title: End-of-life considerations in the ICU in Japan: ethical and legal perspectives.
abstract: In Japan, the continuation of critical care at the end of life is a common practice due to the threat of legal action against physicians that may choose a palliative care approach. This is beginning to change due to public debate related to a series of controversial incidents concerning end-of-life care over the last decade. In this review we contrast and compare the history and evolution of end-of-life care in Japan vs. the USA and other Asian countries. Efforts by the Japanese Society of Intensive Care Medicine (JSICM) to establish better end-of-life care systems, as well as future directions in palliative care in Japan, are discussed.
authors.affiliation: Department of Critical Care Medicine, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1264, New York, NY 10029 USA.
authors.forename: Jun
authors.initials: J
authors.lastname: Makino
authors.affiliation: Clinical Professor of Emergency/Critical Care Medicine Department, St. Marianna Medical School, 2-16-1 Sugao Miyamae-ku, 216-8511 Kawasaki City, Kanagawa, Prefecture, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Fujitani
authors.affiliation: Department of Critical Care Medicine, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1264, New York, NY 10029 USA.
authors.forename: Bridget
authors.initials: B
authors.lastname: Twohig
authors.affiliation: Department of Critical Care Medicine, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1264, New York, NY 10029 USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Krasnica
authors.affiliation: Department of Critical Care Medicine, Mount Sinai Medical Center, One Gustave L. Levy Place, Box 1264, New York, NY 10029 USA.
authors.forename: John
authors.initials: J
authors.lastname: Oropello
keywords: Advance directive; Asian countries; East; End-of-life; ICU; Japan; Living will; Palliative care; USA