Does anyone have knowledge or experience about writing their will in regards to medical treatment in case one would end up in a condition to not express it? Would such a will be actually honoured should it run against close relatives wishes?
Incident this morning got me thinking again about how my and my wife’s weltanschauung are utterly incompatible when it comes to life and death decisions. We have few medaka fish in a fish tank and one of them has been upside down, being still in a corner beating its gills frantically since yesterday. In my country of birth the law says that if an animal is in a wounded or sick state persons who encounter it must try to arrange medical care for it. If that is unfeasible and letting it live would be cruel its life must be ended. I find this ethically sound and it’s how I was brought up and how I generally respond to suffering and wounded animals.
So after our kid pointed out the medaka I said that we should kill it.
Didn’t fly well with my J-wife. I’m a murderer it seems.
It should be “left to nature”. I pointed out that there is a corpse of a roach she chemically killed in the genkan, a fridge full of industrially produced meat, and that fish tanks do not appear in nature where predators would kill a suffering medaka. This did not sway her even a bit, quite the opposite.
We’ve had few similar fights on the same topic and I know that she and her extended family have kept their relatives alive with life extending prodecures way beyond what I would consider ethical. They are quite adamant that ending life in any way is wrong. I’m afraid that in case I would end up in a irreversibly bad condition but they could keep me alive they could do it to an unreasonable degree. I’d prefer to just die if things would go to that.
I’d like to write and register a will for the healthcare system, but unsure how to go about it. Google says I should go to 公証人 and write an 遺言 that includes 尊厳死宣言公証書 and 延命医療の拒否.
Anyone got experience with doing this or carrying it out?
Edit: on second thought removed some ranty prose
13 comments
Don’t worry OP. She gets a windfall when you die, so she won’t be so against it when you get there.
not sure what I just read and don’t want to get dragged into this, but DNRs are not really a thing in Japan.
[https://www.jaam.jp/dictionary/dictionary/word/0308.html](https://www.jaam.jp/dictionary/dictionary/word/0308.html)
so your wish can’t generally be implemented by a document.
Here is your peer-review:
People have different values to you and this post just seems like you want to have moral superiority over your wife.
Majority of people eat meat. Majority of people kill bugs. Majority of people feel bad killing their pets despite this. Majority of people want their family members to live as long as possible.
Your wife is a normal person.
I don’t know how to move this forward legally but just to say it was a thought provoking post and I hope there are some practical responses.
I agree with OP’s moral perspective. Even if those around you see it differently, stick to your guns OP. It’s a personal but also heavily culturally informed issue.
No euthanasia, but broad approval of death penalty. Not my ethics, but i don’t want to be judgmental.
I have two ideas (but not sure that flies by inheritence laws), after reading the comment saying that you probably cannot do it directly:
1) have you marked the all tissues OK on your health insurance card? when it comes to organ harvesting the time is of the essence, so at least in case of a road accident, your organs would be prioritized on the spot.
2) Can you put clauses in your general will?
E.g. If my wife honored my wish to not extend my life on cables beyond xx amount (or at all), then 50% of my assets go to her. If she did not, 20%. 30% go to a charity of your choice.
If you then clearly communicate this to your wife, she knows and can make the choice. You wont find out and be bothered about it or if you suffer on cables, you will have at least this knowledge (though she probably could fight it with a lawyer if you dont make it juristically sound-proof to begin with).
Also, beware, that if you maintain your own national identity, your native country’s inheritence laws might be relevant.
On the other hand, if I was worried about my spouse not respecting my wishes around what I consider a respectful death, I guess maybe the relationship is unlikely to last til the relevant time of life.
(calling you a murdered over a dying fish is extreme… I understand your confusion. I once killed an insect – a spider or ant – in a grey room level experimental room and the other person was upset, so now if I kill an insect in front of someone, I ask “are you comfortable with me killing this spider right here” or do it super discreetly… does your family know how many fish they have? next time just discreetly remove the dying fish and pretend that everyone is healthy and happy again – if the number is low and your kid is keeping track. Buy a new one or tell the kid, that you found it properly dead and removed it because the other fish were feeding on the carcass or less extreme that the other fish dont get sick or sad)
DNR is well-known in Japan, but there are no laws or guidelines either way. Many doctors or hospitals will honor them, but some won’t (I think you need one for each facility). I don’t know about living wills in particular.
Regarding pets, there is no “Old Yellar” feeling here, no coup de grace.
Wills will usually be followed, but can be contested if any of the children or the current spouse are left out.
Sir, this is a Wendy’s.
“I said that we should…”
**bad strategy**.
since your interlocutor is Japanese, **first** you should have pointed out the objective condition (something is so and so / happening), and then hypothetically asked an open ended question as to what would be the most appropriate way to deal with the situation, upon listening to the other side’s answer (which would most likely be also noncommittal), you should have **then** pointed out that one of the **possible** solutions would be to do so and so (perhaps, adding that such a course of action would actually be common in your home country), **thirdly** you should have gauged the reaction of the other side, and **only** then finalized your overall stance
**THIS is HOW** you should talk to Japanese people (believe me, i have personally stepped on so many landmines during such conversations that i know the routine)
As far as I know you can have a DNR or a will regarding medical procedure but there is no legal obligatory to follow it. And often your family is consulted and their decision is what matters.
The thing is, compared to other countries in Japan you are less an individual and more part of a group. In this case the family. So that’s why it is seen as a family decision rather than giving your personal preferences priority.
