ritsumeikan journal volume 36, march 2018 of asia pacific ...volume 36 ritsumeikan journal of asia...
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Ritsumeikan Center for Asia Pacifi c StudiesRitsumeikan Asia Pacifi c University
Beppu, Oita, Japan
Ritsumeikan Journal of Asia Pacifi c StudiesVolume 36, March 2018
Contemporary ethical implications of Shusaku Endoâs The Sea and Poison Atsushi Asai, Taketoshi Okita, Aya Enzo and Yasuhiro Kadooka âŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠ 1
A comparison of refusals between Chinese speakers in Taiwan and MalaysiaMei-Ying Chen âŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠ 9
æ¥æ¬åäŒæ¥ã®æ°è£œåéçºã«ãããé»å®³èŠå ïŒåºæ¬ææ³ã«åºã¥ã仮説ã®æ瀺 è€äºãèª äž âŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠ 21
Addressing environmental concerns in the Asia Pacifi c region through community media Benjamina Paula Gonzalez-Flor, Juvy Leonarda N. Gopela and Marifi T. Magsino âŠâŠâŠâŠ 37
Donors, government and society in Indonesiaâs democratic electionsAsra Virgianita âŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠ 51
Ritsumeikan Journalof Asia Pacific Studies
Volume 36March 2018
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Ritsumeikan Center for Asia Pacifi c StudiesRitsumeikan Asia Pacifi c UniversityBeppu, Oita, Japan
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ISSN 1344-4204
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Ritsumeikan Journal of Asia Pacific StudiesVolume 36, March 2018
Contemporary ethical implications of Shusaku Endoâs The Sea and Poison Atsushi Asai, Taketoshi Okita, Aya Enzo and Yasuhiro Kadooka âŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠ 1
A comparison of refusals between Chinese speakers in Taiwan and MalaysiaMei-Ying Chen âŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠ 9
æ¥æ¬åäŒæ¥ã®æ°è£œåéçºã«ãããé»å®³èŠå ïŒåºæ¬ææ³ã«åºã¥ã仮説ã®æ瀺 è€äºãèª äž âŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠ 21
Addressing environmental concerns in the Asia Pacific region through community media Benjamina Paula Gonzalez-Flor, Juvy Leonarda N. Gopela and Marifi T. Magsino âŠâŠâŠâŠ 37
Donors, government and society in Indonesiaâs democratic electionsAsra Virgianita âŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠâŠ 51
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Contemporary ethical implications of Shusaku Endoâs The Sea and Poison
Atsushi Asai,1 Taketoshi Okita,2 Aya Enzo3 and Yasuhiro Kadooka4
Background: The Kyushu Imperial University human vivisection case and Shusaku Endoâs The Sea and Poison
The 1945 Kyushu Imperial University human vivisections are among the most infamous of medical atrocities involving Japanese doctors or researchers. Japanese doctors at Kyushu Imperial University School of Medicine, at the direction of the Japanese army, vivisected eight American captives, all of whom were killed. The doctors killed the captives by injecting diluted seawater into their veins, removing their lungs or livers, and through other horrific experiments that tested their physical limits. Twenty-three Japanese individuals, including army officials and Kyushu University doctors, were convicted of war crimes and sentenced to death by hanging, life in prison, or other penalties (Kumao, 2015; Takahashi, 2015; Ogaki, 2015; Japan Times, 2015).
In 2015, the Kyushu University Medical History Museum began to display two items related to human vivisections (Japan Times, 2015; Sankei Newspaper, 2015). The exhibit triggered active social discussion. Comments primarily included war criticisms such as, âthe war drove the doctors madâ and âthe war caused this foolishness,â and blame against Japanese militarism at that time such as, âthe abnormal atmosphere where the armyâs orders were absolute caused the atrocity.â Moreover, doubts as to why doctors, who are supposed to save human lives, committed such brutal acts were expressed from professional perspectives (Takahashi, 2015; Ogaki, 2015; Japan Times, 2015; Sankei Newspaper, 2015). One individual involved in the vivisections as a medical student confessed that he was not sure whether or not he could have refused participation under circumstances where strong abhorrence to American soldiers predominated if he were a professor at the medical school (Shimosaki, 2015 June 22). On the other hand, one of the senior faculty members concerned claimed âwe could have prevented it from happening even in that age if we had been sturdyâ (Kumamo, 2015; Shimosaki, 2015 June 22).
1 Professor, Department of Medical Ethics, Tohoku University Graduate School of Medicine Email: [email protected] 2 Assistant Professor, Department of Medical Ethics, Tohoku University Graduate School of Medicine 3 Assistant Professor, Department of Medical Ethics, Tohoku University Graduate School of Medicine 4 Associate Professor, Department of Bioethics, Kumamoto University Faculty of Life Sciences
Abstract The 1945 Kyushu Imperial University human vivisections are among the most infamous of medical atrocities involving Japanese doctors. The Japanese novelist, Shusaku Endo published The Sea and Poison, a fiction novel based on the incident in 1958. His story features young doctors, Suguro and Toda, and depicts their motivations to join the killing, as well as their regrets or the lack thereof. Endo forces us to ponder why they involved themselves in the human vivisections and what might have dissuaded them from doing so. Even today we lack clear answers to these questions. This paper will present our deliberations on the contemporary implications of Endoâs questions and positions set forth in The Sea and Poison. We suggest that Suguro failed to refuse participation in the vivisection because of his emotional exhaustion and emptiness, which could have been caused by war, the doctorsâ true colors, or the dark side of medicine. It is argued that Suguro is no different from many of us, and that Todaâs claim that we are, deep down, unmoved by the suffering and death of others describes part of our minds. The meaning of strong conscience and compassion is also discussed.
