Why Can’t Japanese People Decide?—Withdrawal of Ventilatory Support in End-of-Life Scenarios and Their Indecisiveness

  • Eisuke Nakazawa
  • Keiichiro Yamamoto
  • Reina Ozeki-Hayashi
  • Akira AkabayashiEmail author


According to a recently updated survey on end-of-life care conducted by the Ministry of Health, Labour and Welfare (Japan) in 2017, the collective intention regarding end-of-life care has not yet reached a consensus. Within the general public, 66.0% (n = 973) approved of the idea of preparing written advance directives that describe the type of medical care or treatment they wish to receive (or not) if they were to become unable to make a decision. However, 91.3% (n = 642) of these had not actually written out any advance directives (MHLW 2018). In other words, while many Japanese think that it would be good to express their intentions about the end of their lives, most have not actually put this into action. Even when the sample population was limited to elderly over 60 years of age, 85.0% did not have anything in writing, despite agreeing that this would be a good idea (MHLW 2018). These results are fairly consistent with those from a survey conducted in 2013 (MHLW 2014).



Funding Information

This study was supported by Pfizer Health Research Foundation.

Compliance with Ethical Standards

Conflict of Interest

Although AA is President of the Japan Association for Bioethics (JAB), this paper reflects the authors’ personal academic analyses and opinions. It does not represent JAB’s official position on this issue. The other authors have no conflict of interests to declare.


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Copyright information

© National University of Singapore and Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of Biomedical Ethics, Faculty of MedicineUniversity of TokyoTokyoJapan
  2. 2.Division of Medical EthicsSchool of Medicine, New York UniversityNew YorkUSA

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