Open AccessEthical Issues Around the Withdrawal of Dialysis Treatment in Japan
Author(s) -
Miho Tanaka,
Satoshi Kodama
Publication year - 2020
Publication title -
asian bioethics review
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.249
H-Index - 7
eISSN - 1793-8759
pISSN - 1793-9453
DOI - 10.1007/s41649-020-00109-3
Subject(s) - autonomy , dialysis , newspaper , medical treatment , medicine , bioethics , medical law , terminally ill , law , intensive care medicine , political science , nursing , palliative care , psychiatry
In Japan, terminating life-sustaining treatment (LST) in non-terminal patients is legally and ethically problematic given the lack of legal regulations regarding the termination of LST, including dialysis treatment. This article describes an ethically problematic case that happened at a hospital in Tokyo in March 2019, in which a patient died after a physician withdrew kidney dialysis upon the patient's request. Most national newspapers in Japan reported the case extensively and raised the question of ethical and legal permissibility of withdrawing dialysis treatment from non-terminal patients. In this article, we first examine the case within the current policy framework in Japan and then discuss how Japan can improve its end-of-life practice, focusing specifically on the patient's right to self-determination and treatment refusal. We recommend that policymakers consider legalizing the termination of LST and the patient's right to refuse treatment based on the principle of respect for autonomy.