Keywords: The Sea and Poison, Shusaku Endo, human vivisection, war, Japan, research ethics
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Contemporary ethical implications of Shusaku Endoâs The Sea and Poison
In 1958, the Japanese novelist Shusaku Endo published The Sea and Poison (Umi to Dokuyaku), a fiction novel based on the incident described above (Endo & Owen, 1971).
Outline of The Sea and Poison In 1945, when defeat in the war was certain, Dr. Suguro and Dr. Toda were both young interns of First Surgery at a University Hospital and had been taking care of many inpatients with tuberculosis. Even though the US Air force had bombed the hospital daily, professors at the University were ardently aiming to become the Dean of the School of Medicine. Professor Hashimoto of First Surgery operated on a young relative of the previous dean, but she died from massive blood loss during the surgery and this failure left him at a disadvantage in the election for dean. To recover from this situation, Professor Hashimoto and two First Surgery faculty members decided to participate in the vivisection of an American prisoner of war at the request of Japanese martial medical officers. Both Suguro and Toda were asked to join and assist the vivisection by their supervising doctors, Dr. Shibata and Dr. Asai. Toda decided to join without hesitation. Suguro was undecided, but did not refuse. They participated in the vivisection of a U.S. military captive together with many Japanese military personnel. After the vivisection, Suguro suffered deeply from remorse, guilt, and self-hatred, while Toda did not experience any psychological change.
The novel describes in detail the background, motives, and conflicts concerning participation in the vivisection, as well as the state of mind after the lethal experiments of the two protagonists, who have distinct personalities. Endo is considered to be the only major Japanese novelist to confront the problems of individual responsibility in wartime (Gallagher, 1971). In The Sea and Poison, Endo questions why they involved themselves in the vivisection, an unethical human experiment; what might have dissuaded them from participating in this abhorrent wrongdoing; and in what manner we ought to judge the protagonistsâ individual responsibilities in their involvement in this atrocity during wartime. He published a sequel to this work, A Song of Sadness (Endo, 1981). The sequel depicts Suguroâs life about 20 years later as he continues to be nihilistic due to the deep regret and guilt about his participation in the vivisection.
Even today, 60 years later, we lack clear answers to the above-mentioned questions presented by Endo. It is important that we try to answer these questions, and we also need to deeply consider the meaning of the main charactersâ perceptions in this novel. First, just as Suguro and Toda faced the Second World War 70 years ago, any one of us could confront territorial disputes, terrorism, religious conflicts, racism, discrimination against the socially vulnerable, and indiscriminate mass murder at any time. There is a strong feeling that we are now living in an uneasy, unstable, and dangerous world, and that people could be unknowingly and rather easily swept to the same fate of emotional exhaustion and sensitivity paralysis that Suguro experienced. Second, unethical medical research has not discontinued entirely in Japan or in other countries (Sasaguri, 2012). Some have noted that Japanese medical communities have failed to reflect adequately on the evil actions of Unit 731, a biological warfare unit of the Imperial Japanese Army known to conduct human vivisections (Hickey, Li, Morrison et al., 2015; Shimosaki, 2015 June 25).
This paper will present our deliberations on the contemporary implications of Endoâs questions and positions set forth in The Sea and Poison from ethical and professional perspectives. First, we consider why Suguro involved himself in the vivisection and what might have dissuaded him from participating. We then present several ethical implications of the novel. We refer to Endoâs other works when they are relevant to our themes.
Why did Suguro involve himself in the human vivisection and what might have dissuaded him from participating?
Why did the protagonists in The Sea and Poison involve themselves in the human vivisection and what might have dissuaded them from participating? When thinking about Endo's question, we primarily consider the psychology of Suguro. We will touch on Todaâs psychology in the following section. First, why did
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Suguro not refuse participation? What is most important in considering this question is that nobody forced him to participate, he had adequate time to ponder the implications of participation, and had several opportunities to refuse. Assistant Professor Asai said, âYou are perfectly free, you know. Really!â Associate Professor Shibata also added, âNo, no! No forcing.â
Actually, he did nothing in the operating room when the three professors and Toda were vivisecting the prisoner of war with the help of two nurses. He screamed, âNo, I canât,â âLet me go. I want to get out,â and just stood beside the wall of the room trying to imagine this was an ordinary patient operation. No one, including military personnel, blamed him for doing nothing (Endo & Owen, 1971). This suggests that there was no coercion or, at least, there was no strong or explicit pressure imposed on Suguro. As a matter of fact, 30 years later in A Song of Sadness, Suguro told a young pressman interested in the human vivisection experiments that it would have been possible to refuse participation if he had really wanted to (Endo, 1981).
