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About the author...
Professor Rihito
kimura, originally a law professor, became interested in bioethics
long before the word was coined. When he was a visiting professor
of Asian Studies at Saigon University, Vietnam 1970-1972,
a student came to his home and asked about Prof. Kimura's
daily diet. After Prof. Kimura detailed his diet of fish,
rice and tea, the student told him not to eat the fish or
drink the water and, perhaps, he ought not eat the rice. Curious
at this directive, Prof. Kimura asked why. The student showed
him pictures of deformed infants and sick people who, he said,
suffered from the results of the defoliant U.S. troops were
using in the war. This "Agent Orange" was being washed into
the river, contaminating the fish and into the ground, contaminating
both the drinking water and the rice crops. Shorty after this
event, Prof. Kimura said, the Japanese Embassy in Saigon issued
a directive to Japanese in Vietnam not to eat the fish or
drink the water. Japanese experts of fish genetics had discovered
that the dioxin in the chemical affected the DNA structure
of fish exposed to the dioxin. Medical ethics are required
of physicians but bioethics has a wider scope, encompassing
the doctor, the patient, the ecology and is an area of widening
impact on everyone. Today, Prof. Kimura divides his time between
his position as Visiting Professor and Director, International
Bioethics Project at the Kennedy Institute of Ethics, Georgetown
University and as Professor of Bioethics and Law, Department
of Health Science, School of Human Sciences, Waseda University
in Tokyo. Prof. Kimura said bioethics is still not widely
taught but Waseda has a two week mandatory course for freshmen
and a full term mandatory course for upperclassmen. Prof.
Kimura lectures to a full house of 300 students and, unlike
many university level courses in Japan, he requires full participation
by his students in the discussion of bioethics.
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My idea of Bioethics
is for example, the issues of value or rights of the persons. Like
patient 's right. We are usually thinking about the patient that
once they are admitted in the hospital everything is hung of the
physician so the once I made the critical comments to the physician
that patients have right to be respected in the hospital setting,
the physician over said "NO, Once you cross the gate of this hospital,the
patients should follow what the phisitian said. The regal science
or human life study has nothing to do whith medicine." that was
the medical exparts are saying. The patients has nothing to do with
medicene. It is the regal idea, not the medical idea. So I challedge
that by name of super inter decepline ,to callnge what physician
was thinking during this maybe around this 4000 years. The point
of life its-self, life should be studied by having notion of super-interdiscipline
that means, we must have inter change,very positive inter action
of the ideas even including some conflict or challenge among them.
Bioethics is not began from the physician, not bigan from medical
experts, Bioethics has began from the patient,nurses, and patient's
family. So the many people would say Bioethics is sort of social
regal ethical imprication of biomedicine, but it is not really convey
the real meaning of the ideas which has started from the patient
side so this idea of Bioethics has as you have recognized as developed
during the 60's and 70's whichi has very colse relationship with
other rights movements. Student's rights movement, women's revelation
movement, comsumer's rights right movement, and the all kinds of
rights related social action becames so popular in 1980's to quetion
what is the power, what is the authority. Bioethics is the one of
this expression of the people's re-gaining power in the side of
people that's means the patients want to have their own power among
them. Not informed only by the physician but we want to make our
own decision. That is the reason why the Bioethics most important
principal is the principal of economic.
| What
is the right and responsibility of the patient which professor
Kimura has adviced to form " A Patient Bill of Rights" of the
Japanese mecidal cooperatives? |
As you have recognized,
very clearly it is a movement by the lay people to change the system,
to change the power to shift from physician to patients. Patient's
economy. It's the one of the most important thing. Rights
and responsbility are quite obvious that all the information before
words in the hand of physician and medical exparts and usually these
things are not told to the patient or family members so everything
in the hand of physician and the name of theraputic privilage. Because
physicians trained, had education, and experiance to make medical
dicision for the therapy of the patient. So there is nothing to
do with patient. We have to make a decision on behalf of of patient
that is the basic elements of the pattrnalism. Bioethics is the
idea began from 1960's based on civil rights and patient's right
movement against this paternalism. Of course, in the area of theraputic
privilage there has been some sort of elements maybe still here
in Japan sill some countries to have vanish come paternalism by
some part of southeast of Asia. But generally speaking even the
WHO may a publication of patient rights in Europe mention the patient
has right to make a final decision because it is the valuish. The
patient is the center core of the medical treatment. For this, we
need "Informed consent" It includs to 1.Give true information 2.
