Dichotomies of collectivism and individualism in bioethics: Selective abortion debates and issues of self-determination in Japan and ‘the West’

Dynamic axes of informed consent in Japan

Scholarship in cross-cultural bioethics routinely frames Japanese informed consent in contrast to informed consent in North America. This contrastive analysis foregrounds cancer diagnosis disclosure and physician paternalism as unique aspects of Japanese informed consent that deviate from American practices. Drawing on in-depth interviews with 15 Japanese medical professionals obtained during fieldwork in Japan from 2013 to 15, this article complicates the informed consent discourse beyond East-West comparisons premised on Anglo-American ethical frameworks. It expands professional perspectives to include nurses, medical social workers, clinical psychologists, and ethicists and it addresses informed consent for a broad range of conditions in addition to cancer. The results suggest that division of affective labor is an under-theorized dimension of informed consent that is perceived as at odds with principled demands for universal informed consent. These practical tensions are conceptualized as cultural differences, with Japan identified in terms of omakase as practical and supportive and the United States identified in terms of jiko kettei as principled and self-determining. These results have implications for the methodology of cross-cultural bioethics as well as for theories and practices of informed consent in both Japan and the United States. I conclude that responsible cross-cultural work in bioethics must begin from the ground up, incorporating all relevant stakeholder perspectives, attitudes, and experiences.

Effects of post-traumatic growth on the dorsolateral prefrontal cortex after a disaster

The relating to others factor of post-traumatic growth (PTG), which involves mutual help and a strong sense of connection with humanity, is important for young people who are coping with stress. The prefrontal cortex (PFC), especially the dorsolateral PFC (DLPFC), may play an important role in post-traumatic stress disorder (PTSD) with regard to coping and resilience. We hypothesized that the neural correlates of PTG may be responsible for resilience to the correlates of PTSD. Our study tested this hypothesis by examining whether measures of PTG, particularly the measures of relating to others after a disaster, were associated with increased regional grey matter volume (rGMV) in the PFC by assessing individuals who had experienced the East Japan Great Earthquake. We calculated the delta-rGMV by subtracting the rGMV obtained 3 months before the disaster from the rGMV obtained after this disaster using voxel-based morphometry. The magnetic resonance imaging data obtained from 26 subjects (M/F: 21/5; age: 21.2 ± 1.6 yrs.) showed that the total scores on a PTG inventory and the subscore for relating to others at the post-assessment were positively and significantly associated with the delta-rGMV in the right DLPFC. The DLPFC seems to be the main neural correlate of PTG.

Fatigue and relating to others 3 months after the 2011 Great East Japan Earthquake

Most inhabitants of Tohoku district suffer from chronic fatigue after the 2011 Great East Japan Earthquake. Chronic fatigue following disasters may lead to serious illness, even death. Posttraumatic growth appears to counteract fatigue. We predicted that the chronic fatigue would be inversely related to the posttraumatic growth factor "relating to others," as represented by mutual helping and a strong sense of connection with humanity. Young 59 healthy volunteers, residing in Miyagi prefecture, were recruited 3 months after the disaster. We measured the subjects׳ total scores on the Japanese version of the Checklist Individual Strength questionnaire (CIS), the Trait Anxiety (T-A) subscale of the State-Trait Anxiety Inventory (STAI), the Center for Epidemiologic Studies Depression Scale (CES-D), and four subscores on the posttraumatic growth inventory (PTGI). Stepwise regression analyses were conducted with score on the CIS as the dependent variable and other scores as independent variables. Scores on the "relating to others" factor of the PTGI showed a significant negative relationship with the CIS score, whereas the scores on the T-A subscale of the STAI and the CES-D were positively related to the CIS score. Human ties and mutual help were negatively related to the degree of the chronic fatigue.