The reason that Suguro consented to join in the vivisection remains vague, and he himself seems unsure of this point for a while. It could be that his colleague Toda decided to participate without reservation and Suguro just followed his decision. It could be due to headache, nausea, or absent-mindedness caused by the smoke from charcoal fires and cigarettes in the faculty room. However, he soon abandoned thinking of the true reason and rather quickly concluded, âItâs all the same.â He added, âNo matter how much you think, it doesnât help. Iâm just one person. What can I do with the world?â (Endo & Owen, 1971). A day before Suguro and Toda were asked to join the vivisection, Suguroâs first patient died, in spite of his efforts to make sure she did not die in the midst of everyone being the way out. Her death made him think that, âFrom now on, for myself, for the War, for Japan, for everything, let things go just as they likeâ (Endo & Owen, 1971).
It seems to us that Suguro was caught in the insignificance of life and helplessness around him in a time when everyone had been the way out, and he lost all energy to positively commit to anything, judge moral appropriateness, and make his own choices. He suffered from emotional exhaustion and sensitivity paralysis. In A Song of Sadness (Endo, 1981), he told the pressman that he had not refused to participate in the human vivisection because he might have been too tired to do so. Thus, Suguro did not refuse it because of his nihilism and despair in the face of the overwhelming fate of war that naturally disregards human lives. A critic pointed out that this overwhelming fate is likened to a black sea in The Sea and Poison, and in his dream he saw himself in the dark sea, his figure a battered husk swept round in the current (Endo & Owen, 1971; Saeki, 1958).
Furthermore, we think that Suguro was deeply disappointed in both medical doctors at his medical school and medicine itself, and this disappointment contributed to despair over his life as a young physician. The elderly lady who had been Suguroâs first patient had been selected as a candidate of Dr. Shibataâs lethal experiments. She died of her underlying disease just before the experimental surgery. A young relative of the previous dean was a means towards Professor Hashimotoâs advancement. She subsequently died during the unnecessary operation and, even worse, Hashimoto attempted to conceal the surgical death from the family in an attempt to save his own neck.
At the same time, Toda representatively explained the dark nature of medicine, âKilling a patient is not so solemn a matter as all that. It is nothing new in the world of medicine. That is how we have made our progress.â After the young relative of the late dean was killed during her operation, Suguro asked himself, âIs this what it means to be a doctor? Is this what medicine means?â (Endo & Owen, 1971). Therefore, the two kinds of despair caused by the war and medicine exhausted his positive commitment to the world and paralyzed his sensitivity to otherâs suffering. We would like to add one more possible reason for Suguroâs deep despair: the clear contradiction between war and medicine, or the meaninglessness of medicine in the midst of war, which kills everybody. It is possible that Suguro felt the helplessness of medicine in the face of the mass killing of war, especially after he failed to save his first patient.
According to Saeki (1958), this work indicts a Japanese mental and ethical vacuum, and suggests that this state of mind allows Japanese people to avoid making a serious ethical or religious choice when the choice is essential. It has also been pointed out that Endo thought that pantheism in the East does not have
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Contemporary ethical implications of Shusaku Endoâs The Sea and Poison
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Contemporary ethical implications of Shusaku Endoâs The Sea and Poison
the tension of opposites, such as that between good and evil, or flesh and spirit, and that he saw the calm passivity of pantheism as the dominant Japanese religious mood (Gallagher, 1971). Endo was baptized as a Catholic while a very young schoolboy and he created his works as a Christian (Gallagher, 1971; Saeki, 1958).
Given Endoâs basic perception about Japanese spirituality, we think he suggests in the novel that Suguro passively participated in the vivisection because he lacked a strong conscience based in the voice of God. If he had a strong spirit based on religious faith he could fight against his circumstances and refuse participation; no serious choice was made due to his lack of robust conscience. By that token, in the conversation between Suguro and Toda immediately after their consent to participate in the vivisection, Toda told Endo abruptly, âA man has all sorts of things pushing him. He tries by all means to get away from fate. Now the one who gives him the freedom to do that, you can call Godâ (Endo & Owen, 1971). We think that Endo claims as a Christian that God sets us free from the fate forcing us to do evil; God injects values and a firm meaning of life into a person's empty mind and removes highly-toxic nihilism, and the conscience given by God orders us to love others impartially. In the same way, Endo might think that unethical conduct in clinical practice and research activities in healthcare were problems of our soul and could disappear if the spirit of healthcare personnel was filled with charity. We believe that Endo regards our nihilism as poison in our soul, despite the fact that no commentator has claimed so to the best of our knowledge.
