Argument on removal of respirator in Japan.
In 2006, some newspapers reported that a surgeon, removed respirators from some patients without their consent. This event precipitated debate on the issues of respirator removal and death with dignity in terminal care in Japan. I discussed the ethical arguments pertaining to respirator removal in the following order: (1) selected reports on terminal care from academies, government, etc.; (2) three viewpoints of this issue; (2a) respect for the sanctity of life (SOL); (2b) respect for the quality of life (QOL) and (2c) respect for autonomy; (3) prerequisite conditions. I believe that if a patient who is suffering from a terminal illness and desires removal of respirator, to respond to his desire is to return him to a "natural" state, and that, consequently, this is ethically permissible. However, a physician must take into consideration a patient's dignity of life before he removes a respirator from that patient. Even if a patient decides autonomously that he wishes his life to be prematurely terminated, he is not in a position to carry out this act himself. Therefore, the conduct of physicians has become an important issue.
Kurosu
Mitsuyasu
M
Department of Bioethics (Medical Ethics), Tokyo Medical University, 6-1-1 Shinjuku Shinjuku-ku, Tokyo 160-8402, Japan. krs-uou@tokyo-med.ac.jp