Mitigation Care

The status of medical doctors in Japan is high enough to form a privileged community in every corner of its society. In this situation, it is unlikely for a patient to reject medical care even if he/she does not want, because initiative of whether or not to cure a disease is on the hand of doctor. As its result, a patient actually cannot have a right to halt terminal care. Some doctors, however, attempt to take care of patients based on patients’ happiness. Mitigation care is one of those actions.

It is easier for medical doctors to make a small community. The number of students in medical college is limited because of the limitation of facility of each college. Although the government of Japan took a policy of increasing medical divisions in every prefecture in 1960s, the doctors are not much increased last a half of century. It might have been possible that pressure group of doctors lobbied to limit the numbers.

With the help of universal health care system, the doctors are guaranteed of their stable income, which is always higher than middle class workers. There is a point system, in which doctors are rewarded based on how much treatment they do to their patient. The more they treat, the richer they become. Nevertheless, they ignore this negative aspect of system, because they actually too busy to feel guilty of their rich income.

A typical problem is seen at the terminal care. Doctors are so proud of their skill to cure illness that they tend to try to extend the life of incurable patients. If a patient is too old to decide what to do, he/she can be forced to stand for painful treatments. Even though the doctor does not want it, patient’s family may sometimes request the doctor to exercise life extension care, because they cannot accept the incurability of the patient. Without knowing true situation of himself/herself, the patient does not have a right to choose how he/she will end the life.

Mitigation care is one solution for that kind of tragedy. It is based on the decision to halt medical care in incurable stage of a disease. With substantial consultation to medical doctor, patient chooses to leave hospital and live ending period of life in his/her own home with loved families. Recognizing that the death is not a failure of medical care, but a natural consequence of a human being, more doctors get to understand the importance of mitigation care.

This includes an important meaning in democracy of Japan. To be independent from doctors’ decision is to obtain individual dignity. Choosing the end state of one’s own right should be regarded as an inalienable right of a democratic citizen.