanese and Nazi doctors in the Second World War was undisputedly the most unethical, outrageous and abhorrent in the whole human history. A number of similarities exist between the experiments performed by Nazi and those undertakings by Japanese doctors. Both are intentionally killing, torturing and harming human beings in the name of medicine and science. In his commentary on Tsuchiya, Morioka emphasizes that Japanese bioethics should start “by the reflection of Japanese army Unit 731’s human experimentation” because “Western bioethics got started by the reflection of Nazi’s human experimentation.” Indeed, it is illuminating to compare and contrast the different responses to and historical consequences of Nazi and Japanese doctors’ medical killings in the West and in Asia.

In the West, Nazi doctors’ atrocities have been taken very seriously in past decades. Almost immediately after the World War II, the Nuremberg Tribunal headed by American judges brought to trial of 23 Nazi physicians, professors and medical administrators for “crimes committed in the guise of scientific research.” Seven of them were sentenced to death by hanging and nine were sentenced to long prison terms. More importantly, the historic Nuremberg Medical Code was formulated and promulgated as a part of the judgement of the Nuremberg Court. The influence of the Code over contemporary Western bioethics is so profound that one could not imagine what today’s bioethics would look like without the Code. At least partly due to the Code, the ethics of experimentation with humans was the first and has been the major agenda in Western bioethics ethical review of research involving humans has become standard practice and informed consent has become probably the most important moral principle in medical research and medical practice in the West. The influence of the Code can be easily seen in such international documents as all versions of the World Medical Association’s Declaration of Helsinki on Biomedical Research Involving Human Subjects and the United Nations International Covenant on Civil and Political Rights. According to email communication with German bioethicist and Sinologist Ole Doering, because of the past, many German physicians and even more social scientists, especially the younger generations after the 1970s, have done a lot of work to show the fact of continuing threads combining Nazi medicine with current medical practice and the necessity of being always alert as to political, social and structural feature related to medicine with might favour inhuman medical conducts. On the other hand, the infamous Tuskegee Syphilis Study can been seen as a result of the lesson of Nazi doctors’ human experimentation and the Nuremberg Medical Code being treated as irrelevant and thus ignored by physicians and doctors in the United States.

But, atrocities committed by Japanese doctors are much less known. There was no counterpart of the Nuremberg Trial for Japanese doctors’ atrocities and therefore no similar document like the Nuremberg Code in Asian bioethics. It has been revealed that in order to use the data from Japanese experiments to develop its own biological warfare program in the name of national security, the government of the USA played a most inglorious role in protecting Japanese doctors from trial. The Americans’ treatment of Japanese doctors can never be justified by either Western or East-Asian or any other moral standards. Nevertheless, what I would like to stress here is that, no matter how outrageous the conduct of the US officials was in dealing with this matter, this should not become an excuse for us, human beings in the year 2001, especially Japanese and Chinese medical ethicists, not to take Japanese doctors’ atrocities seriously.

Not only less well-known, Japanese doctors’ human experimentation has also been much less explored academically and intellectually. In the West, there are numerous books and articles to seriously explore the Nazi doctors’ atrocities. Among brilliant academic and intellectual works in the English language on the subject are Robert Proctor’s historical study Racial Hygiene: Medicine under the Nazis (Harvard University Press, 1988), Robert Lifton’s psychological enquiry The Nazi Doctors: Medical Killing and the Psychology of Genocide (Basic Books, 1986), and, more relevant to medical ethics, edited by George Annas and Michael Grodin, The Nazi Doctors and the Nuremberg Code: Human Rights in Human Experimentation (Oxford University Press, 1992).

But, the Japanese doctors’ human experimentation is treated as having little relevance and is rarely discussed in today’s Chinese and Japanese medical ethics. The historical, psychological, socio-cultural, and moral-ethical dimensions of Japanese doctors’ experimentation have been far from well explored. Fortunately, from the references of Tsuchiya’s article, we see that some historical documents and studies have been published: Chinese Central Archive’s Vivisection: Japanese Army’s War Crime, Natsuko Yoshikai’s Unforgettable Memory: A Document of Army Surgeon Yuasa’s Vivisection, and Kei’ichi Tsuneishi’s The Conspiracy of Medical Researchers. According to email communication with Tsuchiya, Han Xiao, the President of the Unit 731’ Crimes Museum in Ping Fang where the factory of death was located, has been studying the Unit since 1969 and published a series of research including Unforgettable Memory (translated into English by Lu Cheng, Harbin, 1985). Nevertheless, to my knowledge, few ethical explorations have been done yet by East-Asian medical ethicists on the subject as well as on its practical and theoretical implications for today’s medicine and bioethics in Asia. Among the few literature of approaching to the subject from a medical ethics perspective is Chinese scholar Yuan-Fang Chen’ “Japanese Death Factories and the American Cover-up”—basically a commentary on Harris’ book— first presented at the first East Asian Bioethics Congress held in Beijing in 1995 and then published in Cambridge Quarterly of Healthcare Ethics 6 (1997) 240-242.

