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Dying with dignity in Japan

Japan With Kids - Forums: Health Topics: Dying with dignity in Japan
By Cornelia on Friday, May 4, 2001 - 12:54 pm:

Recently I heard a woman's story about how her husband was prevented from dying with dignity against his wishes. His death was not only prolonged (he was paralyzed and eventually went into a coma) by about 6 years, but National Health Insurance did not cover this situation but by some minor percentage, and it took her 16 years to pay off the enormous debt at the same time that she was raising 3 sons who were all under 12 when her husband became ill. She also told me that as far as she knew there is no "Living Will" system in Japan as we know it in the USA.

Today I came across mention of the "Japan Society for Dying with Dignity" and wondered if anyone has any information on this Society and what it does?


By Cornelia on Sunday, January 18, 2004 - 11:24 am:

It's been a while since I last asked this question, and a lot of new people have joined these forums, so I'd like to ask again in case someone now can help me find an answer. Is there anything like a "Living Will" respected in Japan, and can anyone provide info on the "Japan Society for Dying with Dignity" or similar organizations with similar aims?

This is kind of urgent because a friend of mine is in the hospital with a poor prognosis, and I want to try to make sure that he is not put through unecessary procedures for minimal positive outcome, if it is at all possible. He has no family to stand up for him, only the welfare worker assigned to his case.


By Yuko Kubota on Sunday, January 18, 2004 - 12:48 pm:

Have you searched the phrase "Japan Society for Dying with Dignity" through yahoo japan? It will give you their official website in Japanese;
http://www.songenshi-kyokai.com/
You can write to them through;
http://www.songenshi-kyokai.com/dwd04.htm
Have you asked the welfare worker about these things? I think they're supposed to give you info.
Or have you asked your local kuyakusho or hokenjo? I'm sure they can find some free English help lines that can provide you professional details on medical and lawful matters.
There are hospices or the likes in Japan too. Perhaps you can find details by checking the above organizations/people.


By Esther Sanders on Sunday, January 18, 2004 - 4:30 pm:

Dear Cornelia:
When my mother-in-law had terminal cancer six years ago, we used a quasi-volunteer organization called Life Care System, which I believe was under the umbrella (or perhaps vice versa) of a place called the Sato Clinic. A Dr. Sakai (one of I think 2 or 3 M.D.s in the group) came to our home to give my MIL regular checkups, mobilized the local public health nurses to visit, filled necessary prescriptions, and came at the very end as well. He accepted National Health Insurance. I believe he speaks a fair bit of English, but am not sure as we always used Japanese. He was very kind and very keen on his mission of helping terminally ill people die with dignity and unencumbered by unwanted "supports." The clinic's tel. no. is, or was:
(03) 3292-5117.

If there's no answer there, let me know and I will try calling Dr. Sakai at his home tel. no., which I have but will not post here.

Regards, Esther Sanders


By Tara on Monday, January 19, 2004 - 2:58 pm:

Here's a report on this topic published on the Embassy of Japan's web site in Denmark:
"Japanese Reactions to the Euthanasia Law in the Netherlands" dated May 7, 2001 http://www.dk.emb-japan.go.jp/info/Japan%20Brief%20etc2001/ jb070501.htm

The Annual Report on Health and Welfare is a bit dated (1998-99)
http://www.mhlw.go.jp/english/wp/wp-hw/vol1/p2c3s3.html

and finally, also in English,
http://www.jpf.go.jp/j/media_j/publish_j/jfn/pdf/jfn25_2.pdf
has some thoughts on organ transplantation in Japan: "The Brain-Death Controversy: The Japanese View of Life, Death, and..." which mentions that "few Japanese have adopted the practice of executing a living will".


By Cornelia on Saturday, June 18, 2005 - 11:57 am:

The recent battle in the Terri Schiavo case (Florida, USA) has caused a huge surge of interest in Living Wills in the USA.
From The New York Times:
"People used to think this conversation was only relevant in the emergency room or the lawyer's office. Today those end-of-life conversations are happening around dining room tables and in living rooms."
- PAUL MALLEY, president of Aging With Dignity (USA), on living wills and talking about death and dying. http://www.nytimes.com/2005/06/17/health/17will.html?th&emc=th


Much to my chagrin, I have not even been able to dicuss life insurance coverage here with pertinent Japanese persons, because it is inviting an earlier death. Does anyone know of any book written in Japanese for Japanese that gets down to the basics on PLANNING for your children in the event of an accident, in such a way that even superstitious individuals might be encouraged to make a reasonable plan?

Here's a site where you may be able to find a form for your country http://www.makeyourwill.com/international.htm?gxxeaGn006Catch_All_Living_Wills

but there seems to be a more important consideration, that of designating a durable power of attorney for health care, usually to a family member or close friend.

