The Japanese Ministry of Health and Welfare has implemented a policy of paying physicians to explain the nature of the patient's medical condition and the treatment plan. We describe the precepts of this policy and examine ethical dimensions of this development. We question whether this policy will be sufficient to ensure patients will have the opportunity to become informed participants in medical decision making. The policy also raises a broader philosophical question as to whether informed consent is a fundamental ethical requirement of all doctor-patient encounters or an option that can be exercised by physicians for financial gain. The impact of this policy in Japan merits continued observation from abroad.
- Informed consent
- health insurance
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Akira Akabayashi, MD, PhD, is Professor, Department of Biomedical Ethics, School of Public Health, Kyoto University Graduate School of Medicine, Kyoto, Japan. Michael D Fetters, MD, MPH, MA, is Director of the Japanese Family Health Program, Department of Family Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA.