Page 23 - IJPS-8-2

International Journal of
Population Studies Japan’s death-laden society

and Nagoya. These locations were chosen because these are in Japan since well before reaching the verge of becoming
the most populous cities in the country and may also help a death-laden society. This has been a publicly recognized
capture some potential regional differences in interview issue since the mid-1950s, particularly in rural areas and
participants’ perspectives. A total of 24 experts participated on remote islands (Matsumoto, Kashima, Owaki, et al.,
in the interviews, including government officials, medical 2019). In addition, over roughly the past two decades,
and health-care practitioners, representatives of medical an increasing number of semi-rural areas and mid-sized
institutions, and researchers affiliated with universities cities across the country have come to face the same issue
and think-tank organizations. Initially, three of the due in part to the migration of younger populations to
participants were invited to be interviewed due to their larger cities, including those working in medical fields
organizations’ publicized concerns specifically regarding (Takata, Nagata, Nogawa, et al., 2011). Dying at hospitals
Japan’s prospective transition into a death-laden society. typically requires that doctors provide medical treatment,
Their concerns and discussions were publicly expressed in care, and support just as they do when treating injuries
their whitepapers, newsletters, and online articles, among and illnesses of patients aiming to recover. In many cases,
others. Then, a snowball sampling method was utilized to intensive care, extensive treatments, and use of advanced
recruit the rest of the participants. technologies are called for on behalf of those patients
The interviews were designed to be in-depth and semi- whom the doctors know are going to die at their hospitals
structured and conducted in a one-on-one manner. Each (Interview data, Tokyo, March 22, 2020). It is highly likely
interview followed a set of prepared questions centering that the coming of a death-laden society will exacerbate
around participants’ accounts of their current concerns the doctor shortages that the country has been suffering
and challenges in pursuing their professional missions from for decades (Interview data, Tokyo, August 15,
specifically in the context of the country’s population 2021).
aging and how those concerns and challenges will likely A death-laden Japan will also run in short on hospital
evolve in the conceivable future. In addition to exploring beds. This will be a major challenge as hospitals are the
the participants’ views of these prepared questions, predominant place of death among the Japanese today.
the interviews also left some flexibility for unexpected
themes to emerge. Due to the travel restrictions under the Figure 1 illustrates the composition of place of death
country’s declaration of a state of emergency, nearly half among the citizens in 2020. In this year, about 68.3% of all
of the interviews were carried out remotely using various deaths took place at hospitals. Those who died at home in
ICT software programs including Zoom and Webex. All the same year accounted for only about 15.7% of all deaths,
the interviews were voice-recorded and anonymously and the corresponding figures for retirement homes and
administered. The data were analyzed with a series of long-term care facilities were approximately 9 and 3%,
thematic coding and analyses to categorize specific concerns respectively. While in recent years, the figure for homes has
and challenges conveyed by the interview participants into been on the rise, the majority of Japanese people – nearly
broader themes. As a result of the thematic analysis, five 70% – die at hospitals today (Figure 1).
themes in the data emerged, each of which is mutually
related in reality and yet conceptually distinguishable
enough to be discussed as a unique area of policy challenge
in itself. In what follows, these five themes are discussed as
five key areas of policy challenges that Japanese society will
likely be urged to address on the verge of transitioning into
a death-laden society.
3. Results and discussions

3.1. Shortages in basic medical resources for the
dying

The first area of policy challenge for a death-laden Japan
is prospective shortages in clinical doctors and hospital
beds, basic medical resources necessary for those spending
their past days of life at conventional medical institutions
such as hospitals, due to the ballooning deaths in the Figure 1. Composition of place of death, Japan, 2020 (%).
country’s population. Clinical doctors have been in short Source: Ministry of Health, Labor and Welfare (2022)

Volume 8 Issue 2 (2022) 17 https://doi.org/10.36922/ijps.v8i2.301