Contemporary ethical implications of The Sea and Poison
So far, we have considered The Sea and Poisonâs background, content, and Endoâs thoughts concerning conscience as the voice of God and its role. We suggested that the protagonist, Suguro, failed to refuse participation in the vivisection because of his emotional exhaustion and emptiness. His nihilism and despair could have been caused by war, the doctorsâ true colors, and the dark side of medicine and its limitations. What follows is our argument about the contemporary implications of The Sea and Poison where we will deliberate on the words and ideas of Suguro and Toda, although our arguments and claims may differ considerably from what Endo intended to convey to his readers, i.e., the primary importance of the voice of God.
First, all of us are Suguro; he is no different from many of us. He was a doctor who devoted himself to providing care to patients to the best of his ability with no excessive desire for power or promotion. Endo might have created Suguroâs character as a typically Japanese person. Endo was a Catholic who kept investigating the characteristics of Japanese existence driven by his perceived contradiction between being Catholic and being Japanese (Saeki, 1958; Ozaki, 1980; Takeda, 2012). However, in our opinion, Endoâs inquiry concerning the nature of Japanese people is not limited to the problem of the Japanese and could be universal. We believe that most people, regardless of race, faith, or time, might be unknowingly swept into the same situation of emotional exhaustion and sensitivity paralysis that Suguro experienced if they were placed in the same circumstance. Most of us could similarly remain undermined and passive while only a minority might fight against the overwhelming power of the era. Thus, it can be argued that The Sea and Poisonâs concerns not only address what being Japanese is, but also what being human is.
Everyone has a good side and a bad side that are always engaged in a tug-of-war. Nobody is completely good or bad (Isaka, 2012). A person may do something evil when the bad side predominates. Suguro told one of his patients at his clinic ten years after the vivisection, âFrom now on, Iâm not sure at all. If I were caught in the same way, I might, I might just do the same thing againâ (Endo & Owen, 1971). Toda also told Suguro just after the vivisection, âYou and I happened to be here in this particular hospital in this particular era, and so we took part in the vivisection of a prisoner. If those people who are going to judge us bad were put in the same situation, would they have done anything different?â (Endo & Owen, 1971) Both Eichmann involved in the Holocaust and Dr. Ishii of Unit 731 were just citizens and good fathers in their ordinary lives (Sato, 2005). If Arendtâs claim that Eichmann's evil was mediocre is correct, people could do
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serious evil without being especially evil or in a state of frenzy (Arendt, 1963). Milgram's famous psychological experiment also suggests that it is the case (Milgram, 1974). If our claim that we are no different from Suguro is correct, it is likely that we also would involve ourselves in a brutal wrongdoing in a similar situation.
It is possible that we could commit serious evil deeds even without being involved in overwhelmingly merciless circumstances such as war when our spirits are filled with self-loathing, hostility against society, a sense of alienation, distrust against others, and apathy about life as a consequence of various failures, losses, absurdities, or suffering. This is because we may feel, âItâs all the same,â about ourselves, others, or society as a whole (Endo & Owen, 1971). We should recognize that there is always danger and that even a person of goodwill has the capacity to assist in or initiate an atrocity. It is dangerous to have the conviction that we would never commit any crime or wrongdoing.
Second, it appears that Todaâs attitude towards othersâ pain or suffering expresses part of our mentality. Unlike Suguro, Endo describes Toda as cynical. Toda told Suguro that if the old lady who was Suguroâs first patient died during an air raid she would be just thrown away, "But if she gets killed during an operation, no doubt about it, and she becomes a living pillar upholding the temple of medical scienceâ (Endo & Owen, 1971). Toda did not hesitate to participate and volunteered to take part in the vivisection as an anesthesiologist. He justified conducting the vivisection to advance medicine. Toda confessed that, âTo put it quite bluntly, I am able to remain quite undisturbed in the face of someone elseâs terrible suffering and death,â and, âA patient would die. The parents and the sisters would wail; and I would put on a sad, sympathetic expression. But once out in the corridor, the spectacle would pass out of my mindâ (Endo & Owen, 1971).
Endo depicts Toda as a man who was insensitive to otherâs suffering and born without a conscience, and writes that Toda joined the vivisection because he desired to feel his own pangs of conscience by killing a prisoner of war in a brutal manner (Endo & Owen, 1971). Endo also suggested that we Japanese do not have an authentic sense of guilt, i.e., the fear of remorse, and that all we have is mere fear of the punishment of our own community or society (Saeki, 1958). Toda is a character who embodies this idea. Toda confessed, âFor me, the pangs of conscience were from the fear of disapproval in the eyes of others âfear of punishment which society could bring to bear.â Toda asks all of us, âThere is something I would like to ask you. Arenât you too, deep down, unmoved by the suffering and death of others?â (Endo & Owen, 1971).
This question should be answered honestly. How much are we moved by the death or suffering of others? How often do we avoid doing something evil solely because we fear the contradiction of our own conscience? We believe the claim that we are, deep down, unmoved by the suffering and death of others to correctly describe at least part of our minds. The person who acts with no concern about social sanction and guilt, but only to single-mindedly defend his or her conscience, might be in the minority.
On the other hand, Endo seems to earnestly desire that everyone feels, âI cannot be unconcerned when you suffer,â as the young Frenchman Gaston said, who was described as Jesus in the present Tokyo in A Song of Sadness (Endo, 1981). In Endoâs novel Watashi ga suteta onna (2012), the protagonist, an innocent girl, heard Jesus saying to her, âWhat you need in this world is to connect your sadness with otherâs sadness.â Also in The Sea and Poison, Suguro felt psychological pain when he saw his patient dying of tuberculosis (Endo & Owen, 1971). It is pointed out that Suguro has sympathy and solidarity with others (Endo & Owen, 1971; Kawashima, 2016). We agree with Endo that we need empathy, sympathy, and love for others, and that all are desirable traits in our human world. However, we need to make it clear that our claim does not require the existence of God as a necessary condition.
Third, it is often asked why medical doctors, whose primary role is to save human lives, killed American captives by vivisection. We would answer that they did it because they are medical doctors. The risk that medical doctors and researchers would be tempted to plan, assist, or conduct human vivisections is higher than that for laypersons because doctors have the motive, ability, and purpose to do so. Potential benefits obtained through vivisections would motivate them. In The Sea and Poison, Associate Professor
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Contemporary ethical implications of Shusaku Endoâs The Sea and Poison
Shibata told Suguro and Toda that, âFor a medical research man, from one point of view that is, it is the most sought after kind of opportunityâ (Endo & Owen, 1971). On the other hand, the layperson would not be interested in human anatomy, physiology, or inventing new surgical procedures. They also would have no capacity or access to conduct a vivisection. We believe that when doctors and researchers regard patients or subjects as the enemy or worthless, an extremely strong or narrow sense of mission may make them reckless and drive them to carry out atrocities. Their devotion to medicine and its progress could thus justify killing people whom they judge worthless in the name of advancing medicine.
We are not suggesting that medical doctors are inferior to laypeople in terms of personality, but they are not accepted to medical school for their strong empathy or excellent character. They are not selected for the strength of philanthropic spirit either. Hence, it is not surprising that some doctors, just like Suguroâs superiors, attempted to obtain new scientific knowledge by killing their enemies in an era of war. There is no strong reason that being a medical doctor would completely prevent getting involved in medical killing. Indeed, German doctors were believed to be willing to participate in brutal human experiments conducted at several concentration camps in the Nazi era (Weinke, 2015). The report about the Kyushu University human vivisections indicates that there were some doctors who visited the operation room to observe the vivisections because it interested them (Kumamo, 2015).
A layperson might stab, beat, or hang a prisoner of war to death against the international law banning inappropriate treatment of captives. Medical doctors might kill the prisoner by medical experimentation. Which is ethically more problematic? We argue that the latter is much worse than the former from a professional perspective because medical doctors have a mission to contribute to the health and welfare of others. In The Sea and Poison, Suguro had the impression that the confidence in doctors as medical professionals was quite enough to put the prisoner at ease when he looked at the first victim of vivisection (Endo & Owen, 1971). The captive may have thought it impossible for medical doctors in their white coats to hurt him, even if they were the enemy. We should not ignore the huge gap between doctorsâ evil intentions and patientsâ trust. Medical atrocities inevitably betray social trust in medicine and are therefore intolerable.
Fourth, we agree with Endo about the importance of possessing a strong conscience that could prevent us from being swept away by a merciless destiny. In general, conscience is an inner sense that distinguishes right from wrong, and it is an individual moral conviction that compels us to do good and not do evil (Thompson, 2010; Benjamin, 2014). In a religious discussion, conscience may be thought of as the âvoice of Godâ speaking within the individual. But, the internalization of parental and social norms, and the voice of conscience, could simply be an echo of social, parental, or religious admonitions (Thompson, 2010; Benjamin, 2014). Thus, doubt can rightly be presented concerning the accuracy of judging right and wrong. Conscience plays no direct role in ethical deliberation and is not an infallible guide to conduct (Benjamin, 2014).
In The Sea and Poison, Professor Hashimoto's German wife Hilda reprimanded a nurse who attempted to euthanize a dying inpatient suffering severely from respiratory difficulty by saying, "Even though a person is going to die, no one has the right to murder him. You are not afraid of God? You donât believe in the punishment of God?â (Endo & Owen, 1971) We are unsure whether Hilda was undoubtedly right and the nurse was absolutely wrong. In A Song of Sadness, Suguro 20 years later conducted voluntary active euthanasia for an old man who had been suffering from intractable pain due to terminal gastric cancer and consistently desired to die. When he was about to inject a large dose of morphine to the patient, Jesus told Suguro that he must not kill the terminal patient (Endo, 1981). However, was Suguro ethically wrong? We wonder how Jesus would deal with the severe suffering of a dying patient. At the very least, it can be argued that we should not treat equally the evil of voluntary active euthanasia and the evil of vivisecting prisoners of war.
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Conclusion: Can we stop future atrocities?
