Survey of the general public's attitudes toward advance directives in Japan: How to respect patients' preferences

Hiroaki Miyata, Hiromi Shiraishi, Ichiro Kai

Research output: Contribution to journalReview article

31 Citations (Scopus)

Abstract

Background: Japanese people have become increasingly interested in the expression and enhancement of their individual autonomy in medical decisions made regarding medical treatment at and toward the end of life. However, while many Western countries have implemented legislation that deals with patient autonomy in the case of terminal illness, no such legislation exists in Japan. The rationale for this research is based on the need to investigate patient's preferences regarding treatment at the end of life in order to re-evaluate advance directives policy and practice. Methods: We conducted a cross-sectional survey with 418 members of the general middle-aged and senior adults (aged between 40 and 65) in Tokyo, Japan. Respondents were asked about their attitudes toward advance directives, and preferences toward treatment options. Results: Over 60% of respondents agreed that it is better to express their wishes regarding advance directives (treatment preferences in writing, appointment of proxy for care decision making, appointment of legal administrator of property, stating preferences regarding disposal of one's property and funeral arrangements) but less than 10% of them had already done so. About 60% of respondents in this study preferred to indicate treatment preferences in broad rather than concrete terms. Over 80% would like to decide treatment preferences in consultation with others (22.2% with their proxy, 11.0% with the doctor, and 47.8% with both their proxy and the doctor). Conclusion: This study revealed that many Japanese people indicate an interest in undertaking advance directives. This study found that there is a range of preferences regarding how advance directives are undertaken, thus it is important to recognize that any processes put into place should allow flexibility in order to best respect patients' wishes and autonomy.

Original languageEnglish
Article number11
JournalBMC Medical Ethics
Volume7
DOIs
Publication statusPublished - 2006 Oct 18
Externally publishedYes

Fingerprint

Advance Directives
Patient Preference
respect
Japan
Proxy
Legislation
autonomy
Appointments and Schedules
Therapeutics
legislation
Tokyo
Administrative Personnel
Surveys and Questionnaires
physician's care
Decision Making
Referral and Consultation
funeral
Cross-Sectional Studies
flexibility
illness

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Survey of the general public's attitudes toward advance directives in Japan : How to respect patients' preferences. / Miyata, Hiroaki; Shiraishi, Hiromi; Kai, Ichiro.

In: BMC Medical Ethics, Vol. 7, 11, 18.10.2006.

Research output: Contribution to journalReview article

@article{53e2f7584e764f9ea029637b11d51872,
title = "Survey of the general public's attitudes toward advance directives in Japan: How to respect patients' preferences",
abstract = "Background: Japanese people have become increasingly interested in the expression and enhancement of their individual autonomy in medical decisions made regarding medical treatment at and toward the end of life. However, while many Western countries have implemented legislation that deals with patient autonomy in the case of terminal illness, no such legislation exists in Japan. The rationale for this research is based on the need to investigate patient's preferences regarding treatment at the end of life in order to re-evaluate advance directives policy and practice. Methods: We conducted a cross-sectional survey with 418 members of the general middle-aged and senior adults (aged between 40 and 65) in Tokyo, Japan. Respondents were asked about their attitudes toward advance directives, and preferences toward treatment options. Results: Over 60{\%} of respondents agreed that it is better to express their wishes regarding advance directives (treatment preferences in writing, appointment of proxy for care decision making, appointment of legal administrator of property, stating preferences regarding disposal of one's property and funeral arrangements) but less than 10{\%} of them had already done so. About 60{\%} of respondents in this study preferred to indicate treatment preferences in broad rather than concrete terms. Over 80{\%} would like to decide treatment preferences in consultation with others (22.2{\%} with their proxy, 11.0{\%} with the doctor, and 47.8{\%} with both their proxy and the doctor). Conclusion: This study revealed that many Japanese people indicate an interest in undertaking advance directives. This study found that there is a range of preferences regarding how advance directives are undertaken, thus it is important to recognize that any processes put into place should allow flexibility in order to best respect patients' wishes and autonomy.",
author = "Hiroaki Miyata and Hiromi Shiraishi and Ichiro Kai",
year = "2006",
month = "10",
day = "18",
doi = "10.1186/1472-6939-7-11",
language = "English",
volume = "7",
journal = "BMC Medical Ethics",
issn = "1472-6939",
publisher = "BioMed Central",