tell clear objectives 3.tell alternative 4. tell the risk 5. tell
prognosis. We have the right to this informed consent is one of
the most element propulations responsibility and patient'rights.
Otherwise patient can not had their own real quality of life.
| How
do you think of the public policy for Bioethics should be? |
Biothics public policy
is the one of the most improtant elements of Bioethics development.
As you have recognized during this, Bioethics should be the bases
for the public policy.
There should be the notion of Bioethics public policy by having
input from not only professial but also lay people. One of the important
thing, for example there are many ethics committe, the one of the
important development of Bioethics is to form, to have ethics committe.
Many madical institutions, such as hospitals to have a review of
the protical insurt study all kinds of desease. We must have a review
of the reserch studies. In the reserch protcal, we must have different
kind of professions, like layers, nurces, esseisist, and lay people.
Public policy will be making through all kinds of studies. In the
process of all these, the Japan up to this time, the mainly professonals
are conserned about this. But once we open the session, for example,
this session is usually because of my strong voice, this committe
has changed its system to be opened. Of course, some cases are opened
but,others are not to public except gernalist. We have to avoide
secret meeting that might make mistakes. The public policy is the
bases for the study of Bioethics which we have to cooporate with.
21st. century, we need young people's voice.
| What
does the state of western country around Bioethics? |
The Bioethics is as
I interpret, there are many interpretation of Bioethics I am not
sayinga this is only interpretation, but these kinds of interpretation
of Bioethics haveing the input from civil rights movement, women's
revelation movement rather unique interpretation. this is originaly
started by me around 30years ago. Because I was working in WHO during
my stay in Geneva for three years, I had consideration with WHO
people focusing on human lifes and medicine. It mixed several people
from United States, Europe, Africa, and Asia undernize, overnize
civil singings of conference in 1972-1975. It is a gradual process
forming my idea to interpolate this movement of Bioethics rather
having focus on the people's rights movement. But you see that many
people would think that Bioethics is the development of new medical
ethics which is mainly for the physician. that are some people of
course has you know, the people in Japan or all over sometimes quoting
my paper without having any sighntation. bioethics is superinter-deciplinaly
studies which include protocol science, law, medicine. it's a kind
of new way lofe. towards 21st. century, new way of looking at lofe
not suprited into content. In taht sence, the Bioethics is now developing
so well and if Bioethics developing so well, there are expert there
has been many production of Bioethics expert again to have very
narrow way of point of veiw. To stick to the very detail issue because
it is very diffical to talk about wide issues, so always there is
tendency to habve professonal to speak of narrow thing, if it is
narrow defenition, for example the cander,true styding of Bioethical
issues can be treated in the wider perspectives  ro
smaller perspectives. there is a dendency of too much professonal
way of looking at Bioethics. One of the big problem, if I say, Bioethics
is now getting to be institutionalize in government level. Bioethics
originally has been people's movement it has some sort of anti-government
element because we do want our life should be no regulated by athe
government. It is a kind of open ending our own story to have our
own way of life based on our own body. If you look at countries
in the world, there are many bioethics origanizations of now developing.
Many countries in government level, there has been professonal Bioehics
has been born. Who do not know the real roots of Bioehics why it
is happened be based Bioethcs is front of them. Cutting from the
roots, they are thinking of bioeehics in government level and international
level. One of the expression is very vividly we recognize words
in last year's international conference of bioethics held up Nippon
University in Tokyo. We had the special session by the government
which omit the people whichi the government Bioethics expert gathered.
Into the meeting,
"WE
NEED TO PARTICIPATE IN THE MEETING!!"
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