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Introduction to the Project on Bioethics for Informed Choices - page 93 / 115





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Bioethics Education623

Courses Re-thinking Health and Illness

- Hiroaki Koizumi .

Kojimachi Gakuen Women’s High School, Tokyo JAPAN

Email: hirotty@mte.biglobe.ne.jp

In the background to the birth of bioethics has been the strong assertion of patients’ rights as consumers that has come about since the influences of the American civil rights movement, and additionally the women’s liberation and consumer movements, spread into the field of health care from the 1970s onwards. The framework of bioethics became the right to self-determination and theories of the person. Looking at international trends in bioethics, in contrast to a broadly permissive bioethics founded on the American self-determination of the individual is a European bioethics that gives greater priority to the common good over the individual.

The teaching materials used in bioethics education are for the most part centered around case studies involving cutting-edge medical technologies, but there is a need to promote the creation of teaching materials based on a broad understanding of the meaning of “bio” or life. This “education on life” must cover fully the following contents, which branch into many fields of learning.


Fostering the spirit of veneration for life, and an awe towards life itself


Cultivating respect for basic human rights and qualities of citizenship


Aiming to nourish the ability for self-determination, and harmonizing this with the common good


Aiming at the harmonization of advances in science and technology with society


Esteeming diversity and pluralism


Developing one’s own view of life


Consideration of our coexistence with others

In the present day the ideas of "healthism", putting health above all, have gained great influence, and we see many people applying themselves to walking or dieting etc. in order to maintain or improve their health. Also anti-bacterial goods are lined up on display in the shops, and people strive to approach as near as possible to a bacteria-free state.

We speak of illness as opposed to health, but is there really such a thing as a perfectly healthy person? If we make a diagnosis after thorough testing, then no-one is free of disease. Though we might be healthy, there is always the possibility we’ll become sick, and we exist side-by-side with disease. We truly are “Homo Patients”.

Until the 18th century doctors used to ask the sick “What’s the matter with you?” but in modern times this has changed to the question “Is somewhere not quite right?” The French thinker Michel Foucalt observes that doctors have changed from looking at disease as involving the whole the body, to seeing the human body as like a machine composed of various parts. This means they have changed to a view that tries to understand disease as a breakdown in one of the body’s constituent parts.

Disease also has aspects that must be considered within the extents of the society to which the sick individual belongs, and under the weight of its history. One of these is that disease and their names have a symbolic significance, distinct from their original meaning, which can take on a social connotation, becoming the object of social discrimination and prejudice. This is what Susan Sontag called “Disease as Metaphor”.

Furthermore there are violations of human rights that occur due to the exclusion of, and discrimination against the sick arising out of prejudice and excessive fear of disease. Such is the discrimination against, and exclusion of AIDS, the plague, cholera, Hansen’s disease, and mental diseases etc. In our country the Prevention of Leprosy Law was finally abrogated only in April 1996. Under this law, sufferers from Hansen’ disease and their families were marked with an inexpungible social stigma. We must vanquish these negative attitudes towards the sick of discrimination and exclusion.

. pp. 623-624 in Macer, DRJ., ed., "Challenges for Bioethics from Asia" (Eubios Ethics Institute, 2004).

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