One more point is that there is quite a lot value put on ‘gaman’. Endure until the very end is seen as virtue even if said person isn’t aware of it’s surroundings any longer. I’ve seen this when my wifes grandmother died. She had cancer that spread through her whole body. In addition she had Alzheimer. It was obvious that she was no longer aware of her surroundings and that even breathing was painful. Yet after she died at home (likely from organ failure) the doctor talked about her casue of death like this. “最後まで頑張ったので老衰にしましょう”. So basically because she fought until the end her casue of death will be ‘died of old age’. This apparently put most of the relatives at peace. To this day my wife is more or less disgusted by this. Her grandmother was simply suffering and not fighting. Having her endure that all and then having ‘old age’ as cause of death is purely done for the family and not for her grandmother. But my wife is also in support of assisited dying, so her views are rather uncommon in Japan.
I don’t know your age OP, and I’ve never dealt with legal “will” documents so far, but as a Japanese nurse I’ve dealt with a lot of old-age DNARs (Do Not Attempt to Resuscitate) and terminal care so please let me share my thoughts and experiences.
There are patients and families that are well-informed about medical stuff either through reading or having close people in the medical/caregiving industry, have family members who has disease/needs care so they naturally have to think about these stuff early on, pretty assertive with what they want and would even bring up DNARs on their own before us asking them, properly talking to their loved ones early on.
Then there’s the other side: unprepared people, people who “don’t want to think/confront bad stuff”, people who just throw their hands and lets the doctors decide (some doctors only see ¥ and not the patient), people who are dense to the reality of the patient despite many times of explanation and urging, people who request to do “anything and everything no matter what” (even if the patient suffers and there’s not much point).
Only YOU can decide how you want to go and it’s you who will feel it/experience it. So be assertive of what you want, your rights. If you bring a document or sign the hospital’s document, even a “no blood transfusion” (Jehovah), we honor it.
Don’t wait too long until you have Alzheimer’s (認知症) because your family will have to decide for you.
Even if some days you can think properly and voice out, “I don’t want this, that hurts so don’t do it”, us nurses have no choice but to honor your family’s request (of course with as little pain and discomfort as possible) or else we’ll get sued for “neglect, murder”. Or you can go violent every time and we’ll have to give up and chart “too violent, rejecting care” after multiple people tries. That also works as well, but it sucks for the physically abused nurses and caregiver staff.
Personally for me, in my driver’s license I wrote 「胃ろう拒否、透析拒否」 These are PEG/PTEG and dialysis. Please research them if you don’t know about these yet.
I know a doctor who puts PEG into almost every single patient whose family said “I trust your judgement doctor, I leave it up to you” when the doctor only sees it as a money-making scheme. (And most of those families don’t even visit, maybe only twice a year.)
Before that talk happens we usually try to talk to the family about the realities of it but they would not listen to a lowly being like us.
When you get PEG, you’ll be more prone to pneumonia and we’ll have to suction out the phlegm from your nose or mouth by inserting a tube 喀痰吸引 and it’s NOT fun for the patient. This procedure is everyday, multiple times a day, sometimes there are patients with never ending pneumonia so that means suffering for the rest of their days. They beg us not to do it the moment they see us preparing the tube, and we don’t really want to do it but we have to or else they’ll slowly choke and die.
Sorry for the long and depressing rant. It’s not always sad in the hospital ward, there are also bright moments with patients but people sometimes have to know reality. If you have spare time, please read, search and think for a bit. It will save you later.
I agree with your point of view. As a pet owner, I’ve had to take the (sometimes not so difficult) decision of taking some of my boys to the vet for a lethal injection rather than let them suffer needlessly.
Based on what you explain it sounds as if your wife’s point of view is not based on rational thought. Could it be that they have been religiously indoctrinated into this belief?
> her extended family have kept their relatives alive with life extending prodecures way beyond what I would consider ethical.
It won’t help. But I have a strong image of your J-relatives storing people in liquid filled tanks in basements.
Rather than the logic conclusion that the procedures are actually ethical and common place in Japan. Where you, at least presently, abide.
Oh. Considering what is left did you really delete the Ranty prose.. ha ha
I feel for what you’re saying. Extension of life care is often taken too far, and hopefully you can get some understanding with your wife that you may not necessarily want it.
As to pet death? It’s always best to choose your words here. We use words like “put it to sleep” because it feels more comfortable. People have emotions and feelings and “we should kill it” sounds like murder, while “we’ll help it pass comfortably” is an act of caring. Not sure what words exactly you used but yeah, initial impressions matter and peoples emotions aren’t something to just be dismissed(I say this as an annoyingly logical person that used to beat people over the head with logic and be endlessly frustrated as to why they wouldn’t understand).
Sounds like you also need to learn how to argue with people(especially your wife). You shouldn’t be trying to prove them wrong. You should be trying to make them come to your way of thinking, and make them think it was their own idea. Use guiding questions, and admit fault where you’ve made it, and they’ll be more willing to do the same.
You’re not wrong and your wife isn’t wrong. Both are coming from somewhat different philosophies and it’s worth having an exchange of ideas to understand each other. Life extension treatment is a tough subject because families often feel a responsibility they must extend a precious family members life, and often they simply don’t comprehend the suffering or are in denial about the long term recovery prospects. And of course sometimes less scrupulous medical facilities may try to profit from the situation.