Healthcare Decision-Making in an Aged Society: How Law and Medicine Conciliate for Ethical Governance

By Yukio Sakurai

Healthcare Decision-Making in an Aged Society offers a comprehensive and original examination of the ethical, legal, and institutional dilemmas that define healthcare decision-making in super-aged societies. Using Japan as both a paradigmatic case and a normative testing ground, it advances a central argument: the challenges of demographic aging cannot be resolved by law or medicine in isolation. Instead, they require a principled conciliation between rights-based legal frameworks and the relational, cultural, and institutional realities that shape clinical practice and everyday care. Through interdisciplinary and comparative analysis, the book reveals that the persistent gap between formal legal ideals and lived caregiving and medical practices is not an anomaly, but a structural condition of aging societies.

At the conceptual core of the volume lies relational autonomy, presented as the most ethically robust and culturally resonant framework for reconciling individual dignity with social embeddedness in contexts of cognitive decline, dependency, and end-of-life vulnerability. The book argues that ethical governance in aged societies depends on normative integration: the alignment of hard law, soft law, professional ethics, and cultural meaning within accountable institutional structures. Moving beyond patient-level tools such as advance directives and supported decision-making, it addresses the structural foundations of governance-from healthcare financing and professional hierarchies to spiritual care, genomic medicine, and adult support and protection. Ultimately, the volume offers both a conceptual foundation and a practical blueprint for rights-based yet culturally responsive healthcare governance in super-aged societies.

• Format: Hardcover
• Language: English
• ISBN: 1969318872
• ISBN13: 9781969318870
• Release Date: July 2026
• Publisher: Common Ground Research Networks
• Length: 460 Pages
• Weight: 2.30 lbs.
• Dimensions: 1.4" x 6.1" x 9.2"