Should East-Asian Moral Traditions Be Regarded as Ethically Responsible for Japanese Doctors’ Human Experimentation?

One of the key issues raised in Tsuchiya’s article and Morioka’s commentary is the relationship between Japanese doctors’ participation in the mass murder and Asian moral traditions. While I tend to agree with most of they have said in their works, I cannot agree with them on this issue. Tsuchiya seems to claim that there is a kind of cause and effect relation between the two as he says that “it is the Japanese and East-Asian values, such as respect for authority and harmony, in the Japanese medical profession that not only made possible the massacre by human experimentation in China during the period of 1933-1945 but also prevented a public investigation after the war.” Both Tsuchiya and Morioka have thus argued for the necessity of re-evaluating such Asian values such as respect for authority and search for harmony.

On the one hand, I share the suspicion of Tsuchiya and Morioka on the project “East-Asian Bioethics” especially if its proponents consider Japanese doctors’ atrocities having nothing to do with the bioethics they are proposing and advocating. I agree with them that a critical attitude to our own East-Asian moral traditions is definitely needed. I also share with Morioka’s concern that “simple rejection of Western individualism and human rights approaches will misguide us to another Unit 731.” Although it is a very legitimate call to develop an Asian or Japanese or Chinese medical ethics in this age of Western dominance, this Asian or Japanese or Chinese medical ethics, no matter what it is, should not first of all aim to be different from a so-called “Western” one. Actually, there are many "Western" approaches, just as there are many Asian. Also Western influence in Asia is not necessarily a bad thing for Asian people. We should not blindly reject everything Western in order to resist the negative aspects of Western values and bioethics. Cultural identity is important, but even more important is to build up a medical ethics for, of and by Asian, Japanese, and Chinese people. Where the values of this medical ethics originate is of secondary or even little importance.

On the other hand, I do not think that Asian moral and social values inevitably lead to Japanese doctors’ factories of death. Actually, I believe that Japanese doctors’ human experimentation is not only against Western morality, against the common sense of humanity, but also against Asian and Japanese moral principles and ethical ideals. There are many different moral traditions in East-Asia, including Buddhism, Confucianism and Daoism, and each of these traditions has many different schools or sub-traditions. Let me use Confucianism as an example to explain my point of view since Confucianism has long been an essential part of Japanese morality and culture. It is undeniable that the highly hierarchical and authoritarian system of medical school, which according to Tsuchiya was a significant factor for Japanese medical researchers’ participation in medical killing under the social pressure as well as their supervisors’ order, has a lot to do with authoritarian tendencies and elements in Confucianism, the State Official Confucianism to be exact. But it would be unfair and wrong to claim that Confucianism as a whole has directly resulted in the atrocities committed by Japanese doctors or that it morally approves of Japanese doctors’ experimentation. Japanese doctors’ atrocities are obviously against such basic and fundamental Confucian values as ren (humaneness or humanity All the Chinese characters in this paper are pronounced in Chinese not in Japanese), yi (righteousness or justice), li (rite or ceremony), zhen (truthfulness or sincerity) and xing (faithfulness). It is true that Confucianism does promote values such as respect of authorities life parents, emperor and the state. But in Confucian moral tradition the worldly authorities are rarely advocated as the highest moral authority and the blind obedience as the highest virtue. On the contrary, not only the critics of Confucianism like Mo Zi and Zhuang Zi, but also Confucius, Mencius and Confucians themselves saw tian (the Heaven) and dao (the Way) as even higher authorities than any secular power when it comes to the issue of morality and moral judgements. It is one thing that Confucianism emphasizes the virtue of xiao (filial piety) more greatly than any other moral-religious tradition in the World. It is another thing to say that Confucianism then ethically approves people to kill or torture innocent human beings by just obeying their parents’ order. As a matter of fact, one can even argue that Japanese doctors’ experimentation is in fact against the value of harmony per se since medical killing does not promote but disturb or damage the social harmony.

