Tracing the Birth of Bioethics in Japan

December 8, 2004

The Center for Biomedical Ethics & Law (CBEL), a comprehensive academic bioethics center, was established at the University of Tokyo, Japan, in October 2003. The center is a platform for those who engage in teaching, research, and policy development in bioethics and provides interdisciplinary education to ethics committee members, professionals, and students. The CBEL also conducts research projects in biomedical ethics in collaboration with international scholars and serves as a public resource for those who work in bioethics. The faculty comes from a variety of academic disciplines, including philosophy, law, sociology, psychology, nursing, and medicine. After a preparatory period of pilot teaching and study, the CBEL opened its programs to the public in September 2004. The center represents a culmination in the development of bioethics as a major priority for Japan.

Bioethics has led to important changes in academic disciplines, public discourse, and policies in Japan. Probably the most visible change in Japanese bioethics has occurred in the 21st Century. There were twice as many articles and books on bioethics in the National Library in 2000 than there were in 1999. An increasing number of scholars and lay people have shown an interest in bioethics, participating in the ever-increasing public forums and lectures. Furthermore, governmental committees dedicated to bioethics and bioethical policies have become common in Japan. In 2000, the Bioethics Committee Council for Science and Technology (BCCST) published Fundamental Principles of Research on the Human Genome. Following publication of the work, from 2001 to 2003, ethical guidelines for the human genome, embryonic stem cells, gene therapy, epidemiology, and clinical research were established. These guidelines emphasize the role of informed consent and research ethics committees. The recent development of ethical guidelines demonstrates that the Japanese government now considers bioethics a major approach to the advancement of life science and medical technology.

Having said that, there is plenty of room for growth in bioethics. It is important to note that there are still a persistently small number of experts in the field. Few institutions have provided the educational program for ethics committee members in Japan. To resolve this problem, the CBEL was founded by a grant from the Ministry of Education, Culture, Sports, Science and Technology.

The intensity of the current interest in bioethics in Japan belies the comparatively sluggish development of the subject. In contrast, bioethics in the United States was widespread among academic fraternities and in the public perception as early as the 1970s. A key to understanding this contrast may lie in the "birth of bioethics" in Japan. Professor Alberto Jonsen, a well-known American bioethicist, elucidated a rich history of bioethics in the United States and pointed out two distinct concepts: bioethics as a discipline and bioethics as a discourse. The discipline is described as the process by which philosophical theories and methodologies have been transcribed, including the four principles of bioethics—respect for autonomy, beneficence, nonmaleficence, and justice. In the process, American bioethics has been transformed into an interdisciplinary field in which philosophers, lawyers, and social scientists participate. The discourse is carried out in public by many people in a variety of settings. "From its beginnings, bioethics has gotten people talking." (Jonsen, 1988: 352) Bioethics as a discourse is grounded in debates and discussion, including bioethics education, ethics committees, community discourse, social movements, and bioethical policies. Given such bioethical concepts, Japanese bioethics has developed through the intersection of bioethics as a discipline and bioethics as a discourse.

In Japan, bioethics as a discipline has relied greatly upon translations of American and European works. For instance, the earliest translation of bioethics was Professor Van Rensselaer Potter's "Bioethics" (1971), which was translated into Japanese in 1974. Professor Potter is the medical scientist who proposed the notion of bioethics within a framework of environmental ethics. Subsequently, the early notion of bioethics in Japan embraced environmental ethics. At the beginning of 1980, however, the notion of bioethics as biomedical ethics spread gradually among Japanese scholars, who translated bioethical work at the Kennedy Institute of Ethics at Georgetown University and at the Hastings Center. In the 1980s, Japanese scholars started organizing their own discipline for bioethics. In 1988, for example, Professor Hyakudai Sakamoto reported a collaborative project on bioethical theories and methodologies, although his work did not lead to a coherent approach to bioethics. Since 1986, a group of scholars at Chiba University has developed a systematic translation project on bioethics. The project has been importing several philosophical ideas and theories, including the American concept of "autonomy" in the 1990s, and the European concept of "dignity of life" in the 21st Century.

As for bioethics as a discourse, public concerns about the use of genetic recombination technologies and environmental problems in the 1970s provided the basis for early debates on life sciences and bioethics in Japan. Dr. Taro Takemi, president of the Japan Medical Association, was eager to open public forums for medical ethics in the late 1970s. In addition, Professor Rihito Kimura and Mr. Akihiko Okamura initiated public lectures for bioethics in many places, in the context of patients� rights movements in the early 1980s. Although these events triggered the introduction of bioethical debates in the early 1980s, bioethics arose as a discourse as the result of fierce national debates on brain death in the mid-1980s, leading the Japanese public to become widely acquainted with bioethics. These bioethical debates were characterized by the participation of well-known legal scholars, such as Professor Kouichi Bai, who intervened in the medical discourse on brain death, to obtain a social consensus on the new definition of death. In fact, the Japanese term for bioethics (seimei-rinri) came to be widely used in the mass media after the ad hoc committee on brain death was formed.

The interaction between discipline and discourse in bioethics has become an interesting topic in Japan. There is no doubt that the brain death debates created the intersection between the academic disciplines and public discourse. In 1988, the Japan Association for Bioethics was established to introduce interdisciplinary fields of bioethics. One of the key debates focused on brain death and organ transplant. That debate continued for more than a decade, demonstrating the difficulty of shaping a national consensus on brain death and organ transplantation, even after the enactment of the Organ Transplant Law in 1997. After the news of the cloned sheep, Dolly, gained worldwide media attention in 1997, the Council for Science and Technology introduced the Bioethics Committee (BCCST) for Cloning the same year, followed by the Bioethics Committee for Embryo Stem Cell research in 1998, and for Human Genome research in 1999. Although bioethical debates were affected by the "vertical division of governmental administration" in the 1980s and 1990s, several governmental administrations, including three ministries, reached consensus in launching bioethical policies in the 21st Century. These governmental debates produced a chain of bioethical studies, public debates, and policies in the 21st Century. This policy-based intervention into biomedicine greatly impacted the growth of bioethics in Japan. It is clear that public interest in bioethics will ensure its continued evolution and development in the years to come.

The views expressed above are those of the author and may not necessarily reflect the views of the organization.