It may come as a surprise to many of you that Japanese doctors generally don’t tell the truth. You are probably asking yourself, what does this author mean? It means exactly as how it sounds. Japanese doctors have a reputation of not being transparent in their actions and holding back pertinent information about your health.
For example, when the man who was revered as a divine being by his people, Emperor Hirohito, was showing deteriorating health and unexplained vomiting, his doctor knew what was causing it, but withheld the diagnostic from him.
“I don’t regret that I didn’t tell him about his cancer” — Akira Takagi, Emperor’s Chief Doctor
According to a survey conducted in the mid-1990s, only one out of five cancer patients were honestly told of their diagnosis1.
A New York Times article cites a cancer diagnostic experience of 50-year-old Kazuku Makino. Her doctor diagnosed her with gallstones and suggested surgery to remove them. Makino, being a former nurse, sniffed out, for the lack of better but no truer words, the bullshit, and opted out of having unnecessary surgery.
Makino’s doctor suspected she had gallbladder cancer. The diagnostic proved to be correct. The cancer spread to her system and Makino died shortly after.
Her family sued the hospital for malpractice, but the courts rejected their claim. What resulted was a 1989 landmark case won by the medical industry in which doctors weren’t obligated to inform their cancer patients their true condition.
Some doctors argue that informing the patient of a terminally ailing disease would cause unhealthy psychological stress to the patient. As far as I know, no reputable journal or study has supported this claim.
Japanese doctors also have a reputation in prescribing medicine for every symptom or even non-symptom the patient may have. Oftentimes, the medicines are overprescribed. Some prescriptions aren’t even labeled for user readability, but with a hidden code for those only in the medical field can understand. So who knows what kind of medicine you are ingesting (or if you are unlucky, putting medicine into that backdoor of yours).
What is up with all the sketchiness? Doctor’s make a commission off of the medicine.
Why can Japanese doctors get away with this?
How Doctors Are Viewed
To understand why Japanese doctors operate the way they do, one must understand how the Japanese view their relationship between themselves and their doctor.
In the United States, medical care is viewed as a service. The doctors and medical staff provide the skilled services, while the patients are the paying customers. The customers expect to get what they are paying for. The Japanese society on the other hand generally view doctors as their masters and the patients as the subordinates who are indebted to the master for his or her services.
As such, it is extremely rude and looked down upon to question their doctors, in addition to go around consulting other doctors for second opinions. The doctors tend to not go into a detailed explanation of the diagnostic and treatment being administered.
Again, to contrast this to U.S. doctors, the patient is informed of the specifics of the treatment, such as what and why it is being conducted, and the possible outcomes, good and bad, that may result. A big reason behind informing the patient is legal protection for the doctor and the medical practice.
Unfortunately, the Japanese tend to dislike causing drama. If any hint of malpractice was involved, it is very rare for them to take legal action against their doctors. And if no legal action is taken against the doctors, then they are left unchecked to do whatever they want.
What the Japanese expect from their doctors in regards to full disclosure has been changing the past few decades. In a survey conducted in the 1990s, 60% of the people surveyed would want to be told by their doctor if they were diagnosed with cancer. In a research that was conducted in 2004, 86% surveyed wanted full immediate disclosure2.
Not all doctors aren’t forthcoming with the results. Those who have studied or done work overseas, especially in Western countries, tend to bring back with them the practice of being forthright. How do your country’s doctors operate? Koichi has also written an similar article on Japanese doctors. Check it out!
Japanese Journal of Clinical Oncology Volume 24, Issue 5, October 1994. ↩
Kai, I., Miyako, T., Miyata, H., Saito, T, Tachimori, H., (2004). Disclosure of cancer diagnosis and prognosis: a survey of the general public’s attitudes toward doctors and family holding discretionary powers. BMC Medical Ethics, 5:7. Retrieved June 17, 2004. ↩