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[Members Only] J.Jpn. Surg. Soc.. 118(3): 281-285, 2017
Feature topic
ETHICAL MEDICAL CARE AT THE END OF LIFE
Based on the proposal of the Japanese Cardiovascular Society on terminal care, guidelines were created by the Japan Emergency Society and Japan Intensive Care Medicine Society. The guidelines define terminal care during the emergency and intensive medical treatment stages, and the two societies believe that withdrawal of life support is possible if the situation meets those definitions. The guidelines are one possible route, and it is assumed that terminal medical care and its results are not a single entity in all cases. Therefore the guidelines were created based on the recognition that sincere dialogue with patients and their families is important and that clinical ethics and offering palliative care are necessary. Among the features of the guidelines are an emphasis on process, respect for individual will, judgments by teams including multiple specialists and nurses, and the provision of palliative care. The Ministry of Health, Labor and Welfare has developed guidelines concerning the medical decision-making process at the final stage of life as indications for consensus formation among patients, their families, and medical staff to make the best possible decisions on care. It is important to aim at medicine focused on respecting the dignity of human life until its end.
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