Attitudes of Japanese and Japanese-American physicians towards life-sustaining treatment

Lancet. 1995 Aug 5;346(8971):356-9. doi: 10.1016/s0140-6736(95)92230-x.


Doctors in different countries have different approaches to bioethical problems. We studied how attitudes to life-sustaining treatment for terminally ill patients differ in Japan and the USA by administering a questionnaire to Japanese (136) and Japanese-American (77) physicians. In a series of clinical scenarios the questionnaire asked what life-sustaining interventions the doctors would recommend to a patient with metastatic gastric cancer. Most Japanese physicians would recommend blood transfusions for gastrointestinal bleeding (74%), total parenteral nutrition for malnutrition (67%), and vasopressors for life-threatening hypotension (61%) when the patient did not know of his diagnosis and outlook. Significantly fewer Japanese physicians would want these interventions for themselves: 29% would want transfusion, 36% would want total parenteral nutrition, and 25% would want vasopressors. 36% of Japanese physicians would override the explicit request of a competent moribund cancer patient to withdraw all life-support. By contrast, among Japanese-American physicians only 42% would recommend blood transfusions, 33% total parenteral nutrition, and 34% vasopressors to a terminally ill cancer patient who did not know of his diagnosis or outlook. Cross-cultural studies in medical ethics can help physicians and the public in different countries to take a fresh look at accepted practices and the ethical reasons behind them.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Asian
  • Attitude of Health Personnel*
  • Cross-Cultural Comparison*
  • Cultural Diversity*
  • Ethics, Medical
  • Humans
  • Internationality*
  • Japan
  • Life Support Care / psychology*
  • Male
  • Middle Aged
  • Physicians / psychology*
  • Social Values
  • Stomach Neoplasms / secondary
  • Stomach Neoplasms / therapy
  • Surveys and Questionnaires
  • Terminal Care / psychology
  • United States
  • Withholding Treatment*