The remark of Associate Professor Shibata to Suguro and Toda, â[t]here are going to be some vivisections performed on American prisonersâ is extremely hateful (Endo & Owen, 1971). However, the vivisections actually occurred 70 years ago in Japan (Kumamo, 2015). It could occur again in the future. If there had been a research ethics committee at the medical school in 1945, could it have stopped the atrocity? We are unsure. It is possible that the ethics committee would resolutely oppose it based on international law or universal human rights. On the other hand, the committee might become a follower of the power at the time and its decision, based on the conscience of fascist Japan, could be used to justify conducting lethal human experiments. Toda told Suguro that the conscience of man seemed to vary a good deal from man to man (Endo & Owen, 1971). Indeed, medical research that seriously harms subjects has been happening in Japan from the end of World War II to the present (Sasaguri, 2012). What should we do to prevent medical atrocities like human vivisections from occurring in the future? It is important to continue current education regarding human rights, professionalism, and medical ethics, including clinical research and medical humanities, for medical researchers, healthcare students, and professionals. We would argue that what is most important is that human compassion, which is a strong feeling that it is unbearable and impossible to remain indifferent to in the face of anotherâs misfortune, is nurtured in as many individuals as possible as an outcome of these educational interventions (Jullien, 2002). We believe this compassion to be the same feeling as Gastonâs, âI cannot be unconcerned when you suffer,â and Suguroâs emotional pain in the face of the dying patient. However, we cannot expect dramatic effects of these interventions on how we feel about the suffering or pain of others. Given the limited ability of human beings to empathize, sympathize, or love others, how to nurture human compassion is an unresolved issue. To our regret, it is difficult for us to live with philanthropy. In fact, many are killed by terrorism or homicide every day worldwide. Our trial and error continues.
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Trans.). Tokyo: Kodansha gendaishinsho. (In Japanese) Gallagher, M. (1971). Introduction. In S. Endo, The sea and poison (pp. 1-7) (P. Owen, Trans). Tokyo:
Tuttle Publishing. Hickey, D., Li, S. S., Morrison, C., Schulz, R., Thiry, M., & Sorensen, K. (2016). Unit 731 and moral repair.
Journal of Medical Ethics. doi:10.1136/medethics-2015-103177. Isaka, K. (2012). SOS no Saru (A monkey of SOS). Tokyo: Chuko bunko. (In Japanese) Kawashima, H. (2016). Endo Shusaku: Wakai no monogatari (Stories of reconciliation). Osaka: Izumi shoin
2016. (In Japanese) Kumamo, I. (2015). The Kyushu Imperial University human vivisections: The truth after 70 years. Tokyo:
Iwanami Shuppan. (In Japanese) Milgram, S. (2008). Obedience to authority: An Experimental View (1974) (H. Yamagata, Trans.). Tokyo:
Kawaide bunko. (In Japanese) New Kyushu museum breaks taboo with POW vivisection display. (2015, April 4). Japan Times News.
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Contemporary ethical implications of Shusaku Endoâs The Sea and Poison
The Kyushu University Medical History Museum began to display items related to human vivisections of eight American captives. (2015, April 4). Sankei Newspaper. (In Japanese)
Ogaki, K. (2015, August 4). The Kyushu Imperial University human vivisections: A clinic in Fukuoka displays 40 items demonstrating the foolishness of war. Mainichi Newspaper. (In Japanese)
Ozaki, H. (1980). Commentary. In S. Endo, Mahiru no akuma (A devil at midday) (pp. 313-320). Tokyo: Shincho bunko. (In Japanese)
Saeki, S. (1958). Commentary. In S. Endo, Umi to dokuyaku (The sea and poison) (p. 197). Tokyo: Shincho bunko. (In Japanese)
Sasaguri, T. (2012). Ethical principles and guidelines. In T. Sasaguri & K. Muto (Eds.), Bioethics series: Medical research (pp. 24-50). Tokyo: Maruzen shuppan. (In Japanese)
Sato, M. (2005). Commentary. In F. Aoki, Unit 731 (pp. 520-534). Tokyo: Shityo bunko. (In Japanese) Shimosaki, C. (2015, June 22). The scalpels of madness: The Kyushu Imperial University human
vivisections no. 2. Nishinippon Newspaper. (In Japanese) Shimosaki, C. (2015, June 25). The scalpels of madness: The Kyushu Imperial University human
vivisections no. 4. Nishinippon Newspaper. (In Japanese) Takahashi, K. (2015, July 18). The Kyushu Imperial University human vivisections of eight American
captives. Yomiuri Newspaper. (In Japanese) Takeda, T. (2012). Commentary. In S. Endo, Watashi ga suteta onna (A woman whom I deserted) (pp. 310-
330). Tokyo: Kodansha bunko. (In Japanese) Thompson, M. (2010). Understanding ethics. Oxford: Bookpoint Ltd. Weinke, A. (2015). The Nuremberg trials (2006) (T. Itabashi, Trans.). Tokyo: Chuko shinsho. (In Japanese)
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Figure 4.1: The overall frequencies of each refusal strategy used per person in each group.
