Discuss bioethics in an interdisciplinary forum

Second, “American” bioethics did not ask questions such as “What is the meaning of life?,” “How can we live in this society without regret?,” and “What is human?” Whenever we think deeply about difficult bioethical problems like selective abortion, euthanasia, manipulation of human genes, and organ transplantation, we come to the above philosophical questions in the end. In addition, psychological and sociological approaches should be introduced to research on these issues, but the word bio-“ethics” seemed to exclude these disciplines. I thought it would be more fruitful to discuss bioethics in an interdisciplinary forum.

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Cross-cultural Approaches to the Philosophy of Life in the Contemporary World
(2004)
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Environmental ethics and bioethics

As I mentioned before, when I first studied “American” bioethics in the 1980s, I was very frustrated because it seemed to me a somewhat narrow and shallow approach to the issues of life. Some of my friends had similar impressions. First, it discussed only medical issues. It did not deal with environmental issues. It is ironical that V.R. Potter who coined the word “bioethics” in 1970 regarded this word as a kind of “environmental ethics” rather than a medical ethics. For me, separating medical ethics from environmental ethics seems senseless because humans live on this planet surrounded by nature and our health and happiness cannot be separated from the environment. My first impression was that medical ethics should not be separated from environmental ethics.


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Cross-cultural Approaches to the Philosophy of Life in the Contemporary World
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Balanced perspective on autonomy and relationships

Daniel Fu-Chang Tsai writes in his recent paper that Confucius’ concept of person has two dimensions, namely, “the vertical dimension,” which is the autonomous, self-cultivating one, and “the horizontal dimension,” which is the relational, altruistic one (11). He says that “some may argue that there is no vertical dimension at all in the Confucian personhood. This is incorrect.” He concludes as follows:

When a person exercises autonomy, he is no choosing in a context-free, conceptual vacuum but considers himself a person-in-relation, with many roles to play and responsibilities to take, in accordance with different relationships (…). The tension might be difficult to resolve, but the traditional tendency of social orientation should surely be balanced by, and reconciled with, respecting the individual’s rights and autonomy (Tsai 2001: 48,49).

Here we can see a well-balanced perspective on “autonomy” and “relationships.” This kind of mature thinking can be found everywhere on this planet and is not the patent of Confucius or East Asia.

We sometimes use the words “Japanese bioethics,” “American bioethics,” and “Asian bioethics,” but these wordings are apt to make us think that there is “the” Japanese bioethics, “the” American bioethics, and so on. This is not true. There are various bioethical ideas and actions in each region. Of course there are clear cultural differences between distant countries, but if we take a closer look at one area, we can find considerable gender differences, religious differences, economic differences, etc., and at the same time it is also true that we actually share many things across borders. Hence, we should say “bioethics in Japan” instead of “Japanese bioethics,” “Genomics in Asia” instead of “Asian Genomics,” and so on. Anyway, we have to abandon the East/West dichotomy and its variations. [187/188]


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Cross-cultural Approaches to the Philosophy of Life in the Contemporary World
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Communitarian bioethics and individual freedom: Comparison

Even in the USA, so-called “communitarian bioethics” has been discussed by Ezekiel J. Emanuel (1991) and Daniel Callahan (1996) in the 1990s. American feminist bioethics has put a special emphasis on caring and relationships. It seems that current bioethics throughout the world seeks balanced development between “individual freedom” and “the value of community and relationships.”

Scholars at the City College of New York conducted a comparative study of US/Japan values in 1988. In their research, students in both countries responded to “the values that they believed best characterize people in their country.” The results were interesting. The top 3 for the USA were “Family,” “Education,” and “Friendship,” and the top 3 for Japanese were “Friendship,” “Peace/Getting Along,” and “Respect.” Both sets of responses look similar and sound communitarian (CCNY 1998). [186/187]


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Cross-cultural Approaches to the Philosophy of Life in the Contemporary World
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Fundamental human rights and Japan

