RT Journal Article SR Electronic T1 Tsunami-tendenko follows the antiextinction principle, not utilitarianism JF Journal of Medical Ethics JO J Med Ethics FD BMJ Publishing Group Ltd and Institute of Medical Ethics SP jme-2023-109674 DO 10.1136/jme-2023-109674 A1 Cato, Susumu A1 Oshitani, Ken YR 2024 UL http://jme.bmj.com/content/early/2024/02/26/jme-2023-109674.abstract AB This paper examines the concept of ‘tsunami-tendenko,’ a guideline suggesting that individuals prioritise their own safety over aiding others during large-scale disasters. Kodama defends tsunami-tendenko against accusations of egoism by arguing that the principle can be justified ethically on consequentialist (or more precisely, utilitarian) grounds. Kodama asserts that attempting to assist others during such disasters heightens the risk of ‘tomo-daore,’ where both the rescuer and the victim may perish. He claims that having people focus solely on saving themselves can maximise the overall number of lives saved. However, we challenge Kodama’s assertion that utilitarianism inherently favours tsunami-tendenko over mutual assistance during disasters. Instead, this paper proposes an alternative ethical foundation for tsunami-tendenko grounded in the ‘antiextinction principle,’ which prioritises minimising the potential for catastrophic outcomes. When considering the ethics of responding to disaster, it is important to distinguish between maximising the number of lives saved (utilitarianism) and minimising the risk of tomo-daore (antiextinction principle). This distinction may be overlooked if the distribution of probabilities is not considered. We conclude that the antiextinction principle aligns more naturally with tsunami-tendenko, emphasising the avoidance of catastrophic outcomes—a concern not always addressed by utilitarianism. Therefore, tsunami-tendenko should be regarded as a societal guideline aimed at preserving community sustainability by averting total destruction.