IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v174y2017icp159-168.html
   My bibliography  Save this article

Dynamic axes of informed consent in Japan

Author

Listed:
  • Specker Sullivan, Laura

Abstract

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.

Suggested Citation

  • Specker Sullivan, Laura, 2017. "Dynamic axes of informed consent in Japan," Social Science & Medicine, Elsevier, vol. 174(C), pages 159-168.
    • Handle: RePEc:eee:socmed:v:174:y:2017:i:c:p:159-168
    DOI: 10.1016/j.socscimed.2016.12.031
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953616307110
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2016.12.031?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Long, Susan O. & Long, Bruce D., 1982. "Curable cancers and fatal ulcers : Attitudes toward cancer in Japan," Social Science & Medicine, Elsevier, vol. 16(24), pages 2101-2108, January.
    2. Elwyn, Todd S. & D. Fetters, Michael & Gorenflo, Daniel W. & Tsukasa Tsuda, 1998. "Cancer disclosure in Japan: Historical comparisons, current practices," Social Science & Medicine, Elsevier, vol. 46(9), pages 1151-1163, May.
    3. Kato, Masae & Sleeboom-Faulkner, Margaret, 2011. "Dichotomies of collectivism and individualism in bioethics: Selective abortion debates and issues of self-determination in Japan and 'the West'," Social Science & Medicine, Elsevier, vol. 73(4), pages 507-514, August.
    4. Charles, Cathy & Gafni, Amiram & Whelan, Tim, 1997. "Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango)," Social Science & Medicine, Elsevier, vol. 44(5), pages 681-692, March.
    5. Charles, Cathy & Gafni, Amiram & Whelan, Tim, 1999. "Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model," Social Science & Medicine, Elsevier, vol. 49(5), pages 651-661, September.
    6. Elwyn, Todd S. & Fetters, Michael D. & Sasaki, Hiroki & Tsuda, Tsukasa, 2002. "Responsibility and cancer disclosure in Japan," Social Science & Medicine, Elsevier, vol. 54(2), pages 281-293, January.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Karnieli-Miller, Orit & Eisikovits, Zvi, 2009. "Physician as partner or salesman? Shared decision-making in real-time encounters," Social Science & Medicine, Elsevier, vol. 69(1), pages 1-8, July.
    2. Paul C. Schroy III & Karen Emmons & Ellen Peters & Julie T. Glick & Patricia A. Robinson & Maria A. Lydotes & Shamini Mylvanaman & Stephen Evans & Christine Chaisson & Michael Pignone & Marianne Prout, 2011. "The Impact of a Novel Computer-Based Decision Aid on Shared Decision Making for Colorectal Cancer Screening," Medical Decision Making, , vol. 31(1), pages 93-107, January.
    3. Coast, Joanna, 2018. "A history that goes hand in hand: Reflections on the development of health economics and the role played by Social Science & Medicine, 1967–2017," Social Science & Medicine, Elsevier, vol. 196(C), pages 227-232.
    4. Tate, Alexandra, 2020. "Invoking death: How oncologists discuss a deadly outcome," Social Science & Medicine, Elsevier, vol. 246(C).
    5. Wirtz, Veronika & Cribb, Alan & Barber, Nick, 2006. "Patient-doctor decision-making about treatment within the consultation--A critical analysis of models," Social Science & Medicine, Elsevier, vol. 62(1), pages 116-124, January.
    6. Shosh Shahrabani & Amiram Gafni & Uri Ben-Zion, 2008. "Low Flu Shot Rates Puzzle—Some Plausible Behavioral Explanations," The American Economist, Sage Publications, vol. 52(1), pages 66-72, March.
    7. Barnett, Erin R. & Boucher, Elizabeth A. & Neubacher, Katrin & Carpenter-Song, Elizabeth A., 2016. "Decision-making around psychotropic medications for children in foster care: Perspectives from foster parents," Children and Youth Services Review, Elsevier, vol. 70(C), pages 206-213.