After opening the country to the world in 1868, the Japanese were very eager to absorb European ideas, such as “human rights,” “freedom,” and “democracy.” Japanese history of the last 100 years could be illustrated as that of a harsh struggle between people who wanted to maintain hierarchical and paternalistic systems, on the one hand, and people who wanted to replace them with more individualistic ones based on human rights and freedom, on the other. In 1874, Taisuke Itagaki began a nation-wide political movement, “the Freedom and People’s Rights Movement (Jiyuu Minken Undo).” Many thinkers and activists joined Itagaki and were put in jail and killed, but this movement prepared the basis for Japanese democracy. (When Itagaki was stabbed, he is said to have shouted, “Even if itagaki dies, freedom never dies!”) When a group of severely discriminated people (Hisabetsu Buraku Min) demanded their civil rights in 1922, the words they uttered were “freedom,” “liberation,” and “equality.”

The contemporary Japanese bioethics movement began in the early 1970s when disabled people claimed their “right to live” and “disabled children’s right not to be killed by their parents,” and when feminists claimed that their “right” and “freedom” to abortion must be maintained. It is striking that contemporary Japanese bioethics began with voices of minority groups demanding “rights” [185/186] and “freedom.” Since I examined this topic elsewhere (Morioka, 2002), I will not write about it further here.

My point is that voices for “freedom” and “human rights” have already been integral parts of Japanese history and culture. They are part of the Japanese tradition. Here, Sakamoto’s argument that in Asia “the sense of ‘human rights’ is very weak and foreign, and that they have no traditional background for the concept of human rights” cannot be applied to Japan. His claim that “Eventually, there is no room for the idea of fundamental human rights” is unfounded. Most of the younger Japanese philosophers and sociologists who are interested in bioethics take “fundamental human rights” for granted, and then they are trying to fit bioethical ideas into contemporary Japanese culture and relate them to Japanese people’s emotions. They stress the importance of “human relationships” together with “human rights.”


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Importance of sense of security

Thirdly, they were trying to protect “the fundamental sense of security.” They did not use these words, but what they really had in mind was this. They thought that technology of selective abortion was dangerous because it systematically deprives us of the sense that our existence is being accepted unconditionally. It is a kind of trust in the world and society, and this trust provides us with the foundation upon which we can survive in our society. This is a sense of security with which I can strongly believe that even if I had been less intelligent, ugly, or disabled, at least my existence would have been accepted equally to the world, and if I should succeed, fail, or become a doddering old man, my existence will continue to be accepted equally to the world. This is the basis of our life upon which we keep sane in this society. I want to call it “the fundamental sense of security.” Selective abortion and some new reproductive technologies are problematic because they systematically erode “the fundamental sense of security” we have to keep protecting. Here lies the most important problem of “new eugenics” in the 21st century.

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Disability Movement and Inner Eugenic Thought
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Transformation from self-negation to self-affirmation

Secondly, what they were persisting in was a transformation from the state of “self-negation” to the state of “self-affirmation.” Disabled people were denying themselves because they had been led to believe that they were valueless in this society. Women, too, believed that they were less valuable than men. Hence, their fight against the Eugenic Protection Law Revision Bill was an irreplaceable process of acquiring a sense of “self-affirmation” that they are valuable as they are, and they do not have to deny themselves anymore. And once people get “self-affirmation,” most of their inner problems must have been solved. The main theme of their bioethical thoughts in that period was how to acquire “self-affirmation,” and the aim of their bioethical actions was to create society where various people can live with “self-affirmation.” Hence, their bioethics included a therapeutic dimension at its core; this is one of the reasons I want to call their activities “life studies.”

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Disability Movement and Inner Eugenic Thought
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Fight against both the Establishment and ourselves

The problem of “inner eugenic thought” has not been solved because all of us share it inside us and we cannot escape completely even if we wish to. However, it is worse to take our “inner eugenic thought” for granted, and never try to change our attitude. Hence, they thought what is needed was a fight both against the Establishment and against our own inner eugenic thought. The basic characteristic of their bioethics was “fighting.” In this sense, their thoughts and actions were a little different from “bioethics” we are familiar with today, that is, bioethics as a rule-making process by physicians, politicians, and ethicists, or bioethics as a series of analytical discussions for professional scholars. Their thoughts and actions are closer to “life studies” that I have advocated for years. Actually, I have studied much from their thoughts, and the idea of life studies has developed through this research. Strictly speaking, their thoughts and actions may be called “life studies” rather than “bioethics,” if the latter should mean some academic analyses and a process of rule-making by ethicists. I had a debate over this topic with some researchers, and the conclusion was that it depends on how we define the concept of “bioethics.”

