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Japanese doctor sparks euthanasia debate

From: The World Today, Shane McLeod

The 50-year-old doctor headed up the surgical department at the local hospital at Imizu, north-west of Tokyo. Between 2000 and 2005 he helped at least seven terminally ill cancer patients to end their lives by switching off or removing their respirators.

The provisions of a 1995 court ruling outlined the circumstances in which Japanese doctors can help their patients to die. But in this case, those provisions may not have been met.

The Director of Imizu Hospital, Hidetsugu Asanoi, has apologised to the patients involved.

“The problem is whether there was clear consent from the patients themselves,” Mr Asanoi says. “We deeply apologise for causing anxiety.”

The 1995 ruling permits euthanasia in cases where death is imminent, that the patient is suffering extreme pain, there’s no way to alleviate that pain and the patient gives consent to have medical treatment withdrawn.

In the case of the hospital in Imizu, the lack of written consent from the patients is the central problem.

Yesterday, the unnamed doctor at the centre of the case told local reporters that fulfilling all the conditions is difficult. “From now on, if there’s a situation where we can confirm the patient’s wishes, there will not be any misunderstanding,” the Doctor says. “But if they are in a completely unconscious condition, we cannot make a judgement in many cases. Therefore, it’s a real problem.”

The doctor says respirators were switched off while family members were present.

Misao Shirai is from the Japanese Society for Dying with Dignity, a group that wants Japan’s Government to act to clear up the legal uncertainties.

“There’s no official standard or procedure,” Mr Shirai says. “No law has been enacted and the Health Department hasn’t created any guidelines. In the past there have been cases where judges have established various conditions to recognise euthanasia, therefore there are some standards for permitting at the judicial level.”

Mr Shirai says euthanasia has, until now, not been a very significant issue for many Japanese, but he thinks the current case will get people thinking about it.

“There were several cases before this, but each time they ended vaguely,” he says. “This time there were seven patients. It’s a large number that has died. I think it’s a shocking case for Japanese society and many people will be affected. In the minds of Japanese people, thinking about life and death, the awareness of facing death is very low. We often say we shun or loathe death and people don’t consider death as their own problem. I think that goes a long way to explain people’s attitude towards euthanasia.”

Police in Toyama prefecture, where Imizu is located have indicated they are investigating the deaths. They say they’re considering whether to launch a murder investigation.