    8. Peek, Monica E. & Odoms-Young, Angela & Quinn, Michael T. & Gorawara-Bhat, Rita & Wilson, Shannon C. & Chin, Marshall H., 2010. "Race and shared decision-making: Perspectives of African-Americans with diabetes," Social Science & Medicine, Elsevier, vol. 71(1), pages 1-9, July.
    9. Krystina Lewis & Dawn Stacey & Dan Matlock, 2014. "Making Decisions About Implantable Cardioverter-Defibrillators from Implantation to End of Life: An Integrative Review of Patients’ Perspectives," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 7(3), pages 243-260, September.
    10. May, Carl, 2013. "Agency and implementation: Understanding the embedding of healthcare innovations in practice," Social Science & Medicine, Elsevier, vol. 78(C), pages 26-33.
    11. Entwistle, Vikki & Williams, Brian & Skea, Zoe & MacLennan, Graeme & Bhattacharya, Siladitya, 2006. "Which surgical decisions should patients participate in and how? Reflections on women's recollections of discussions about variants of hysterectomy," Social Science & Medicine, Elsevier, vol. 62(2), pages 499-509, January.
    12. Glory Apantaku & Magda Aguiar & K. Julia Kaal & Patrick J. McDonald & Mary B. Connolly & Viorica Hrincu & Judy Illes & Mark Harrison, 2022. "Understanding Attributes that Influence Physician and Caregiver Decisions About Neurotechnology for Pediatric Drug-Resistant Epilepsy: A Formative Qualitative Study to Support the Development of a Dis," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 15(2), pages 219-232, March.
    13. Christoph Engel & Werner Gueth, 2018. "Modeling a satisficing judge," Rationality and Society, , vol. 30(2), pages 220-246, May.
    14. Mendick, Nicola & Young, Bridget & Holcombe, Christopher & Salmon, Peter, 2010. "The ethics of responsibility and ownership in decision-making about treatment for breast cancer: Triangulation of consultation with patient and surgeon perspectives," Social Science & Medicine, Elsevier, vol. 70(12), pages 1904-1911, June.
    15. Hardman, Doug & Geraghty, Adam W.A. & Lown, Mark & Bishop, Felicity L., 2020. "Subjunctive medicine: Enacting efficacy in general practice," Social Science & Medicine, Elsevier, vol. 245(C).
    16. Kirsten McCaffery & Les Irwig & Patrick Bossuyt, 2007. "Patient Decision Aids to Support Clinical Decision Making: Evaluating the Decision or the Outcomes of the Decision," Medical Decision Making, , vol. 27(5), pages 619-625, September.
    17. Moss, Jennifer L. & Reiter, Paul L. & Rimer, Barbara K. & Brewer, Noel T., 2016. "Collaborative patient-provider communication and uptake of adolescent vaccines," Social Science & Medicine, Elsevier, vol. 159(C), pages 100-107.
    18. Paton, Alexis & Armstrong, Natalie & Smith, Lucy & Lotto, Robyn, 2020. "Parents’ decision-making following diagnosis of a severe congenital anomaly in pregnancy: Practical, theoretical and ethical tensions," Social Science & Medicine, Elsevier, vol. 266(C).
    19. Chen, Yen-Yuan & Tsai, Shih-Li & Yang, Chih-Wei & Ni, Yen-Hsuan & Chang, Shan-Chwen, 2013. "The ongoing westernization of East Asian biomedical ethics in Taiwan," Social Science & Medicine, Elsevier, vol. 78(C), pages 125-129.
    20. France Légaré & Stéphane Turcotte & Dawn Stacey & Stéphane Ratté & Jennifer Kryworuchko & Ian Graham, 2012. "Patients’ Perceptions of Sharing in Decisions," The Patient: Patient-Centered Outcomes Research, Springer;International Academy of Health Preference Research, vol. 5(1), pages 1-19, March.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:174:y:2017:i:c:p:159-168. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.