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Disability Movement and Inner Eugenic Thought
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Abortion and economic reasons

In 1974, the Eugenic Protection Law Revision Bill finally failed to pass the Diet. The clause for selective abortion did not added to the law. A group of physicians in abortion clinics have continuously demanded a clause for selective abortion, but every time they insisted it women and disabled people acted against them. Hence, the Japanese law has not had such a clause up to the present. However, we should understand that when a woman has a disabled fetus she is allowed to abort it if she claims “economic reasons.” The debated issue was whether the clause should be added to the law; in other words, it was a debate over the symbolic meaning of the clause when added to the law. (Eugenic Protection Law was revised in 1996, and its name was changed to Maternal Protection Law.)

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Disability Movement and Inner Eugenic Thought
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Right to Abortion does not Conflict with Liberation of Disabled People

In 1973, Tomoko Yonezu, Lib Shinjuku Center, said that women were confronted with disabled people by the Establishment. She went on to say that women and disabled people must fight together against the Establishment which indirectly forces women to abort disabled fetuses. (Yonezu was/is a disabled woman.)

In the same year, Lib Shinjuku Center published the article, “the Right to Abortion does not Conflict with the Liberation of “Disabled People.”” They said that women and disabled people should cooperate to build society where women are delighted to give birth to their babies whether babies are disabled or not. Here the “Paradigm of United Front between Women and Disabled People” was formed, and this paradigm made the basis of the Japanese bioethics movement in 1970s and 80s.
The important points are as follows.

1) Japanese bioethics started as grass-root movements. It was created by minority groups such as women and disabled people in their process of fighting against the Establishment. The year of the birth of Japanese bioethics was 1972-1973.

2) They started their bioethical thoughts by gazing at their own “inner eugenic thought.” Selective abortion and eugenic thinking were something they had to fight against and overcome. They were thinking that reducing the number of disabled children was not the answer.

3) They believed that our society based on utilitarianism and the principle of efficiency must be changed into more humane and less competitive one. In such a society, for the first time, women can give birth to disabled babies and raise them embraced by a sense of security.

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Disability Movement and Inner Eugenic Thought
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Inner eugenic thought and feminism

Their accusation was accepted seriously by women’s groups. For example, Kawasaki Women’s Conference stated as follows in 1973.

First of all, we have to criticize ourselves in that we are occupied by eugenic ideology, and in that we have discriminated and suppressed disabled people.
(…)
We have been occupied by the logic of efficiency, and we have considered rapidity as virtue. We have been wishing to give birth to babies with normal bodies. Therefore, in the first place, we have to start by confronting our own inner eugenic ideology.

They stressed the necessity of transforming themselves, and then tried to fight against discriminative society. We should pay attention to their words, “inner eugenic ideology.” This phrase implies that the fundamental problem is situated not outside, but just “inside us.” The word “inner” was added to emphasize this. Later, people began to call this notion “inner eugenic thought,” and these words became a keyword in contemporary Japanese bioethics. I believe the question how to tackle “inner eugenic thought” should be a big topic for our international bioethics and life studies.

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Disability Movement and Inner Eugenic Thought
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State should not interfere in the sex and reproduction

In 1972, women’s liberation groups insisted three points, namely, (a) the state should not interfere in the sex and reproduction of individual women, (b) abortion is a right of women, and (c) we have to create a society where women want to give birth based on their own intentions (2). However, the members of Blue Grass Group had a serious doubt about the idea that women have a right to abortion, because such a right logically includes the right to selective abortion, which would suppress and disempower disabled people. They concluded that if “the right to abortion” includes “the right to selective abortion,” it must not be accepted. They accused women’s liberation groups of having the “egoism of people with normal bodies” that belittles and denies the existence of disabled people.

