Notification in the japanese culture

Abstract

The medical scene in Japan seems to be in confusion concerning medical advice especially ‘notification’. This is partly the result of ignoring Japan's long history and culture, importing just its concept from the West and manipulating public opinion on notification through the mass media. If too much attention was paid to ‘informed consent’, the doctor would have to kill the patient when a patient says he wants to die. The patient's words, however, do not always reflect his real intention but may be an emotional sign that the patient wants a doctor to worry more about him. This may be a warped expression of ‘amae’ or emotional dependence peculiar to the Japanese. In the background of the Japanese who use such kinds of expressions, there is a characteristic religious perspective including Buddhism, Shintoism and so on, which might be hard for Christian Westerners to understand. Medical advice led by the media is a matter that concerns people in Christian countries based on individualism. On the other hand it is not a matter for Japanese who have been constructing family-oriented regional communities without establishing individualism. It is the relationship with other people that a person asks for the most in a clinical situation such as when the person is faced with his own death. © 2004, Japan Society for Head and Neck Cancer. All rights reserved.