Finally, Figure 1 presents the most preferred strategies of both groups. Three notable facts were found. First, both groups were identical in terms of the top six favored strategies used; namely, (1) reasons, (2) regrets/apology, (3) address form, (4) inability, (5) unwillingly, and (6) alternatives. These results are consistent with the literature (Chen et al., 1995; Liao & Bresnahan, 1996; Hong, 2011) that Chinese people are inclined to give reasons and express regret while refusing. Second, a few indirect refusal strategies such as criticism, empathy, future acceptances, and principles as well as fillers were rarely used by the participants. Finally, Taiwanese subjects outperformed their Malaysian counterparts on almost every strategy used, except statement of regret (i.e., Malaysian: 3.52 tokens; Taiwanese: 3.24 tokens) and fillers (i.e. Malaysian: 0.22 tokens; Taiwanese: 0.18 tokens). 4.3 Power relationship and social distance on the frequency of refusal strategies Two social factors, power relationship and social distance, were embedded in each situation to test whether the participants vary their refusing in different situations. Table 5 presents the mean, standard deviation and the total refusal strategies in each situation of two groups.
As can be seen in Table 5, while the total number of refusals strategies used in two power-high situations (situation 1 and 2) were highest, the total number was the lowest in two power-equal situations (situation 3 and 4). The mean number of strategies used by the participants in the Malaysian group ranged from an average of 1.92 strategies in the situation 4 (=P, +D) to 2.86 strategies in the situation 2 (+P, +D). Likewise, the participants in the Taiwanese group produced overall strategies from an average of two strategies in situation 3 (=P, -D) to 3.5 strategies in situation 2 (+P, +D). The standard deviation also reflected a substantial heterogeneity within each group. Table 5: Mean, standard deviation (SD) and the total refusal strategies in each situation of two groups Group S1(+P,-D) S2(+P,+D) S3(=P,-D)
S4(=P,+D) S5(-P,+D) S6(-P,-D)
Malay Total Refusals Mean (n = 50) SD
141 2.82 1.024
143 2.86 .969
96 1.92 .922
96 1.92 .633
113 2.26 1.026
115 2.3 .909
Taiwan Total Refusals 170 176 101 125 147 148 Mean (n = 50) 3.4 3.5 2.0 2.5 2.94 2.96 SD .857 1.147 .914 1.025 1.420 1.087
Each refusal type includes the frequent use and the percentage (%) in parentheses.
0.18
2.161.46 1.62
3.24
0.28
4.52
1.160.38 0.54
0.74 0.82 0.240.22
1.2 1.22 1.34
3.52
0.08
3.98
0.80.16 0.18 0.44 0.42 0.16
00.5
11.5
22.5
33.5
44.5
5
Taiwanese
Malaysians
Ritsumeikan Journal of Asia Pacific Studies Volume 36, 2018
Figure 4.1: The overall frequencies of each refusal strategy used per person in each group.
Finally, Figure 1 presents the most preferred strategies of both groups. Three notable facts were found. First, both groups were identical in terms of the top six favored strategies used; namely, (1) reasons, (2) regrets/apology, (3) address form, (4) inability, (5) unwillingly, and (6) alternatives. These results are consistent with the literature (Chen et al., 1995; Liao & Bresnahan, 1996; Hong, 2011) that Chinese people are inclined to give reasons and express regret while refusing. Second, a few indirect refusal strategies such as criticism, empathy, future acceptances, and principles as well as fillers were rarely used by the participants. Finally, Taiwanese subjects outperformed their Malaysian counterparts on almost every strategy used, except statement of regret (i.e., Malaysian: 3.52 tokens; Taiwanese: 3.24 tokens) and fillers (i.e. Malaysian: 0.22 tokens; Taiwanese: 0.18 tokens). 4.3 Power relationship and social distance on the frequency of refusal strategies Two social factors, power relationship and social distance, were embedded in each situation to test whether the participants vary their refusing in different situations. Table 5 presents the mean, standard deviation and the total refusal strategies in each situation of two groups.
As can be seen in Table 5, while the total number of refusals strategies used in two power-high situations (situation 1 and 2) were highest, the total number was the lowest in two power-equal situations (situation 3 and 4). The mean number of strategies used by the participants in the Malaysian group ranged from an average of 1.92 strategies in the situation 4 (=P, +D) to 2.86 strategies in the situation 2 (+P, +D). Likewise, the participants in the Taiwanese group produced overall strategies from an average of two strategies in situation 3 (=P, -D) to 3.5 strategies in situation 2 (+P, +D). The standard deviation also reflected a substantial heterogeneity within each group. Table 5: Mean, standard deviation (SD) and the total refusal strategies in each situation of two groups Group S1(+P,-D) S2(+P,+D) S3(=P,-D)
S4(=P,+D) S5(-P,+D) S6(-P,-D)
Malay Total Refusals Mean (n = 50) SD
141 2.82 1.024
143 2.86 .969
96 1.92 .922
96 1.92 .633
113 2.26 1.026
115 2.3 .909
Taiwan Total Refusals 170 176 101 125 147 148 Mean (n = 50) 3.4 3.5 2.0 2.5 2.94 2.96 SD .857 1.147 .914 1.025 1.420 1.087
Each refusal type includes the frequent use and the percentage (%) in parentheses.