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Disability Movement and Inner Eugenic Thought
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Idea of annihilation of disabled people

The grounds of their opposition were as follows.

First, it contains “the idea of annihilation of disabled people.” Adding a clause for selective abortion of disabled fetuses to the law is equivalent to legally declaring that disabled people do not need to be born in this society. This easily leads us to think that a disabled person is “an existence which should not exist.” As a result, they would suffer more discrimination and harm. Their lives would be more endangered in this society.

Second, disabled people are psychologically disempowered. In the above situation, more and more ordinary people begin to glance at disabled people; thinking, “I wish they were not born,” and these repeated glances slowly deprive them of power to live by themselves and of a sense of self-affirmation. As a result, they are forced to live passive and negative lives separated from the community. Moreover, members of Blue Grass Group thought that this disempowerment process would gradually broaden to include various minorities, and in the end, all of us would fall victim to it. They consider this to be the most dangerous problem lurking behind selective abortion.

Third, “people without productivity” are abandoned. Those who do not have the ability to product goods would be more and more abandoned in the above society. Not only people with congenital disabilities, but also 1) those who became disabled by accident or disease, 2) senior citizens, and 3) physically weak people would become candidates for discrimination

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Disability Movement and Inner Eugenic Thought
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Why disabled people shoud be killed?

In 1972, the Eugenic Protection Law Revision Bill was presented to the Diet. This bill aimed at restricting women’s access to abortion, but at the same time, it contained a clause for selective abortion of a fetus with severe disabilities. Blue Grass Group strongly opposed to this bill because it would deny the existence of disabled people. In the leaflet, “Is It Natural that Disabled People should be Killed?: An Objection to The Eugenic Protection Law Revision Bill,” published in 1972, they wrote as follows.

We disabled people are living. We really want to live.
Actually, many fellow disabled people are trying hard to live their painful lives.
And other people can never judge whether our lives are “happy” or “unhappy.”
It is even more unallowable that egoistic non-disabled people should kill disabled fetuses because they are “defective descendents,” and that they should make an excuse that it is done for the “happiness of disabled people (fetuses).”
All of you citizens, students, and workers.
We strongly oppose to the Eugenic Protection Law Revision Bill that is based on the idea that fundamentally denies the existence of “disabled people” and leads us to kill “disabled fetuses” in their mothers’ wombs.
(Extraction from the document. The expression “defective descendents” was found in Article One of the Eugenic Protection Law.)

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Disability Movement and Inner Eugenic Thought
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Aoi Shiba no Kai, We act like this

Hiroshi Yokota announced the declaration of activity, “We Act Like This,” in their journal Ayumi in 1970. The following is a translation of the epoch-making document.

We Act Like This
Blue Grass Group (Aoi Shiba no Kai), 1970

* We identify ourselves as people with Cerebral Palsy (CP).
We recognize our position as “an existence which should not exist,” in the modern society. We believe that this recognition should be the starting point of our whole movement, and we act on this belief.

* We assert ourselves aggressively.
When we identify ourselves as people with CP, we have a will to protect ourselves. We believe that a strong self-assertion is the only way to achieve self-protection, and we act on this belief.

* We deny love and justice.
We condemn egoism held by love and justice. We believe that mutual understanding, accompanying the human observation which arises from the denial of love and justice, means the true well-being, and we act on this belief.

* We do not choose the way of problem solving.
We have learnt from our personal experiences that easy solutions to problems lead to dangerous compromises. We believe that an endless confrontation is the only course of action possible for us, and we act on this belief. (Translation by Osamu Nagase, italics by Morioka. See note (5).)

Their declaration was based on the philosophy of “self-affirmation.” They thought that CP people do not need to adjust themselves to society, but that they should present their existence as it is, in other words, the existence as an unsocial and inefficient being.

