session 1

Current Situation of GID Families in Japan

Waki TOYA, The National Cerebral and Cardiovascular Center of Japan

In Japan, there are no laws prohibiting discrimination against lesbian, gay, bisexual, and transgender (LGBT) people, and the Japanese Constitution does not allow same-sex marriages. Legislation for civil unions has not been a popular topic in the political scene, either. With the establishment of the ‘Act on Special Cases in Handling Gender for People with Gender Identity Disorder (GID)’ in 2003, Japanese people have begun to acknowledge GID. A GID person has the potential to change his/her gender on the family register and if a GID person was a heterosexual, he/she can legally marry. However, there has been confusion in the government over GID family formation with assisted reproductive technology (ART).

Firstly, here is a case reported in January 2010: Officials in Shiso City in western Japan refused to accept an application from a married couple who wanted to register a baby born through donor insemination (DI) on their official family registration record because the officials knew from the family register that the father’s legal gender had changed. For over 60 years in Japan, ‘natural male’ husbands have been registered as fathers of resulting children through DI. There have been several cases similar to the Shiso case in Japan, and with some bumps and detours, government decided to allow GID men who have children through DI to be registered as the father at last in December, 2013.

Japan currently has no law concerning ART, and adoption has not been promoted for very long. Meanwhile, almost all developed countries have restrictions on permitting LGBT people to have children. The issues surrounding governments’ decisions include religion and culture, the welfare and healthy development of the child, and international politics. For future discussion about LGBT family formation in Japan, some issues unique to Japan need to be discussed.


Rethinking the Baby-box; Germany’s New Law for Confidential Birth in Comparison with Recent Approaches in Japanese Obstetrics

Tobias BAUER, Kumamoto University

Kyoko SAKAMOTO, Osaka University of Pharmaceutical Sciences

Fourteen years have passed since the first Babyklappe was set up in Germany while Japan’s, hitherto only, baby-box was implemented seven years ago. In the light of rising critical assessment of this kind of approach to saving newborns from maltreatment, abandonment, or neonaticide, we discuss in this presentation recent, alternative approaches in both countries from the viewpoint of the benefit of the child.

Following the announcement of the German Ethics Council’s opinion on the Anonymous relinquishment of infants (2009) and a survey on Anonymous birth and Babyklappen in Germany (German Youth Institute, 2011), German politicians have set out to tackle the problem of baby-boxes. In the presentation, we discuss both the ethical and legal problems of baby-boxes as reported in the abovementioned citations as well as the effort by German politicians to provide alternatives to baby-boxes through a new law for confidential birth (enforced May 2014).

The large number of baby-boxes in Germany (estimated to be over 80) contrasts sharply with the only baby-box in Japan, run by the Jikei Hospital in Kumamoto. Nevertheless, it is evident that the dedicated engagement of the Jikei Hospital to save the lives of newborns by using a baby-box has stimulated the development of related but different approaches, such as the recent countrywide project undertaken by obstetrics clinics via the “Anshin Haha to Ko” organization – an organization which plans to assist in Special Adoptions in order to save newborns unwanted by their biological mother.

After comparison of recent approaches in both countries, we close by considering the implications and ramifications of such, again both ethically and legally, with respect to the hitherto baby-box practices. Through this comparison we try to demarcate, under the criterion of benefit to the child, the ethical requirements and desiderata of recent and future approaches.


Cutting-edge Reproductive Medicine and Ethics in Japan―an Ethical View on the Clinical Application of Both the New Type Preimplantation Genetic Diagnosis and Dr. Netsu’s Selective Reduction

Masayuki KODAMA, National Institute of Fitness and Sports in Kanoya

 The Japan Society of Fertilization and Implantation(JSFI) was held in Oita on August 8-9, 2013. Many of symposiasts who took part in the JSFI symposium were of the opinion that in the prevention of balanced chromosomal translocations-related recurrent miscarriage it was remarkably effective to make the new type preimplantation genetic diagnosis(the new type PGD) using comparative genome hybridization(CGH) for only the carriers of balanced chromosomal translocations.

At the meeting, Dr. Yahiro Netsu gave a presentation which introduced the results of 1,001 cases of the selective reduction in Japan, including 36 cases of the selective surgery to reduce the fetuses with congenital disease for the purpose of evading physical danger for women with a multiple pregnancy.

