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No.29
No.29 ,Society  Jan 16, 2016

Thinking about End-of-life Care for the Elderly
Chapter 2: From the perspective of medical ethics

AITA Kaoruko, Uehiro Associate Professor for the Center for Death & Life Studies and Practical Ethics, the Graduate School of Humanities and Sociology, the University of Tokyo

One of major issues concerning end-of-life care for severely frail elderly is what to do when they can no longer eat even with assistance. The major trend in Japan in the 1990s was the use of feeding tubes when severely frail elderly could no longer eat. For example, there was a hospital that created a policy of “choosing natural death when severely frail, bed-bound elderly with advanced dementia can no longer eat.” The hospital came in for some harsh criticism, saying that the hospital was practicing a policy of“passive euthanasia” by withholding tube-feeding that could enable elderly people to continue to live. Today, nearly twenty years later, there have been an increasing number of media reports in recent years claiming quite the opposite of what newspapers argued in the 1990s. These reports present skeptical views about the utilization of artificial feeding, such as the gastrostomy, in elderly people living the final phase of their lives, saying that although such treatments could enable the elderly to continue to live for some more time in some cases, they could undermine their dignity as human beings. In particular, PEG tube-feeding has advantages over other types of artificial hydration and nutrition (AHN), and a dramatically increasing number of people have been using this treatment. ... [Read more]

No.29
No.29 ,Society  Jan 15, 2016

Thinking about Terminal Care for the Elderly
Chapter 1: Medicine in the age of longevity

OHSHIMA Shinichi, President Emeritus, National Center for Geriatrics and Gerontology

With the world’s highest average life expectancy, Japan is facing population aging. In this situation, the entire society is bewildered by this rapid change. Population aging inevitably leads to changes in medical care. The issue of death just ahead of that is considered to be a sacred cow, and if people attempt to discuss the issue, they face a barrage of different views and are unable to make progress with their arguments. If this issue is left unsolved, however, things will get even worse. Japan is the world’s largest population-aging country. The major indexes for aging society are the percentage of population aging, the average life expectancy and the rapidity of population aging, and Japan is number one in the world in all these indexes. Japan has reached over 25% in terms of percentage of population aging. ... [Read more]

No.29
No.29 ,Society  Jan 15, 2016

Thinking about Terminal Care for the Elderly – What it means to attend the deathbeds of the elderly in the age of longevity

MASUDA Hiroya, Chairman of Japan Policy Council, Visiting Professor at the University of Tokyo Graduate School

Now that Japan has become a major country of longevity in the world, social security system reform has long been one of the most important national administrative issues. The Council for the Promotion of Social Security System Reform is currently holding a broad range of discussions from a cross-disciplinary perspective with a focus on 2025, when the baby boomers will reach the age of more than 75 years. However, it is the issue of terminal care that is still left behind when medical and nursing care issues are being considered. Japan’s average life expectancy is the highest in the world, and the percentage of population aging (the ratio of the population aged 65 or over to the entire national population) is over 25%. The number of deaths is also increasing along with this trend, with about 1.2 ... [Read more]

No.29
No.29 ,Society  Dec 22, 2015

“Palliative Medicine” rather than
“Life-Prolonging Medicine” for Elderly People in the Terminal Stage of Life

KOJIMA Akira, Chairman of World Trade Center Tokyo, Inc., Member, Board of Trustees of the National Graduate Institute for Policy Studies

Mark Twain said with humor, “The only two certainties in life are death and taxes.” However, few people attempt to look straight at this undoubted reality, especially the latter. With the technological development of life-prolonging medicine, only “life prolongation” comes to the fore, and it is said that old people are abused in terms of terminal medicine in the name of medicine. I had the opportunity to listen to reports about terminal medicine from two experts on medicine for the elderly at a trustees’ meeting of the Japan Productivity Center that was held in late September 2015. The trustees who attended the meeting showed keen interest in their vivid explanations about reality. The lecturers were Hokkaido Chuo Rosai Hospital Director Miyamoto Kenji and Sakuradai Koujinkai Hospital ... [Read more]

No.29
No.29 ,Society  Dec 16, 2015

What Is True Internationalization?
– Nurturing Creative Leaders –

YAMAGIWA Juichi, President of Kyoto University

What do we mean when we talk about the internationalization of universities? In my view, education and research are two separate problem areas. From the perspective of education, the current focus is on educating global human resources, but what is the ideal image of people who are able to act internationally? To start with, they have the fundamentals of education. They are also able to use the languages of international communication. Another important point is whether they are able to form unique ideas and to express themselves. This is a very difficult point because no matter how much knowledge you cram into your head, it does not follow that you acquire the ability to think and make your own decisions. How to nurture this ability is a major issue. We live in the IT age. Young people these days,... [Read more]