In discussing cross-cultural bioethics, Asian ethics and culture in particular, it is of great importance to overcome the popular way of thinking about the East as the alternative or the opposite of the West. As I have argued in a recent article of mine, “The Plurality of Chinese and American Medical Moralities: Toward an Interpretative Cross-Cultural Bioethics” (Kennedy Institute of Ethics Journal 10: 239-260, 2000), the way of depicting Western morality as individualistic vs. Chinese ethics as authoritarian or communitarian has seriously simplified and even distorted the reality and moral traditions in both the West and China. Morality and ethical tradition in every, including Chinese or Japanese, culture was, is and will remain plural. There is just no such a thing as the Western or Eastern ethics. In fact, a big mistake in the “Asian Values” approach as well as the “East-Asia Bioethics” project is to interpret and promote some elements of the Asian moral traditions, such as harmony and respect for authority, as the only legitimate Asian moral values. In doing so, other even more fundamental values in Asian moral traditions, such as dao (the Way), tian (the Heaven), yi (righteousness or justice) and ren (humaneness or humanity), have been excluded as the legitimate Asian values. As with Japanese doctors’ medical killing, I think it is more accurate to say that some elements in East-Asian moral traditions have something to do with it, but other East-Asian moral values clearly condemn it.

I am aware that, just like the relationship between Nazi doctors’ medical killing and German ethical tradition, the relationship between Japanese doctors’ mass murder and East-Asian moral traditions is very complicated issue. But I do believe that, although Western values such as informed consent are powerful in condemning the mass murder of Japanese doctors, the Western moral tradition is not the only ethical resource for us to go. In other words, East-Asians are still resourceful in face of the moral challenges of Japanese doctors’ human experimentation even if we were completely isolated from the West. East-Asians can, even should in my opinion, go to our own indigenous moral and ethical traditions and come up with powerful weapons to condemn Japanese doctors’ atrocities and criticize other unethical practices in East-Asian medicine in history and today. Both adopting the Western values such as informed consent and re-visiting East-Asian values such as cheng (truthfulness or sincerity) are thus necessary in making medical research and practice more humane and ethical. For me, an important question in studying Japanese doctors’ atrocities is to analyse and elaborate from East-Asian moral perspectives how the experimentation is ethically wrong and what kind of ethical lessons can be learnt.

Challenges and Implications for Chinese Bioethics As a Chinese scholar currently teaching in New Zealand, in a kind of self-exile, I am especially concerned about the challenges of Japanese experimentation for China and Chinese medical ethics. After all, the inhuman experimentation was conducted in Mainland China and most victims of the experiments were our fellow Chinese. Among the many implications of this topic for present-day China, let me mention a few in this and the following sections.

Japanese doctors’ human experimentation challenges each and everyone of us, including Chinese, Japanese, other Asians, and Westerners as well. It challenges all of us who are living and want to continue to live. But, first of all, it challenges living Chinese, Chinese historians of medicine and medical ethicists in particular. Unfortunately, sad to say, so far Chinese scholars in bioethics and medical humanities as a collective have failed in meeting this challenge. Let me repeat what I have just said: After all, the inhuman experimentation was conducted in Mainland China and most victims of the experiments were our fellow Chinese. To my knowledge, so far there exists even no single systematic and in-depth ethical analysis on the topic in the Chinese language. In any case, I am certain that the subject, along with medical experimentation, is far from a central issue in the Chinese circle of medical ethics. For example, in the national standard textbook of medical ethics for the required course given at medical schools throughout China (Yixue Lunlixue , People’ Health Press, 1999), the second section of Chapter Eleven deals with the ethical issues of medical experimentation involving with human subjects, but Japanese doctors’ human experimentation in China were even not mentioned at all. In face of the spirits of those innocent Chinese died in those inhuman medical experiments, we Chinese medical ethicists and historians of medicine must ask ourselves: Aren’t we should be shamed for the lack of serious academic and intellectual treatment on the topic? Have we, as scholars, fulfilled our moral and social obligations to the dead and the living?

Some Chinese may say that we should avoid talking about the bad things happened in the past because in present Chinese and Japanese people should focus on developing trust and friendship. It is definitely true that Chinese and Japanese people should focus on developing friendship. But I cannot see how mutual trust and good friendship can be established under condition of intentionally forgetting history and evading tragedies and injustice happened in the past. For me, it is exactly in order to build up a solid basis for the friendship between China and Japan that we must squarely face the human-made tragedies such as Japanese doctors’ human experimentation. I do not think friendship can be achieved and maintained if ren (humanities) and yi (justice or righteousness) are sacrificed and if inhumane conducts are tolerated. In the same reason, I do not think that China can attain trust and genuine friendship from people in other Asian countries without seriously reflecting over the wrong doings in the past and sincerely apologizing for those misconducts or bad policies.

