Abstract
Japan, with the world’s most aged population, is projected to experience over 1.5 million annual deaths until 2070. Despite the absence of specific laws on informed consent, proxy decision-making, advance directives, and advance care planning (ACP) in Japan, the Medical Care Act of 1948 underscores the obligation of medical professionals to provide comprehensive explanations and promote patient understanding. Furthermore, government guidelines for end-of-life care exist, directing healthcare professionals. As a result, decision-making in end-of-life care predominantly involves family members and medical professionals, prioritizing relational autonomy over individual autonomy. In contrast, Western countries such as the U.S., U.K., and Australia have enacted laws regulating informed consent, proxy decision-making, advance directives, and ACP, emphasizing individual autonomy through legal documents. Legal restrictions limit family intervention, although informal influence may still be exerted. If we classify the former as the “Japanese model” and the latter as the “Western model,” an “East Asian model” emerges as a hybrid. Some East Asian countries have enacted laws, with variations such as family involvement clauses (South Korea and Taiwan) or family involvement in practice (Singapore). Currently, the outcomes in end-of-life care across these models are nearly comparable. However, with ongoing demographic shifts, such as the rising number of older adults living alone, the significance of law and guidelines is gradually being recognized. This paper discusses how to reach a balance between the norms established by law and guidelines and family involvement in end-of-life care for older adults, based on a comparison of the three aforementioned models.
Presenters
Yukio SakuraiStudent, Master of Medical Administration, Tokyo Medical and Dental University, Japan
Details
Presentation Type
Paper Presentation in a Themed Session
Theme
Public Policy and Public Perspectives on Aging
KEYWORDS
Japanese, East Asian, Western Models, End-of-life, Law, Family, Medical Professionals
