Legal Reform Proposal for Independent Nurses’ Practice in Japan
Date Issued
2015
Date
2015
Author(s)
Takahashi, Yasushi
Abstract
Japan is faced with such healthcare-related issues as chronic disease prevalence, and the citizens’ healthcare needs have been changing. Nevertheless, the healthcare supply systems have not caught up with the change, and the field of health care is still dominated by the biomedical model. This dissertation proposes that the doctor/medicine-based healthcare paradigm be supplemented by a nurse/nursing-based system and that, for the supplementation, independence be granted to some nurses so that they could initiate certain healthcare interventions inclusive of preventive measures 1) in the settings where there are not (enough) doctors and 2) for the patients for whom medical interventions are not appropriate. Regarding “1,” in principle, nurses in Japan cannot lawfully initiate (medical) interventions without doctors’ directions. And, regarding “2,” without independence, they have no choice but to follow doctors’ directions even if the directions are not for the benefit of the patients (unless they are obviously wrong). Thus, medicine’s reins on nursing are tight in Japan. In order to release nurses and nursing, this dissertation presents a proposal with such tactics as decentralization of the regulation on nurses and, therefore, demands an amendment to (or revision of) the national statute on nurses: the objective of the proposal is legislative deregulation of nurses’ practice. The proposal itself is as follows: “Japan’s central government should amend the statute on nurses so that it could allow the local governments to open special posts for a limited number of nurses and to have the nurses independently offer health care designed for the communities’ specific needs as local public officers who can do so only within their appointed regions.” The method or nature of this dissertation is qualitative research (for the proposal). The dissertation introduces nursing and law, examines the scopes of practice for nurses of various types, studies the statutes on nurses in some jurisdictions, shows the contemporary healthcare-related issues in Japan, criticizes the existing reform efforts for the solution of those issues, stresses the importance of nurses for the solution, makes the aforementioned proposal, and discusses the outcomes and issues expected of the proposal.
Subjects
biomedical model
deregulation
independence
Japan
law
nurse
scope of practice
Type
thesis
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