Some Chinese may say that the topic is basically of historical significance only but has no direct significance for today’s China and its medicine and bioethics. Yet, seriously studying Japanese doctors’ human experimentation does have a lot of direct practical and theoretical implications for today’s medicine and bioethics in China. For instance, while medical ethics has been a required course in the curriculum in most medical schools in Mainland China since the middle 1980s, research ethics in general is still rarely discussed and far from well established. In the preface to The Nazi Doctors and the Nuremberg Code, George Annas and Michael Grodin observe that “the promise of the Nuremberg Code has not been realized, and the project to protect human rights in human experimentation is an ongoing one that even a half century after the promulgation of the Nuremberg Code remains in its infancy.” If this is the case for the West, then, to protect the human rights in human experimentations is not even really conceived yet in Asian countries including Japan and China. Both political-cultural authoritarianism and medical paternalism, along with cultural and ethical relativism, still dominates today’s Asia including China like a haunting spectre. In this sense, the blood and lives of those victims and martyrs of Japanese experiments were lost in vain. But the blood and lives of those victims and martyrs should not be lost in vain, otherwise, their eyes would always open and watch us. Even worse, the similar tragedies, the same in nature and different only in degree, may again befall over us—you and me, our relatives and friends, our children and children’s children, and our fellow human beings—at any time. The history has taught us this lesson again and again.

In order to see the significance of studying Japanese doctors’ human experimentation for medicine and science in today’s China, it is crucial to overcome the way of thinking of those Japanese doctors as non human beings (bushiren) but merely devils or monsters or beasts and to see them as fellow human beings, though cruel ones. As Tsuchiya has pointed out, most of those Japanese doctors were normal medical researchers and academics. But normal physicians and scientist can conduct extraordinary and inhumane crimes medicine and science can become mad. This is exactly the basic lesson we have learnt from Nazi and Japanese doctors’ atrocities. We therefore should always watch medicine and science closely no matter how noble they appear. In fact, treating some other fellow human beings not as human being is one of the moral and psychological basis for Nazi and Japanese doctors to participating the mass murder without much resistance as well as many other human-made tragedies. We’d better not stand on such a basis ourselves.

More importantly, while studying Japanese doctors’ human experimentation, Chinese scholars should ask at the same time: Is medicine and science in today’s China going mad or on the edge of being mad? As far as I know, though not yet systematically documented, the patients’ well-beings and rights are far from well protected from the power abuse of healthcare providers and medical institutions in contemporary China. As far as I know, it is not uncommon for the patients, especially those who are rural residents, poor and less- or un-educated, to be exploited in the name of science, national interests, common good, and even the patient’s interests in contemporary China. Studying Japanese doctors’ human experimentation will urge us to focus on these contemporary problems and, hopefully, find some solutions. In an article recently published in the Chinese journal Yixue Yu Zhexue (Medicine and Philosophy) (21, 10: 8-9, 2000), I have expressed my discontent with contemporary Chinese bioethics and medical humanities in which the sufferings, problems and voices of the deprived, the underprivileged, the suppressed and the exploited are often at the margin. I have called for a Chinese bioethics and medical humanities centred on individual patients, especially those socio-culturally deprived and underprivileged. I hope that studying Japanese doctors’ human experimentation in China of half a century ago help to build up this kind of bioethics and medical humanities in contemporary China!

Collective Violence, Personal Conscience and the Liberty of Discussion Collective violence widely exists in many places of this world in the twentieth century. Since the middle of the nineteenth century, China has experienced much collective violence such as civil wars, Western and Japanese invasions, political persecutions, the unprecedented famine resulted from misgoverning in the late 1950s and early 1960s, the infamous Cultural Revolution, and peacefully protesting students and civilians being killed by the police and even armed soldiers. Any living Chinese, especially living Chinese scholar, has to and must face the painful and difficult question: How could all these collective violence have actually happened? In many senses, Japanese doctors’ human experimentation is typical of collective violence in the last century. Studying Japanese doctors’ human experimentation in China is therefore of great significance for better “understanding” collective violence against humanity in general, seriously treating collective violence conducted by Chinese over Chinese, and hopefully, preventing the re-occurrence of similar tragedies.

