慶應義塾研究者情報データベース

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• 　医学・医療に関する技術は、近年、目覚ましく進歩しています。こうした技術の進歩は、これまでには不可能であった疾病の診断や予防、治療を可能にするなど、人々に多大な利益をもたらしています。その一方で、技術の進歩は、新たな倫理的・法的・社会的課題（ELSI：Ethical Legal and Social Issues)を生じさせています。医学に関する技術の進歩との関係でいえば、新型出生前診断とその後の人工妊娠中絶に関する問題を一つの例として示すことができます。また、医療に関する技術の進歩との関係でいえば、終末期における生命維持治療の差し控え・中止の問題を一つの例として示すことができます。さらに公衆衛生活動との関係でも、新型感染症に対する予防接種の優先順位の決定の問題など、多くの課題をELSIの例として示すことができます。このような中、近年、医療倫理に関する研究・教育が喫緊の課題であることが、これまで以上に指摘されるようになっています。 　また、上記のように、近年、医療技術は目覚ましく進歩しています。しかし、その技術は複雑・高度化しています。こうした医療環境のなか、医療従事者不足など、技術の複雑・高度化以外の諸問題とも相まって、医療現場では、医療事故が多く生じるようになっています。医療事故の問題は、今日、わが国のみならず、世界的にも大きな問題となっており、医療安全活動や事故対応に関する研究・教育の必要性が強く指摘されるようになっています。 　以上のような状況の変化は、これまでの理論的枠組みを超えた、公共政策のあり方の検討をも必要とするようになっています。このことは、例えば、上記のワクチン接種の優先順位の決定の問題をみると、良く理解することができます。また、医学研究や診療行為に関する行政ガイドラインの検討の問題についても同様です。近時、利益相反に関する問題も、社会に波紋を広げており、そのルールのあり方の検討も重要となっています。 　そこで、本研究室は、公共政策のあり方の検討を含む、医療倫理・医療安全に関する諸課題について、多分野の研究者や、実務者、行政経験者が共同して検討することを目的としています。

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• 医学部, 医療政策・管理学, 兼担教授

• 健康マネジメント研究科委員長

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• 人文・社会 / 新領域法学 （医事法）

• ライフサイエンス / 医療管理学、医療系社会学 （臨床倫理）

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• 医事法、医療倫理、研究倫理、臨床倫理、医療安全管理、リスクマネジメント

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• Health Policy and Law in Japan

  Ezaki J., Maeda S., Izumi T., Health Policy and Law in Japan, 2026年01月

  　概要を見る

  This book provides a comprehensive overview of Japanese health policy and law, written by active public health physicians within the Japanese government and leading researchers in Japan and the United States. This volume uniquely covers the entire essence of how Japan's health policies are formulated and implemented. Key topics include Japan’s governmental and administrative structures, medical and nursing care systems, Universal Health Coverage (UHC), pharmaceutical and medical device regulation, and public health strategies ranging from infectious disease control to cancer prevention, rare disease policy, and maternal and child health, etc. Readers will gain insight into the historical foundations and guiding principles of Japan’s health system, how the country has achieved world‑leading health outcomes, and the policy measures currently underway to meet the challenges of an aging society This book incorporates advice from current undergraduate and graduate students in the United States and Japan, making its content accessible and suitable for use in university education. It also serves as a valuable resource for government officials, policymakers, and professionals in the pharmaceutical and medical device industries. As part of a series on global health policy, this volume is an essential addition to collections supporting public health, policy studies, and international health systems.

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• Medical Professions

  Ezaki J., Mansour D., Maeda S., Izumi T., Health Policy and Law in Japan, 2026年01月

  　概要を見る

  In Japan, a Medical Doctor (M.D.) is referred to as a “Medical practitioner” in medical law. The Medical Practitioners Act was enacted three years after the promulgation of the Constitution of Japan. According to Article 1, “Medical practitioners shall contribute to the improvement and promotion of public health by providing medical care and health guidance, thereby ensuring the healthy lives of the people.”. As can be seen from using the phrase “improvement and promotion of public health” in Article 25 of the Constitution (see Chap. 2), medical practitioners are expected to approach their duties with a mindset that respects human life and dignity. They are expected to treat illnesses and injuries and take the lead in improving and promoting public health in all fields. Medical practitioners must be professionals in both clinical medicine and public health.

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• Legal Obligations of Medical Practitioners

  Ezaki J., Mansour D., Izawa J., Maeda S., Izumi T., Health Policy and Law in Japan, 2026年01月

  　概要を見る

  Chapter 3 introduced the legal definitions and concepts of medical professions. This chapter presents the legal obligations imposed on medical practitioners by the Medical Practitioners Act. Dentists, pharmacists, nurses, and others also have legal obligations corresponding to their respective professional functions under their own acts. No medical practitioner who engages in medical practice may refuse any request for medical examination or treatment without legitimate grounds. As mentioned earlier, medical practitioners are of high public interest. They are tasked with “contributing to the improvement and promotion of public health through medical care and health guidance, thereby ensuring the healthy lives of the people.

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• Hospitals and Clinics

  Ezaki J., Engelbride M., Maeda S., Izumi T., Health Policy and Law in Japan, 2026年01月

  　概要を見る

  To ensure appropriate medical care for the public, it is necessary to define the obligations of the “people” who provide medical care and ensure that the “places” where medical care is provided—such as hospitals and clinics—are managed, staffed, and equipped to enable the provision of high-quality and appropriate medical care. “The Medical Practitioners Act” and “the Dental Practitioners Act” govern medical professionals’ status, duties, rights, and obligations; “the Medical Care Act“regulates matters related to medical facilities. While the Medical Practitioners Act respects Medical Practitioners’ freedom in the content of their medical practice to the greatest extent possible (see Chap. 3), the Medical Care Act imposes strict regulations on establishing and managing medical facilities, the standards for medical facilities, and matters related to advertising, medical safety, and prefectural medical care plans.

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• Discrepancy in perceived appropriate and desired resuscitation durations between physicians and laypersons in cardiac arrest patients

  Tanabe Y., Namba T., Maeda S., Nishikimi M., Ishikawa E., Ohshimo S., Shime N.

  Journal of Intensive Care 14 （ 1 ）  2026年12月

  　概要を見る

  This study examined a discrepancy that exists between the duration of resuscitative efforts that physicians perceive as appropriate and the duration that laypersons desire. We conducted an online nationwide cross-sectional survey with 323 physicians and 2,667 laypersons. Physicians were significantly more likely than laypersons to consider a duration of ≥ 30 min as appropriate for resuscitation, especially in younger patients (age 0–6:85% vs. 27%; age 7–17:84% vs. 29%; both p < 0.001). Although these responses arise from fundamentally different psychological frames, identifying this discrepancy may provide a conceptual foundation for discussing more appropriate termination-of-resuscitation approaches in real-world clinical settings.

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• Ensuring patient safety: a comprehensive approach to radiological errors

  Maeda S., Ishikawa E., Starkey J.

  Abdominal Radiology 51 （ 6 ） 3216 - 3226 2025年

  ISSN  2366004X

  　概要を見る

  Radiologic errors arise from the interaction of human fallibility and systemic weakness. Using a fatigue-related missed renal mass, this paper proposes a model that joins two complementary duties: ethical transparency through disclosure and apology, and system redesign grounded in Just Culture and human factors engineering. Together, these principles create a sustainable path toward safety. We outline common malpractice sources, offer practical guidance for disclosure and apology, and emphasize institutional strategies that transform individual error into system learning and patient-centered improvement.

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• Family presence during resuscitation: a survey of Japanese physicians’ views

  Tanabe Y., Ishikawa E., Yamada T., Shime N., Maeda S.

  Journal of Public Health Germany 34 （ 4 ） 963 - 971 2024年

  ISSN  21981833

  　概要を見る

  Aim: This study aimed to clarify physicians’ awareness of and attitudes toward family presence during resuscitation (FPDR) and related factors. Subject and methods: A web-based questionnaire survey was conducted of 7859 physicians who were members of the Japanese Society of Intensive Care Medicine (survey period: October 12, 2022, to December 31, 2022). Focusing on cardiopulmonary arrest, the survey questioned their awareness and attitudes, with a comparison of exogenous and non-exogenous patients. Results: The proportion of respondents who have family present during resuscitation was 100 (25.0%) for exogenous and 105 (29.2%) for non-exogenous. The proportion who believed that the family’s acceptance of death is greater with FPDR was 255 (61.7%) for exogenous and 245 (65.7%) for non-exogenous. The proportion who believed that the family’s acceptance of death is greater with FPDR included a significantly higher number of respondents who had family present than in the proportion who believed that FPDR has no effect. The proportion who believed that the family is emotionally traumatized by FPDR was 251 (60.8%) for exogenous and 217 (58.2%) for non-exogenous. The proportion who believed that families are emotionally traumatized by FPDR included a significantly higher number of respondents who do not have family present than the proportion who believed that FPDR has no effect. Conclusion: Various international resuscitation guidelines have recommended FPDR from an early stage to alleviate grief and prevent mental disorders. However, these guidelines are not always followed in Japan.

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• Current status of umbilical cord blood storage and provision to private biobanks by institutions handling childbirth in Japan

  Murata M., Kawabe K., Hatta T., Maeda S., Fujita M.

  BMC Medical Ethics 23 （ 1 ）  2022年12月

  　概要を見る

  Background: The Act Regarding the Promotion of the Appropriate Supply of Hematopoietic Stem Cells for Transplant regulates only how public banks store and provide umbilical cord blood (UCB) for research or transplantation. Japan had no laws to regulate how the private banks manage the procedures, harvesting, preparation, and storage of such blood. As a result, the status of UCB distribution remains unknown. We conducted a survey to investigate the current status of UCB storage and provision to private biobanks by Japanese institutions that handle childbirth. Methods: Questionnaire forms were mailed to 3,277 facilities handling childbirth that were registered in the Japan Council for Quality Health Care website. Results: Of the 1,192 institutions handling childbirth that participated in the survey (response rate: 36.7%), 34.4% responded that they currently provide UCB to private biobanks, while 16.1% of facilities did so in the past. Moreover, some institutions currently provide or formerly provided UCB to medical treatment facilities (2.6%), research institutions (5.9%), companies (2.2%), or overseas treatment facilities, research institutions, or companies (0.3%). A certain number of institutions handling childbirth did not even provide explanations or obtain consent when the UCB was harvested from private bank users. Conclusions: This is the first study to determine the status of UCB provision to private banks by Japanese institutions handling childbirth. Future studies will need to examine in detail how institutions handling childbirth provide explanations to private bank users and UCB providers as well as how these institutions obtain consent.

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• An Exploratory Study on Information Manipulation by Doctors: Awareness, Actual State, and Ethical Tolerance

  Maeda S., Nakazawa E., Kamishiraki E., Ishikawa E., Murata M., Mori K., Akabayashi A.

  Clinics and Practice 12 （ 5 ） 723 - 733 2022年10月

  　概要を見る

  (1) Background: To what extent is information manipulation by doctors acceptable? To answer this question, we conducted an exploratory study aimed at obtaining basic data on descriptive ethics for considering this issue. (2) Methods: A self-administered questionnaire survey was conducted on a large sample (n = 3305) of doctors. The participants were queried on (1) whether they consider that information manipulation is necessary (awareness), (2) whether they have actually manipulated information (actual state), and (3) their ethical tolerance. (3) Result: The response rate was 28.7%. Sixty percent of the doctors responded that information manipulation to avoid harm to patients is necessary (awareness), that they have actually manipulated information (actual state), and that information manipulation is ethically acceptable. (4) Conclusion: While the present survey was conducted among doctors in Japan, previous studies have reported similar findings in the United States and Europe. Based on our analysis, we hypothesize that a relationship of trust between patients and medical personnel is crucial and that information manipulation is not needed when such a relationship has been established.

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• 医学研究・医療・健康診断における偶発的所見の取扱いに関する法的課題の検討

  前田, 正一

  科学研究費補助金研究成果報告書 2023年

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• 偶発的所見等の取扱いに関する法的課題の検討

  2023年04月

  -

  2026年03月

  前田 正一, 基盤研究(B), 補助金,  研究代表者

• 医学研究・医療・健康診断における偶発的所見の取扱いに関する法的課題の検討

  2020年04月

  -

  2023年03月

  文部科学省・日本学術振興会, 科学研究費助成事業, 前田 正一, 基盤研究(B), 補助金,  研究代表者

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• 健康マネジメント特論Ⅰ

  2026年度

• 健康マネジメント特論Ⅱ

  2026年度

• リスクマネジメント論

  2026年度

• 健康マネジメント合同演習

  2026年度

• 特別研究

  2026年度

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所属学協会 【 表示 ／ 非表示 】

• 日本医事法学会

  　

• 日本生命倫理学会

  　

• 日本病院管理学会

  　

• 日本社会福祉学会

  　

• 日本公衆衛生学会

  　

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