0.18
2.161.46 1.62
3.24
0.28
4.52
1.160.38 0.54
0.74 0.82 0.240.22
1.2 1.22 1.34
3.52
0.08
3.98
0.80.16 0.18 0.44 0.42 0.16
00.5
11.5
22.5
33.5
44.5
5
Taiwanese
Malaysians
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A comparison of refusals between Chinese speakers in Taiwan and Malaysia
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A comparison of refusals between Chinese speakers in Taiwan and Malaysia
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æ¥æ¬åäŒæ¥ã®æ°è£œåéçºã«ãããé»å®³èŠå : åºæ¬ææ³ã«åºã¥ã仮説ã®æ瀺 (Hindrance issue in new product development by Japanese firms: Proposal of hypothesis based on fundamental concept)
è€äº èª äž Seiichi Fujii1
Abstract Japanese firms that aim for long-term stable growth and allocate their resource for that seem to be unsuitable to the environment of recent society with its invisible needs. This study reviews previous studies about new product development of Japanese firms to reveal those features. Additionally, management characteristics of Japanese firms have become clear through the comparison of previous literature with American management. Furthermore, the introduction of American management systems by Japanese firms is likely very dangerous for them. Finally, a hypothesis is suggested that the fundamental concept is based on long-term accumulation. Keywords: Japanese management, new product development, fundamental concept, long-term,
accumulation
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æ®ãããšãç®æšãšããŠããé·å¯¿ã§ããïŒAbegglen, 2004; åæ pp. 10-13ãèš³æ pp. 27-32ïŒããããŠé·å¯¿äŒæ¥3ã¯ãç°å¢å€åã«ããã掻åã掻çºã§ããããã®å€åã«é©å¿ããèœåãé«ãïŒæ³å 2000ïŒ p.46ïŒãå®å®çãªæé·ãå®çŸã競äºåªäœãããããããã®ãããªèœåã®çºæ®ã¯ãæ¥æ¬ã®äŒæ¥ã«å ±éããç¹åŸŽãšåªäœæ§ãšãªã£ãŠè¡šãããããšãã°ãçµèº«éçšããã£ãããšããè©äŸ¡ãšæé²ã·ã¹ãã ã
å°éçã§ãªããã£ãªã¢ãã¹ããšãã£ã人çåŽé¢ã«ç¹åŸŽãããïŒOuchi, 1981; åæ pp. 17-37ãèš³æ pp. 38-63ïŒããããŠãããã®ç¹åŸŽã¯ãè€éãªçµç¹ãããžã¡ã³ãã«ããèœåã§ããä»ç€Ÿãç°¡åã«ç䌌ã§ããªãïŒè€æ¬ 2003ãp. 112ïŒãæã¡åãããè³æºã掻çšããããšã«ããå¶çºçãªã€ãããŒã·ã§ã³ãçºçããïŒç³äº 1993ïŒãçµç¹äººãšããŠã®æŽç·ŽåºŠãé«ãïŒClerk, 1979; Pascale & Athos, 1982; Ouchi, 1981; Abegglen, 2004ïŒããªã©ã®å©ç¹ãããããã ãã®ãããªç¹æ§ãæã€å€ãã®æ¥æ¬äŒæ¥ã§ãããããã®äžã§ã補é æ¥ã¯é·ãæ¥æ¬çµæžãããåŒã
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ãžé«ä»å 䟡å€è£œåãäŸçµŠããããã«ãªã£ãïŒYoshino, 1976; åæ pp. 66-83ãèš³æ pp. 104-135ïŒKotler et al., 1991; åæ pp. 6-8ãèš³æ pp. 17-22ïŒããã®çµæãè±åœãç±³åœãããã¯ç¬åœã次第ã«è¿œéããæµ·å€ã«æ ç¹ãæããå€åœç±äŒæ¥ãå€ã茩åºããããšãšãªã£ãïŒåå 1992; pp. 22-23ïŒããã®ããæ¥æ¬ã®è£œé æ¥ã¯ãæ°èåœã®å°é ãåé«ãçç£ã®ç©ºæŽåãªã©ãäžçèŠæš¡ã§èµ·ããåé¡ã®åœ±é¿ãåããã
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Ritsumeikan Journal of Asia Pacific Studies Volume 36, 2018
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Ritsumeikan Journal of Asia Pacific Studies, Volume 36, 2018
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Hindrance issue in new product development by Japanese firms
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Ritsumeikan Journal of Asia Pacific Studies, Volume 36, 2018
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Hindrance issue in new product development by Japanese firms
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Hindrance issue in new product development by Japanese firms
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Ritsumeikan Journal of Asia Pacific Studies Volume 36, 2018
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Ritsumeikan Journal of Asia Pacific Studies, Volume 36, 2018
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27
Hindrance issue in new product development by Japanese firms
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Hindrance issue in new product development by Japanese firms
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Ritsumeikan Journal of Asia Pacific Studies Volume 36, 2018
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Ritsumeikan Journal of Asia Pacific Studies, Volume 36, 2018
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