Although the Japan Society of Obstetrics and Gynecology (JSOG) endorses the new type PGD using CGH for only the carriers of balanced chromosomal translocations, it is against the ethical guidelines of the JSOG to decide whether or not embryos should be implanted due to the aneuploidy found in the embryos as a result of the new type PGD. In my opinion, it is at the discretion of the JSOG’s own Randomized Controlled Test which involves multiple facilities whether or not a scientific basis can be found for the value of the new type PGD in cases of recurrent miscarriage, implantation failure, and with women of advanced age.

Dr. Netsu’s 36 cases of the selective reduction may be against Maternal Protection Law prohibiting abortion due to congenital disease, but seeing that there are lots of abortions as a result of parental convenience in Japan, it is difficult to understand the difference between the over 300 thousand abortions per year in Japan and Dr. Netsu’s surgery which selectively reduces a fetus with congenital disease for the purpose of evading physical danger for women with a multiple pregnancy.


Traditional Chinese Medicine and Philosophy in Multicultural Society

Masami TATENO, Nihon University

 The ancient Chinese had such sound and wise conviction that we are born to live healthy and complete our long lives by nature. To understand this fact is philosophy, and to accomplish this nature is medicine. Philosophy and medicine were not in two separate realms, at least in ancient China. They were in one harmony.

First I would take Laotzu’s 老子 philosophy of Tao as one of the most distinctive example of this philosophical background on which this traditional medicine based. Laotzu asserts that we should try to embody the true self, and in order to accomplish it, we should plunge ourselves into the deep realm of our unconsciousness through the practice of self-cultivation based on regulating our breath. This practice is training of breathing, and once they established this philosophical foundation, traditional Chinese medicine was able to be established in its true formula.

Then I will argue that the basic formulation of this ancient Chinese medicine is appropriately based on the philosophical back ground citing Lushi-Chunchiu『呂氏春秋』. In this work, we can find the fundamental ideas of traditional Chinese medicine such as “qi” 気, a psycho-somatic way of praxis, holistic method of remedy, “vis medicatrix naturae”, etc. However the most substantial point in this case is that we cannot understand the true significance of this medicine without an appropriate comprehension of the philosophical background such as Laotzu’s Tao.

Philosophy and medicine should be in one harmony, since philosophy without medicine is impractical, but medicine without philosophy is reckless. Now we should take this case as a virtuous exemplary, and try to find a new and global harmony between philosophy and medicine.


Haruchika NOGUCHI’s Natural Philosophy of “Ki” in Modern Japanese Medicine from the Perspective of Bioprospecting

Tetsuro TANOJIRI, The University of Tokyo

Yumi KAWAKAMI, Seigakuin University

  The schools of Japanese Mind Cure (JMC) (reijutsu or ryōjutsu) established in 1890s Japan constructed their theories by combining traditional Japanese thought with modern European thought. JMC locate the source of authority in the power inherent in human experience. However, as personal experiences are not easily comprehensible to others, the JMC needed to import theories of experience. Their originality was shown by the diversity of sources for their theories, which included Japanese traditional religions, modern European psychiatry, theosophy, and spiritualism.

There have been prior studies of the formation of Western medicine in modern Japan, such as Ellen Nakamura’s “The Private World of a Meiji-era Japanese Doctor: Ishii Kendō’s Diary of 1874” (2013). Moreover, the work of religious studies scholars including Janine Sawada, Shigeru Nishiyama, Susumu Shimazono, Tatsuya Yumiyama, and Shintaro Tanabe, illustrate the existence of medical-religious-ethical complexes or communities in modern Japan. But neither of these models are ideal for the analysis of the history of JMC.

This presentation suggests the concept of “bioprospecting” as a new model for understanding JMC. Bioprospecting is the process of observing and “mining” living things for scientific analysis and practical applications (Hayden, 2003). We argue that Haruchika NOGUCHI (野口晴哉) (1911-1976), a great synthesizer in the history of JMC, established his original “natural philosophy of Ki” through a double bioprospecting of his own experiences, the techniques of Japanese tradition, and the theories of modern Europe. By this, he started a medical movement called “Noguchi Seitai”(野口整体). In this presentation, we analyze this process using recently-uncovered historical records.



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