Euthanasia, assisted suicide, and cessation of life support: Japan's policy, law, and an analysis of whistle blowing in two recent mercy killing cases.

Issues pertaining to euthanasia, assisted suicide, and cessation of life support continue to be a subject of worldwide interest. Euthanasia- particularly "active" euthanasia- is not considered legally or socially acceptable in most countries. In Japan, the first judgment of a case involving euthanasia took place in 1949. Since then there have been another five cases that reached the point of sentencing in 1990. All six cases were examples of so called "active euthanasia", in which the termination of life was performed by family members. However, the focus of discussion has been changed dramatically in recent years, owing to two prominent cases of mercy killing in 1995 (Yokohama) and 1996 (Kyoto), respectively. Medical doctors were involved in both of these cases, and euthanasia moved from being a theoretical problem to a practical dilemma. These cases also drew attention to the fact that assisted suicide could be distinguished from euthanasia. The first part of this paper will summarize the current status of euthanasia and the cessation of life support in Japan, focusing on its historical background and policy. The second part will briefly sketch the characteristics of Japanese law and then will examine the two recent cases of mercy killing mentioned above to try and determine the roles of whistle blowing in the medical practice arena, with particular reference to Japanese culture. This analysis is a challenge to elucidate how ethics and the law interact, and influence medical practice in a specific cultural context.