title: The acceptability of the decision to withdraw life-sustaining treatment based on the living will and substituted judgements involving decision--the tendency of judiciary decisions and guidelines in Japan.
abstract: Recently in Japan, the topic of withdrawing life support is becoming increasingly urgent. The issue of living wills and surrogate decision makers in this process has received little attention. The purpose of this study is to examine recent judiciary decisions in Japan (criminal judgements) and recent guidelines regarding the decision to withdraw life-sustaining treatment based on the living will or surrogate decisions by the patient's family members. We found that most court rulings and all guidelines support withdrawal of life support based on patient wishes stated in a living will. On the other hand, only one judiciary decision supports the use of surrogate wishes in the decision to withdraw support, and the issue of surrogates was not clearly addressed in recent guidelines.
authors.affiliation: Department of Forensic Pathology and Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka City, Fukuoka 812-8582, Japan. ekamishi@med.kyushu-u.ac.jp
authors.forename: Etsuko
authors.initials: E
authors.lastname: Kamishiraki
authors.forename: Shoichi
authors.initials: S
authors.lastname: Maeda
authors.forename: Noriaki
authors.initials: N
authors.lastname: Ikeda
mesh_terms: D000328:Adult; D003657:Decision Making; D005260:Female; D006801:Humans; D007564:Japan; D016224:Living Wills / Q000331:legislation & jurisprudence*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D028761:Withholding Treatment / Q000941:ethics / Q000331:legislation & jurisprudence*