No.28
No.28 ,Society ,Discussions  Oct 13, 2015

A New Era of Michi-no-eki Takes Off!
– Ever-evolving community hubs for local rejuvenation –

Women create vitality and confidence in the region. Michi-no-eki, Den-en Plaza Kawaba (Kawaba Village, Gunma Prefecture)

Michi-no-eki or the roadside station system was launched in 1993, and has since expanded nationwide to a total of 1,040 locations, with annual sales reaching 210 billion yen (as of fiscal year 2012). This nationwide initiative continues evolving as a spearhead for local rejuvenation efforts promoted by the government. The following article reports on the program’s current status and outlook based on discussions held between Ishida Haruo, professor of the Department of Social Systems and Management at the University of Tsukuba, and Hashimoto Goro, Specail editorial board member at the Yomiuri shimbun. (The discussions were held at the Imperial Hotel, Tokyo.)... [Read more]

No.28
No.28 ,Society  Aug 04, 2015

Postman’s Persistence Reunites a Japanese Teacher with Students from Eighty Years Ago

Aletter was sent from Japan to an address in Taichung, in the middle of Taiwan, that did not exist anymore. The letter was sent by a 106-year-old Japanese woman who used to be a teacher at an elementary school there during the period of Japanese rule. A young Taiwanese mailman searched for clues to find the “student” to whom the letter from his Japanese teacher was addressed. The mailman’s persistence has reunited the friendship between the Japanese woman and her students, who are around 90 now. The letter was sent by Ms. Takagi Namie, who lives in Tamana City, Kumamoto Prefecture. Her father was a police officer when she was an elementary school pupil in the Taisho period (1912–1926). Her family moved to live in Taiwan when her father was transferred there and they lived in Taiwan for about thirty years. ... [Read more]

No.26
No.26 ,Society  Jun 03, 2015

A Second Home in Japan
— What comes next after the visitor boom is semi-residence

The attraction is the cheapness of commodity prices and land prices in Japan’s regional cities.

The number of Chinese people visiting Japan is increasing at an explosive rate. In addition to the weak yen, the relaxation of requirements for visa issuance is also providing a boost. There is an increasing trend amongst the high-income classes of wanting to own a home in Japan, too. Chinese tourist visits to Japan are showing an unprecedented upsurge. Last year 2.4 million Chinese tourists came to Japan: an increase of 80% on the previous year. From January 19, a new “five-year multi” visa was introduced which allows holders to come to Japan an unlimited number of times during a five-year period, with up to a ninety-day period of stay being authorized for each visit, and with this momentum the interest of Chinese people towards Japan seems set to heighten even further still. ... [Read more]

No.23
No.23 ,Society  Sep 17, 2014

Former Self-Defense Forces Members Volunteering in Mine Clearance Overseas: They see it as, “Work only we can do.” — An international contribution using a developed skill

Arakawa Ryuichiro・Natsume Yukiaki

In May 2002, retired UXO (Unexploded Ordnance) disposal experts from the Ground Self-Defense Force, established a new organization, the Japan Mine Action Service (JMAS). An estimated 100 million mines and UXO are left untreated around the world. JMAS is an NPO formed to dispose of these by giving local specialists skills and information, working alongside them. Why would people who might have been leading a comfortable retirement life with their grandchildren set out for mine areas? What are their real activities? What are they thinking of? Natsume Yukiaki listened to their frank words. Not About Risking Your Life Natsume Yukiaki: Specifically, how do you go about removing mines and unexploded bombs? Arakawa Ryuichiro: In Cambodia, we meet up with former soldiers from the time of ... [Read more]

No.21
No.21 ,Society ,Discussions  Apr 13, 2014

The Modern-Day Family Without Tora-san

From Otoko wa Tsurai yo (It’s tough being a man) to his latest Chiisai Ouchi (The little house), movie director Yamada Yoji has continued to portray the Japanese family for more than half a century. What has the Japanese family in the Heisei period lost from Showa? BAISHO Chieko: I heard that with your latest, Chiisai Ouchi (The Little House), it’s already been fifty years since Shitamachi no Taiyo (The Sunshine Girl, 1963), which we worked on together. We’ve come a long way, haven’t we? YAMADA Yoji: The movie Otoko wa Tsurai yo was started in 1969. Baisho: Torajiro Kurenai no Hana, which was the last of the Otoko wa Tsurai yo series was released in 1995, so it lasted twenty-six years. Yamada: Looking back, the Kurumas in that series was a collapsed family. ... [Read more]

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