Morioka Article Parts 3-4 Reading Reactions

Main Points

Part 3: The brain death controversy and cultural factors

Morioka introduces several ideas of Japanese researchers regarding the relationship between perceptions of brain death (and organ transplantation) and Japanese culture.

Yonemoto (1987) suggests that the Japanese view of the dead body may be completely different from Western views in that "every part of a deceased person's body" has "a fragment of the deceased's mind and spirit."

Namihira (1988) explains, based on research of the beliefs of the 1985 JAL crash victims' families, that Japanese people do not want to injure a dead body because the soul will come back, and the dead soul may be unhappy if its body is not perfect.

Kaji (1990) points out this Japanese belief is "proto-Confucian" Asian shamanism and common in the East Asian region.

Umehara (1990) rejects the dualistic, Cartesian view of body/soul separation as a Western concept. If the body is warm, he asserts, it is still "alive".

Part 4: Where should Japanese bioethics go?

Phenomena (=reality/truth) vs. Discourse (=how it is talked about in the media, society etc.)

Phenomena:

• Doctors are changing, but still feel that patients should leave decision making to "intimate others".
• Japanese society as a whole is becoming more individualistic like the West, but will not, as whole, become American style. (Mark: Obviously?)
• Opposition to brain-dead donors is strong.
• But the majority feel brain death is death (survey data)
• Morioka feels ordinary surveys may not be effective. (Mark: Why?)
• So, why do people oppose brain-death donor transplants? Morioka feels "closed door medicine" needs to be destroyed first.(Mark: Is that really the main factor?? Help!)
• Japan will be similar to South or East European countries (Mark: ?? In what way? What's the different between EU and American civil societies--HELP!)
  

Discourse Level:

• Is Japan's view really unique as Yonemoto, Namihira, Kaji, Umehara say? Needs "painstaking" research. (I agree)
• "having power of discourse" vs. "whether ordinary people believe them"....different? How? (Unclear)
  
• Modernization of ethics such as informed consent came from outside--"raped by the West" and that causes culture arguments of "sacred cultural units" due to national identity needs. (perhaps so...)
• Sakamoto (1995) is one example: "East Asian" bioethics should be based on East Asian culture and different from Euro-American ones." But Morioka criticizes the notion of East Asia vs. West saying it is not "fruitful". (I agree--East Asia is diverse)
  
• Hardacre: Japan / West distinction is not generalizable. Stereotypes such as "everyone in the West is individualistic" are not true.
• Morioka used to believe in "our bioethics" movement, but now refuses it because 1) nationalism is dangerous, and 2) it "conceals diversity" inside our culture and inside our own minds. (I agree with this.)
  
  
• But cultural factor arguments are not senseless. Seeing the essence of human being resides in not just the brain but the whole body has benefits. Better than seing humans as reasoning, calculating machines?
• Exchanging body parts like "cogwheels inside a clock" may lead to a society treating humans just like machine parts.
• Using brain dead bodies for experiments happened in the 80s in the West -- "This is a logical result from the idea brain-death equals human death." So...let's imagine what will happen down the road...Jonas? (not explained)...reconsider mainsteam biomedicine...
• Conclusion...Main Point...? seems to be: Cultural factor arguments (like Japanese beliefs of the body are different from the West) are valuable for questioning Western imported values such as "the mind and body are separate and brain death is death" which may be dangerous values. (Mark: Interesting view. Not completely explained, but true to some extent.)
  
• Bioethics should consider the future of society...(Yes...obviously...)
  

So...in short, how has Japan responded to imported ideas of bioethics? It has responded with acceptance (with a desire to become more Western?) to some extent of ideas such as informed consent or brain death, but many people have also responded with rejection, saying "Japan is Japan" and Japanese ethics should be different--the soul is not separate from the body. Morioka feels the cultural arguments that Japan (or East Asia) is different from the West have dangers (and rejects them), but also believes they have some value for helping us critique possible problems of Western views such as using human bodies like machine parts.

Something like that? So...everyone, what is your reaction to Morioka's views? The article is not as focused on the main question and organized as an argument as I would prefer, and has too many unexplained ideas that are just thrown in without integration, but is obviously very valuable. It provides very useful insights into the process of how Japanese society and EACH OF YOU as Japanese individuals will make bioethical decisions in the future!

Thanks Dr. Morioka (Just in case you see this online)

Related links:

2008 government survey results
http://www.jotnw.or.jp/studying/29.html



http://www.iza.ne.jp/news/newsarticle/entertainment/celebrity/431503/
　だが、厚生労働省研究班が平成１９年に全国約１５００の病院に行った調査によると、がん患者への病名告知率は６５．７％。１００％近い告知がされているという米国などに比べると差は大きい。