ESSAY ANALYSIS OF LEGAL AND ETHICAL PROBLEMS IN JAPAN: CASE

STUDY OF MEDICAL PROCEDURE BY NURSE IN JAPAN

Arranged to fulfill the task Basic Concept of Nursing course II

By:

International Class (C)/Semester VI/Batch 2020

Fuzna Dahlia Mudzakiroh I1J020010

NURSING UNDERGRADUATE PROGRAM

FACULTY OF HEALTH SCIENCES
JENDERAL SOEDIRMAN UNIVERSITY
MAY 2023
ANALYSIS OF LEGAL AND ETHICAL PROBLEMS IN JAPAN: CASE STUDY
OF MEDICAL PROCEDURE BY NURSE IN JAPAN

1. Introduction
Nurse practitioner positions continue to grow over time, one of which is The
Japanese Nurse Practitioner System (JNP). JNP was founded in 2015 to delegate some
of the duties of doctors to nurses and other health professionals. From the system, it
has been shown that performance of JNP in its tasks has a certain degree of efficacy
and leads to profitable outcomes for patients (such as shorter hospital stays). That is
due to the fact that nurse practitioners provide medical services instead of doctors, and
they are legally responsible for their actions. However, this responsibility is not clear
in practice.
To protect them during medical procedures performed on behalf of doctors and to
keep their medical practice safe, the legal obligations of nurse practitioners must be
clarified. The aim of this essay is to explain how JNP see their own legal
responsibilities in clinical practice.
2. Legal Issues in Nursing Medical Procedures
Although nurse practitioners are legally responsible for the medical care they
provide because it is performed on a physician's behalf, there is considerable
uncertainty over the exact circumstances in which nurse practitioners can be held
responsible for their medical care. For example, in situations where nurse practitioners
and physicians collaborate, even though physicians evaluate the nurse practitioner's
activities, there is some overlapping areas of expertise (e.g., the nurse practitioner may
prescribe medication and perform some cases (Maree & Van Rensburg, 2013), but not
all, follow-up medical procedures), which raises the question of unclear legal liability.
In addition, nurse practitioners should not perform complex medical treatments
on their own. Although nurse practitioners are an important component of the medical
team in the emergency room, they must have the appropriate practical skills to keep
medical practice safe and prevent legal problems (Balestra, 2017). The number of
medical malpractice insurance claims has increased in countries such as the United
 States, where such litigation is very common, given that nurse practitioners have great
responsibilities regarding their practice and the number of patients nurse practitioners
respond to increases every day. In order to protect nurse practitioners with respect to
their medical practice carried out on behalf of doctors and to guarantee the safety of
medical operations, it is necessary to define the legal responsibilities of nurse
practitioners. And, the JNP system is currently the subject of discussion in Japan.
Regardless of their special training, JNPs must follow the doctor's orders when
performing medical procedures, just like any nurse.
3. Ethical Issues in Nursing Medical Procedures
Ethical issues in nursing medical procedures in Japan have also focused on nurse
practitioners and their ethical issues in clinical practice from the perspective of nursing
faculty. In fact, it is known that nursing ethics is a compulsory subject in many
Japanese nursing universities, such as "Biethics" and "Nursing Ethics" are considered
as important subjects in nursing education (Tsuruwaka, 2015). However, many of the
ethical issues that nurse practitioners face in clinical practice are related to the way
nursing staff interact with patients, and studies on this issue have been the subject that
have been conducted in a number of countries (Ramos et al., 2015; Sinclair et al.,
2016).
According to research, many patients' rights and privacy are not protected, and the
patient's wishes are not respected at all. In Japan, in particular, the issue of caring for
patients is widely mentioned (Suganuma et al., 2010; Park et al., 2003). Another ethical
issue identified was not telling the truth to patients and giving them wrong information.
In addition, it has been noted that nurse practitioners often consult other nurses, family
members, or friends rather than faculty of nursing. In fact, it is known that nurses who
talk to nursing faculty will get better emotional support and appropriate information.
4. Conclusion
It can be concluded that legal and ethical issues in nursing medical procedures in
Japan continue to emerge over time. This relates to how nurses still have ambiguous
and overlapping duties with primary doctors. In addition, there are issues in procedures
where nurses commit ethical abuse in their procedures.
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