Attitudes of Japanese and Japanese-American Physicians Towards Life-Sustaining Treatment
Lancet. 1995 Aug 5; 346(8971): 356-359.
Summary: Doctors in different countries have different approaches to bioethical problems. We studied how attitudes to life-sustaining treatment for terminally ill patients differ in Japan and the USA by administering a questionnaire to Japanese (136) and Japanese-American (77) physicians. In a series of clinical scenarios the questionnaire asked what life-sustaining interventions the doctors would recommend to a patient with metastatic gastric cancer. Most Japanese physicians would recommend blood transfusions for gastrointestinal bleeding (74%), total parenteral nutrition for malnutrition (67%), and vasopressors for life-threatening hypotension (61%) when the patient did not know of his diagnosis and outlook. Significantly fewer Japanese physicians would want these interventions for themselves: 29% would want transfusion, 36% would want total parenteral nutrition, and 25% would want vasopressors. 36% of Japanese physicians would override the explicit request of a competent moribund cancer patient to withdraw all life-support. By contrast, among Japanese-American physicians only 42% would recommend blood transfusion, 33% total parenteral nutrition, and 34% vasopressors to a terminally ill cancer patient who did not know of his diagnosis or outlook. Cross-cultural studies in medical ethics can help physicians and the public in different countries to take a fresh look at accepted practices and the ethical reasons behind them.
Allowing to Die; Artificial Feeding; Asian Americans; Attitudes; Blood; Blood Transfusions; Cancer; Case Studies; Communication; Comparative Studies; Cultural Pluralism; Diagnosis; Disclosure; Drugs; Doctors; Ethics; Family Members; International Aspects; Life; Medical Ethics; Nutrition; Patients; Physicians; Prognosis; Prolongation of Life; Resuscitation; Survey; Terminally Ill; Treatment Refusal; Truth Disclosure; Values; Withholding Treatment;
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Survey of Japanese Physicians' Attitudes Towards the Care of Adult Patients in Persistent Vegetative State Asai, Atsushi; Maekawa, Munetaka; Akiguchi, Ichiro; Fukui, Tsuguya; Miura, Yasuhiko; Tanabe, Noboru; Fukuhara, Shunichi (1999-08)
Survey of Japanese Physicians' Attitudes Towards the Care of Adult Patients in Persistent Vegetative State Asai, Atsushi; Maekawa, Munetaka; Akiguchi, Ichiro; Fukui, Tsuguya; Miura, Yasuhiko; Tanabe, Noboru; Fukuhara, Shunichi (1999-08)OBJECTIVES: Ethical issues have recently been raised regarding the appropriate care of patients in persistent vegetative state (PVS) in Japan. The purpose of our study is to study the attitudes and beliefs of Japanese physicians ...