In the field of Clinical Thanatology, we focus on ethical decision-making process in healthcare regarding life and death, which directly affects not only the final destiny of an individual’s body but also that individual’s daily life and life plans. Life and death decision-making involves many factors, such as a person’s own current health condition, the entirety of his/her life, their family members, healthcare providers, and society as a whole. From these points of view, we inquire into what the decision-making process should be, considering the one in the medical treatment, the one in the end of life, and the various values and dignity of an individual’s life.

Introduction to Projects

Consideration of decision-making on treatment and care

The self-determination of those judged to be competent is generally respected. However, when a person is faced with a serious illness, the new emotions resulting from this state may change their values and goals. In addition, they may not be able to determine their priorities themselves and may require help from family members or healthcare providers to do so. The consideration of this leads to an examination of what is meant by respect for self-determination, the role of family members and healthcare providers in shared decision making, and possible practical instruments for decision-making.

Investigation of decision-making for incompetent individuals

In the end-of-life state, individuals may become incompetent and be unable to make decisions on their healthcare because of an impairment of consciousness, impairment of intelligence or other factors. Ethical difficulties arise here. Who should be enabled to make decisions in such a case? How can we make decisions for others? Several factors must be considered, such as precedent values, current benefits and burdens, the wishes of the family, the judgement of healthcare providers, and other parties. The consideration of these factors leads us to explore surrogate decision-making that would maintain the patient’s dignity and best interest.