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Disability Movement and Inner Eugenic Thought
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Fight against one's parents

It is worth noting that they had to fight against their parents, because it was their parents that most strongly suppressed and bound them. They insisted that disabled people must be liberated from their parents first of all. This emotion urged them to live independently from the family. They opposed the idea that attaches importance to the family more than the individual, which was one of the main features of traditional East Asian ethics.

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Disability Movement and Inner Eugenic Thought
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Cerebral palcy and independent living

In the late 1960s, some disabled people with Cerebral Palsy joined “Blue Grass Group (Aoi Shiba no Kai),” a friendship society for people with CP, and started “independent living” in Kanagawa Prefecture. Among them were Koichi Yokotsuka and Hiroshi Yokota, both were the philosophical leaders of the independent living activities at that time. As soon as they joined the group, they began protesting against our society full of discrimination toward disabled people. In 1970, a mother killed her CP child, but the general public sympathized with the mother, not with the killed child. Blue Grass Group accused our way of thinking, and stated that non-disabled people had a strong egoism, that is, our “inner consciousness of discrimination.” They believed that this egoism held by non-disabled people was the main source of discrimination. However, interestingly, they thought that not only non-disabled people, but also disabled people themselves shared this consciousness; hence, all of us have to fight against our “inner consciousness of discrimination.” Of course, their main focus was a discriminative society created by non-disabled people, but they did not turn their eyes away from their own consciousness of discrimination.

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Disability Movement and Inner Eugenic Thought
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Feminists, disabled people, and bioethics

Japanese bioethics began in the early 1970s. Most Japanese scholars still think that Japanese bioethics began in 1980s, but it is questionable. My recent book, Life Studies Approaches to Bioethics: A New Perspective on Brain Death, Feminism, and Disability, 2001, demonstrated that.

Women’s liberation groups and a disability group brought a new type of thinking into our philosophy and ethics. It should be noted that “minorities” in our society, that is, women and disabled people, founded Japanese bioethics. In this sense, it started as “feminist bioethics” and “disabled people bioethics.” This made Japanese bioethics somewhat different from “American” bioethics. Feminists and disabled people were mainly grass-root activists; they did not write academic papers or books. Instead they wrote a great deal of leaflets and handwritten documents. We can read them today because their publication finally began in recent years. Japanese “academic” bioethics began in 1988 when Japanese Association for Bioethics was founded. I wrote about Japanese feminist bioethics elsewhere, hence, I want to concentrate myself on the Japanese disability movement and its impact on bioethics.

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Disability Movement and Inner Eugenic Thought
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Right to live and be different

The Japanese disability movement in the 1970s posed an important question about our inner eugenic thought. Their arguments should be one of the focuses of attention for bioethics and philosophy of life in the 21st century. Their philosophy is comparable with DPI’s declaration, “The Right to Live and be Different,” published in 2000. They are considered to be seeking “life studies,” which has broader and deeper meanings than contemporary academic bioethics.

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Disability Movement and Inner Eugenic Thought
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Various meanings of life

I first used the words "life studies" in my book An Invitation to the Study of Life (1988). Strictly speaking, this book was written in Japanese, hence, corresponding words were "Seimeigaku." I started using the English words "life studies" probably in the early 1990s. "Seimeigaku" is now becoming popular now in Japan, but "life studies" are still unfamiliar to an English audience.

The word "life" has various meanings. We might be bewildered because we come up with so many implications. Let us take a look at some examples on the web.

The words seem to have at least five meanings.

1. The study of one's personal history. See The Aphra Behn Society.

2. The study of issues of everyday life, for example, food, health, leisure, gender, race, discrimination, etc. See College of Applied Life Studies at University of Illinois.

3. The study of religious, spiritual and ethical aspects of human life. See Center for Life Studies, Sunbridge College, NY.

4. The education about wildlife and ecology, for example, Sea Life Studies,Inc., Life Studies' Homepage.

5. Curriculum of high school courses. See Buffalo Grove High School, and Stockport Grammar School. This categorizing at high schools is very interesting to me.

6. Robert Lowell, well known poet, published the book "Life Studies" in 1959, which received the National Book Award.

I propose to add new meaning to the English words "life studies," and give the words new life.

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What is Life Studies
(2004)
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