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ABE Akira "Approaches to the Issues of Euthanasia / Death with Dignity with the View of Ars Vivendi"

Contributing to this Website November 16, 2009
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The philosophy of the Global COE Program gArs Vivendih of Ritsumeikan University (hereinafter, Ars Vivendi) is to "design a society where we all live in harmony with disabilities, diseases, aging, and various differences." To realize this idea, we have been conducting research from various academic perspectives on the types of "techniques" and values or mechanisms (i.e., policies and systems) supporting the practices that are necessary for "the society." I myself have understood this shared philosophy and am actually learning together with graduate students, some of whom have diseases and disabilities, and it has led to a deepening of my awareness of the issues by learning from them rather than by teaching them.

By the way, do you think Ars Vivendifs vision for a society that is as multicolored as a kaleidoscope but never united is anarchistic or chaotic? Though I have no solid ideas regarding this premise, I would like to unconditionally agree to such a gdiverse society,h because gdiversityh means variation and events that include not only the good things but also the bad ones. In other words, diversity prompts us to be open to what could be or what should be better, namely possibilities for changes or initiations. Living in a uniform and homogeneous society is definitely easy due to the lack of troublesome matters. Spiritually, however, my mindset dislikes repetition.

On the other hand, it is also true that we are all equally fated to die although we are all living in different ways. In that sense can we say that gdeathh is an event of gcooperativity without cooperativity?h Or if you prefer, can gdeathh be regarded as a condition of the possibility for life?

The important point is the gfacth that there are people who choose or who have been induced to choose gdeath,h -- a condition for life -- by themselves in this gdiverse society.h Although we understand its importance, we often forget it because of our willingness to escape from reality. It is considered that values and decisions over life or death are usually personal choices. However, even these matters are actually under the individualfs social relations or conditions. And the symbolic case is the gissues of euthanasia / death with dignity.h

In Japan, the enactment of laws relating to euthanasia / death with dignity has not been initiated, which has led to disruption among people with disabilities or diseases, their families and medical sites. In other countries, however, lively arguments over legislations of euthanasia / death with dignity have been made among researchers, people with disabilities, medical / legal personnel, and the public.

With focus on this situation, we started a joint research project. One of the outcomes includes research by Hotta et al., 2009 (see references below). We focused on and investigated the epoch-making court case of Oliver Leslie Burke (UK) who triumphed in demanding the right to live once but was then defeated in the end. We analyzed the case processes and the legal logics in details and then reviewed the statements and the logics of laws and ethics that related to the case. Especially by critically reviewing the principles of bioethics that have a substantial influence on the assessments of euthanasia / death with dignity, we revealed that the arguments based on the principles of bioethics which centered on gself-determination righth have limitations.

Moreover, in the research by Hotta et al. 2009, we presented to the world information on the gdiverseh life of ALS patients in Japan, which is closely related to issues of euthanasia / death with dignity as a mission of gGlobalh COE.

I believe we have achieved certain outcomes through the abovementioned joint research. However, similar to seeing more clearly once we have become accustomed to the dark, the issues have been perceived more clearly but more variedly as the research progresses. Although there are several problems to be examined, under the current environment in which the self-determination right for onefs own medical treatments is basic but important questions such as gCan euthanasia / death with dignity be accepted if the decision is made by the person who has the disability or disease?h or gWhy isn't the right to live accepted, although the right to death seems to be understood?h remain unsolved. We believe that no previous research has solved these questions. This is what we think. If we make a minor concession, we are not satisfied with the answers that have been obtained through the past research.

Thus, our joint research project is going to be expansively continued. With the sponsorship of the Pfizer Health Research Foundation, the project was resumed in fall 2009 together with the new title of ginterdisciplinary research on the normative theory of eeuthanasia / death with dignityf.h This project is being conducted through the cooperation among researchers with gdifferenth fields of expertise -- HOTTA Yoshitaro, a long-serving member of Ars Vivendi, and ARIMA Hitoshi and SAKAMOTO Norihito, who changed their affiliations but are still key members of Ars Vivendi. The gdifferencesh created during the cooperation are of course gcomfortableh again for us.

Our research has two major objectives as outlined below. The first one takes priority in terms of logic.

Firstly, we investigate the consistency between the underlying structures of normative principles and the logic after we carefully classify the principles or legal systems relating to euthanasia / death with dignity, and ethical / legal concepts of trial records, which have been collected from inside and outside of Japan. Secondly, based on the first objective, we aim at upgrading or improving the normative theory for euthanasia / death with dignity by accumulating findings that are useful for the formulation of guidelines or development of legal systems relating to terminal care in Japan.

The significance, originality and expected results from the research are as follows.
1. Formation of a common basis for arguments on euthanasia / death with dignity
2. Formulation of a database of the highest global standards that are based on the collection and classification of basic information from inside / outside of Japan
3. Clarification of practical and concrete issues on the way the systems handling euthanasia / death with dignity should be.

Furthermore, we have paid special attention to what is happening overseas, especially in the UK. Recently the UK has experienced major changes in systems for euthanasia / death with dignity. The assisted suicide bill was submitted to Parliament in 2004 and the palliative care bill in 2006, respectively. Despite such controversial movements, this situation has not been known well in Japan. Therefore, we strongly believe that by reviewing and revealing up-to-date trends, the significance of our research will be enhanced.

A part of our research outcome has been made public via the Ars Vivendi website (http://www.arsvi.com/d/et.htm (in Japanese)) which has been updated progressively.

References

ŸHOTTA Yoshitaro, ABE Akira, MATOBA Kazuko & ARIMA Hitoshi May 9, 2009gThe Importance of Social Support in Decision Making regarding Terminal Care: What ALS Patients in Japan can Teach us,hPoster Presentation at 11th Congress of the EAPC, Vienna, Austria.
ŸHOTTA Yoshitaro, ARIMA Hitoshi, ABE Akira & MATOBA Kazuko February 2009 gLessons from the Case of Oliver Leslie Burke (UK) -- Reevaluations on Principles of Life / Medical Ethics,h Ars Vivendi, Seikatsushoin, vol.1, pp.131-164.


UP:December 21, 2009 REV:December 24, 2009
Preparer & Translation by TAMURA Noriko
Proofread by KATAOKA Minoru
žABE Akira žLife & Death / Euthanasia / Death with Dignity ?