Some people in Japan are still comfortable with the paternalistic role of doctors, but others wish that their own decisions would receive a greater amount of respect. A total of 747 students of universities and colleges and 114 parents of these students participated in a questionnaire survey. Most of the participants thought that autonomy should be respected in situations involving death with dignity and euthanasia, whereas it should not be respected in attempted suicide and involuntary admission of individuals with mental illness. A cluster analysis revealed that the participants could be divided into the following groups: aid in dying advocates (n=577), complete libertarians (n=109), protectors of the mentally ill (n=90), complete paternalists (n=29), and questionables (n=27). The assertion of independence score of the Scale for Independent and Interdependent Construal of the Self showed a significant difference among the 5 clusters. These findings suggest that the traditional paternalistic relationship between doctor and patient is undergoing a gradual transformation in Japan.
The psychometric properties of the Japanese Test of Self-Conscious Affect-3 (TOSCA-3), a self-report measure of self-conscious emotions, were examined in Japanese university students. Confirmatory factor analyses showed good fits of the theory-driven model for 6 emotions to the data. The subscales of the TOSCA-3 showed moderate correlations and internal consistency. Only the Shame subscale was greater among younger students, but women had higher shame and guilt than men. Social desirability moderately influenced some subscales. Test-retest reliability was good for shame and guilt. Time 1 shame predicted time 2 depression a week later. The Japanese version of the TOSCA-3 is a reliable and valid measure of self-conscious emotions among a Japanese population.
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