A Service Or a Right: Informed Consent for HIV-Positive Latin American Men in Japan

Since April 1996, Japanese health care providers who practise informed consent have been financially rewarded. Although there is no precedent for this financial gain, there are no detailed studies. Focused on a group of Latin American men living with HIV/AIDS, this paper clarifies the actual practices of informed consent at Japanese medical facilities. Twenty HIV-positive men were interviewed in order to investigate how they obtained medical treatment and how they were informed about their physical condition. From April to September 2002 and during August 2003 and 2004, a set of six interviews were conducted with each male, who were 28-37 years old. Participants were acquired through a hospital and a non-governmental organization, and by snowball sampling. The interviews showed that most of the informants received information concerning medical treatment, but they were advised neither about alternative treatments nor about the feasibility of seeking a third party's advice. Informed consent and communication between the informants and physicians were obstructed by language and structural, as well as cultural barriers. In conclusion, this paper adds a new dimension to the understanding of informed consent as the authors regard the practice as an educational process for health care providers and patients.