}

TY - JOUR

T1 - Survey of the general public's attitudes toward advance directives in Japan

T2 - How to respect patients' preferences

AU - Miyata, Hiroaki

AU - Shiraishi, Hiromi

AU - Kai, Ichiro

PY - 2006/10/18

Y1 - 2006/10/18

N2 - Background: Japanese people have become increasingly interested in the expression and enhancement of their individual autonomy in medical decisions made regarding medical treatment at and toward the end of life. However, while many Western countries have implemented legislation that deals with patient autonomy in the case of terminal illness, no such legislation exists in Japan. The rationale for this research is based on the need to investigate patient's preferences regarding treatment at the end of life in order to re-evaluate advance directives policy and practice. Methods: We conducted a cross-sectional survey with 418 members of the general middle-aged and senior adults (aged between 40 and 65) in Tokyo, Japan. Respondents were asked about their attitudes toward advance directives, and preferences toward treatment options. Results: Over 60% of respondents agreed that it is better to express their wishes regarding advance directives (treatment preferences in writing, appointment of proxy for care decision making, appointment of legal administrator of property, stating preferences regarding disposal of one's property and funeral arrangements) but less than 10% of them had already done so. About 60% of respondents in this study preferred to indicate treatment preferences in broad rather than concrete terms. Over 80% would like to decide treatment preferences in consultation with others (22.2% with their proxy, 11.0% with the doctor, and 47.8% with both their proxy and the doctor). Conclusion: This study revealed that many Japanese people indicate an interest in undertaking advance directives. This study found that there is a range of preferences regarding how advance directives are undertaken, thus it is important to recognize that any processes put into place should allow flexibility in order to best respect patients' wishes and autonomy.

AB - Background: Japanese people have become increasingly interested in the expression and enhancement of their individual autonomy in medical decisions made regarding medical treatment at and toward the end of life. However, while many Western countries have implemented legislation that deals with patient autonomy in the case of terminal illness, no such legislation exists in Japan. The rationale for this research is based on the need to investigate patient's preferences regarding treatment at the end of life in order to re-evaluate advance directives policy and practice. Methods: We conducted a cross-sectional survey with 418 members of the general middle-aged and senior adults (aged between 40 and 65) in Tokyo, Japan. Respondents were asked about their attitudes toward advance directives, and preferences toward treatment options. Results: Over 60% of respondents agreed that it is better to express their wishes regarding advance directives (treatment preferences in writing, appointment of proxy for care decision making, appointment of legal administrator of property, stating preferences regarding disposal of one's property and funeral arrangements) but less than 10% of them had already done so. About 60% of respondents in this study preferred to indicate treatment preferences in broad rather than concrete terms. Over 80% would like to decide treatment preferences in consultation with others (22.2% with their proxy, 11.0% with the doctor, and 47.8% with both their proxy and the doctor). Conclusion: This study revealed that many Japanese people indicate an interest in undertaking advance directives. This study found that there is a range of preferences regarding how advance directives are undertaken, thus it is important to recognize that any processes put into place should allow flexibility in order to best respect patients' wishes and autonomy.

UR - http://www.scopus.com/inward/record.url?scp=33750850839&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33750850839&partnerID=8YFLogxK

U2 - 10.1186/1472-6939-7-11

DO - 10.1186/1472-6939-7-11

M3 - Review article

C2 - 17044943

AN - SCOPUS:33750850839

VL - 7

JO - BMC Medical Ethics

JF - BMC Medical Ethics

SN - 1472-6939

M1 - 11

ER -