The history in detail...

I guess I should have done this before I gave my opinions,
but I would like to explain a bit about the history of informed consent.

The basic idea of informed consent is that doctors explain to patients
about the treatments that are available -in specific, things such as
the method, the meaning, the effects (good and bad), the dangers,
what is expected to happen afterwards, and the expenses.
They are to explain clearly and adequately, and then recieve an approval.
In other words, doctors inform, and obtain a patient's consent.

There are three big historical trails for this idea.

One is a concept of a court tactic to make the process of explaining to patients
a duty for doctors in the situation of medical malpractice cases increasing.

The second came from the situation that in the early days of heart transplantation,
the surgery was often recognized as a experiment on a human body.
There was a need for doctors to explain things such as the purpose and dangers
of the experiment, and also for patients to give agreement voluntarily.

The third came from the problem that even if a patient knows their own disease,
for example cancer, it would only increase their anxiety if they did not know
about the details of the conditions of their diseases.
There was a need to make a way of guaranteeing the right for patients to be informed.

These three factors lead to the establishment of the idea of informed consent,
in the United States, in the 1970's. It spread very rapidly among advanced countries.
It is said though, that one of the reasons for the spread was that doctors could use
this idea for self-desense in court cases.

In Japan, the concept was adopted in the late 1980's,
but I am having some trouble getting the facts in detail.
I promise to post something about it soon...

Thanks for reading!

More universally...

I have another concern, which is not only for the Japanese medical system.

If a doctor gives information about all the risks,
the possibilities of each treatment not succeeding, or even dying,
would it be possible that they would be able to use that as an excuse
when something bad happens?
Maybe they would be able to protect themselves from
being accused of medical malpractice.

Hmmm... maybe I'm being too negative...
I'd really appreciate any kind of comments.
Thanks.

Japanese society and informed concent

A little while ago here in Japan, informing patients about
all there is to their disease was not so common.

Recently, this situation has changed, and informed consent is now
a standandard in most hospitals.
Doctors explain to patients what they know about the disease,
the options in treatment and their percentages of recovery,
the problems which may occur, and the dangers.
Patients can see what is going on, and have a right to give opinion.

This may sound pretty good,
but my mother (who is a nurse, by the way...) looks at it this way.

The system does not originate in Japan.
It is imported from western societies, where people tend to
be able to state their own opinions clearly.
On the other hand, many Japanese people are not used to choosing
things with their own will, let it be education, religion, or politicians to
support. Many of us have not much experience in having big options
to decide from.
There is an old saying, shiranu ga hotoke, meaning
"He that is not sensible of his loss has lost nothing, and therefore in the
most happy state", which still reflects a way of our thinking.
The saying continues with the words, iwanu ga hana, meaning
"Some things are better left unsaid".
And perhaps you've heard of the phrase,
"See no evil, speak no evil, hear no evil.", which comes from Japan.
I think it's fair to say that in Japan, it is common to look on only the good side
in many situations.

The question is, if such people can simply import the system of informed consent
-which may mean getting bad news and making a big decision at once.
Would it really work like it does in other societies??

I think the concept and its aims are very imoportant things that we must consider,
but there is a need to customize the system to a "Japanese version informed concent"
which can be more easy-going for many of us.

What do you think??