Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jan 17;14(2):133-150.
doi: 10.1007/s41649-021-00201-2. eCollection 2022 Apr.

Discussions on Present Japanese Psychocultural-Social Tendencies as Obstacles to Clinical Shared Decision-Making in Japan

Affiliations

Discussions on Present Japanese Psychocultural-Social Tendencies as Obstacles to Clinical Shared Decision-Making in Japan

Atsushi Asai et al. Asian Bioeth Rev. .

Abstract

In Japan, where a prominent gap exists in what is considered a patient's best interest between the medical and patient sides, appropriate decision-making can be difficult to achieve. In Japanese clinical settings, decision-making is considered an act of choice-making from multiple potential options. With many ethical dilemmas still remaining, establishing an appropriate decision-making process is an urgent task in modern Japanese healthcare. This paper examines ethical issues related to shared decision-making (SDM) in clinical settings in modern Japan from the psychocultural-social perspective and discusses the ideal decision-making process in present Japan. Specifically, we discuss how five psychocultural-social tendencies - "surmise (Sontaku)," "self-restraint (Jishuku)," "air (atmosphere or mood, Kuuki)," "peer pressure (or tuning pressure, Docho-Atsuryoku)," and "community (Seken)"-which have often been referred to as characteristics of present-day Japanese people, may affect the ideal practice of SDM in Japanese clinical settings. We conclude that health care professionals must be aware of the possible adverse effects of the above Japanese psychocultural-social tendencies on the implementation of SDM and attempt to promote autonomous decision-making, thereby allowing patients to make treatment choices that sufficiently reflect their individual and personal views of life, experiences, goals, preferences, and values.

Keywords: Autonomy; Clinical ethics; Japan; Shared decision-making.

PubMed Disclaimer

Conflict of interest statement

Competing InterestsThe authors declare no competing interests.

References

    1. Aoki Yumi, Watanabe Koichiro. Current knowledge and research trends in shared decision making for adults with severe mental illness: A narrative review. Japanese Bulletin of Social Psychiatry. 2020;29:300–313. doi: 10.1111/jjns.12365. - DOI
    1. Asai, Atsushi. 2012. Curious about “sufficient explanation and consent.” Kumamoto Nichinichi Newspaper, 30 December 2012. (Japanese)
    1. Asai, Atsushi, Taketoshi Okita, and Seiji Bito. 2021. Consideration of points that patients should be aware of in the shared decision-making process. CBEL Report 4:15–28. (Japanese)
    1. Blumenthal-Barby Jenny S. ‘That’s the doctor’s job’: Overcoming patient reluctance to be involved in medical decision making. Patient Education and Counseling. 2016;100:14–17. doi: 10.1016/j.pec.2016.07.010. - DOI - PubMed
    1. Brown, Stephen L., and Peter Salmon. 2019. Reconciling the theory and reality of shared decision-making: A “matching” approach to practitioner leadership. Health Expectations 22: 275–283. 10.1111/hex.12853. - PMC - PubMed

LinkOut - more resources