Many research on collective violence happened in China have mainly been focused on the macro political and social features. Yet, for Tsuchiya, a crucial question on the Japanese doctors’ atrocities over Chinese is why ordinary physicians and scientists did not avoid but actually participated in performing the inhuman human experiments. In the Cultural Revolution, some “class enemies” were not only collectively murdered, but literally, eaten by some other fellow Chinese (Zheng Yi: Scarlet Memorial, edited & translated by T. P. Sym, Westview Press, 1996) young middle school girls and boys beat their teachers, principals and fellow classmates to death by their bare hands or with sticks, belts and stones (see Wang Youqing’s several articles published in the on-line Chinese magazine Hua Xiao Wen Zhai at The collective violence in the Cultural Revolution and the violence of Japanese doctors’ experimentation obviously differs in many aspects such as the social and historical contexts. Nevertheless, across time and space there is a striking and scaring similarity between the two: the active participation of ordinary people in accomplishing collective violence. Personal conscience seemed to totally disappear.

According to Confucianism, liangxing or liangzhi (conscience) exists in the heart of every human being and conscience is the key for human beings to be different from other beings such as animals. Conscience is one of the most, if not the single, fundamental force for human beings to do good and to avoid the bad. The individual’s conscience is often quite fragile and tends to surrender to various social, political, cultural and peer pressures. Actually, one of central issues in the Confucian moral tradition is how to cultivate personal conscience. It seems to me that the liberty of thought and discussion is probably the most significant social mechanism for an individual to maintain and develop personal conscience and to stand up for the voices of conscience. If there existed some basic freedom of discussion in the Wartime’s Japan and the Cultural Revolution’s China, there would be more people who listened to the voices of their own conscience, refused to participate in collective violence, and even stood up to stop the atrocities.

A lesson (certainly not the only one) we learnt from the Japanese doctors’ atrocities and collective violence happened in the twentieth century’s China is that a healthy medicine and a well bioethics depend on the liberty of thought and discussion. The importance of the liberty not only lies in the fact that, as the London Declaration of the International Association of Bioethics (printed at the same issue of EJAIB 10 (2000), 174) has stated, “freedom of discussion and association is essential in order to reach thoughtful and reasoned positions in any bioethical debate.” Even more importantly, the liberty of thought and discussion is essential in nourishing the growth of personal conscience. It is indispensable to preventing the worst from occurring. Freedom of discussion may not be able to prevent collective violence from occurring in the beginning. But through nourishing personal conscience it is able to stop the expansion and continuance of such atrocities as conducted by the Japanese doctors and happened in the Cultural revolutions.

An Ending Note Up to now I myself have not yet conducted any serious research on Japanese doctors’ human experimentation in China. This essay, though already too long as a regular commentary, is just a spontaneous response to Tsuchiya’s inspiring article and Morioka’s stimulating commentary. I offer some preliminary thoughts of mine on an extremely significant topic because I, as a Chinese and a Chinese scholar, want to publicly express my admiration and respect to Tsuchiya and Morioka. I earnestly hope that Tsuchiya is writing, or plan to write, more on this subject. I even more eagerly hope that more and more Japanese and Chinese medical ethicists, physicians and medical scientists join Tsuchiya to squarely face the challenges of Japanese doctors’ inhumane human experiments. In the negative sense, medical ethics in East-Asia ought not ignore Japanese doctors’ human experimentation simply for the sake of historical justice. In the positive sense, just as seriously studying Nazi doctors’ crimes conducted in the name of science and medicine has helped the West in safeguarding medicine and medical research to serve, at least not to harm, human beings, seriously studying Japanese doctors’ atrocities should be able to help with the same cause in East-Asia. In the Confucian medical ethics tradition, medicine is usually called “renshu“ (the art of humaneness). Seriously studying an inhumane medical research performed by some Japanese doctors in the past should be able to help make medicine in East-Asia to be no longer bloody, less mad, and hopefully, closer to the moral ideal of medicine as the art of humaneness. In order to seriously reflect on Japanese doctors’ atrocities, as Tsuchiya’s article and Morioka’s commentary have suggested, we must first of all not forget the history, not self-deceive that the tragedy has no implications for today, and not self-defeat by assuming that the tragedy was inevitable.


I am grateful to Takashi Tsuchiya in Japan, Ole Doering in Germany, and Lynley Anderson in New Zealand, for their kind suggestions.

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