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According to the policy statements of professional medical societies in the US and UK, as well as prominent American and English bioethicists, there are no morally relevant differences between withdrawing and withholding life-sustaining treatments. Both withdrawing and withholding life-sustaining treatments are permitted in the US and UK and decisions to initiate either procedure are held to the same criteria in both countries. Leading Japanese bioethicists also support this view. However, due to Japan's unique cultural and institutional backgrounds, terminally ill patients, their family, and medical practitioners would suffer from a disproportionate amount of psychological burden if the withdrawal of life-sustaining treatments were held to the same conditions as withholding treatment, as is commonly done in the US. To prevent such undesirable results, even if we were to recognize no morally relevant differences between withdrawing and withholding life-sustaining treatments, we argue that the decision to withdraw or withhold such treatments can be justified on different conditions in Japan.
Bioethics 16 (1), 84-90, 2006
Japan Association for Bioethics