It is unclear of course if any of these measures will hold in Japan. Does anyone with experience and direct knowledge know how it works here?


By Esther Sanders on Saturday, June 18, 2005 - 12:57 pm:

Good question. Re insurance, there seem to be a number of comprehensive family packages out there now; have you looked into any? (I think one or more have tie-ups with American insurers; e.g., possibly Saison Life and AIG, but I'm not sure). And while we're on the subject, what about appointing legal gaurdians for children in case of parents' death? Have you tried looking for related Japanese professionals via the ACCJ or the American Embassy? And of course, living wills for all and wills in general. I'd like to have updated resources for these, if anyone knows.


By Yuko Kubota on Saturday, June 18, 2005 - 1:14 pm:

Cornelia,

On your message dated June 18th, you're asking about life insurance and not living wills, am I correct?

Then I don't know why you are having trouble discussing it, because every so often, my insurance agent gives me a knock on the door trying to bother my working hours so that I can discuss renewing my life insurance. Or when I used to work at an office, the Nixxxx lady would come every week handing out candies and inviting those with new families to make a contract to their life insurance. And I don't know how many TV commercials and how many magazine coverages I've seen on life insurance.

Just pick up your favorite women's magazine and I'm sure you'll find a consultant service. For example, there is a service for readers of Asahi News Paper;
http://aspara.asahi.com/club/user/guest/entrance.do

Of course, you can get pretty good info just by posting on an internet forum like the following;
http://oshiete.goo.ne.jp/

Talking about life insurance to a dying person is one thing. But I have the impression that, in Japan, the more conservative people are, the more precise they are about issues after death. Wow, we better hurry up and look for that grave my in-laws have been asking us to find for their bones-to-be.


By Admin on Thursday, April 20, 2006 - 12:37 am:

Society wants law for kin to decide euthanasia
Sunday, April 16, 2006 at 06:40 EDT

TOKYO EA Japanese group promoting the right of terminally ill patients to choose dignified death is seeking legislation allowing relatives to decide on euthanasia in the event the patients' will is not clear, group members said Saturday.

It is the first time for the Japan Society for Dying with Dignity to endorse the idea that the decision to be euthanized can be made by those other than the patients themselves.

The move to allow families to make decisions based on the assumed will of the patients could spark debate as the issue of euthanasia has been highlighted in Japan due to recent revelations that a surgeon at a hospital in Imizu, Toyama Prefecture, took off the life support of a number of patients there.

The society has submitted its opinion to a multiparty group of Japanese lawmakers considering legislating dignified death, saying it is "desirable to specify by law" that family members can make decisions for the patients, the members said.

The opinion reiterates the society's principle that the decision should not be made by those unrelated to the patients and lists options that can be taken in the event the patients have not indicated their will in writing.

They include a judicial decision based on sufficient material that suggest the patients' will, a decision by the ethics committee of a medical institution and consensual decision making by the patients' family members, relatives and friends.

Another alternative which allows families to decide is to stipulate the order in which the decision can be made on behalf of the patients among family members, including spouse, children, parents, and brothers and sisters.

Akihiro Igata, the society's chairman and head of Nagoya University of Arts and Sciences, told Kyodo News that his group's position that the patient's will is the premise for euthanasia decisions remains unchanged.

"But when the will is not clear, we thought it was appropriate for the family members to decide by deducing the patient's will such as from conversations they had" in the past with the patient, Igata said.

"We are not saying this is the method that must be taken. We want to continue further discussions," he said.

The lawmakers' group is currently working to compile a bill based on a draft outline which calls for recognizing the right of patients to decide whether or not to undergo life-sustaining treatment and allowing those aged 15 and above to indicate their will beforehand.

The issue of what to do when the patients' will cannot be confirmed is among the outstanding items to be discussed by the group of legislators.

The Japan Society for Dying with Dignity, established in 1976 by doctors, lawyers and academics, conducts activities to promote the right of terminally ill patients to choose to die naturally without receiving futile life-sustaining treatment.

In the cases at the Toyama hospital, police are investigating the deaths of seven patients from 2000 to 2005 as cases of possible murder, as the patients died after the hospital's surgery department head removed their respirators.

The surgeon has said he obtained consent from the families of six of the patients, but not consent from the patients themselves, and that another surgeon was in charge of the remaining patient.

Based on a 1995 Yokohama District Court ruling, euthanasia via dosing or other acts by doctors is deemed legal in Japan only if four conditions are met Ethe patient's death is imminent, there is unendurable pain, there is no other way to remove or alleviate the pain, and the patient wishes to be euthanized.

2006 Kyodo News


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