In Japan, it is still common for medical doctors to limit the amount of information they give to their patients. Doctors in Japan are seen as “kings,” similar to the situation in the U.S. in the 1950s and 1960s prior to managed care. Japanese patients often do not question their physicians with regards to their diagnoses or treatments. A survey conducted by the Ministry of Health, Labor and Welfare (MHLW) revealed that 40% of 1,600 physicians deemed it appropriate to decide how much medical information should be given to patients while only 26% felt that patients should be given as much information as they wanted. Due to this type of doctor-patient relationship, patients are often unaware of their medical condition or the treatments they are receiving.
In terms of patients’ eligibility for clinical trials, many who qualify for studies are often unaware that they can participate. Therefore, it is not surprising that clinical trials and participation in these types of studies have been limited in Japan. Besides the lack of information and knowledge, clinical trials were also considered taboo. The public often viewed physicians who participated in clinical trials negatively.
This type of mentality has created a large barrier for clinical test recruiting in Japan. Due to these long established attitudes, not many are willing to participate in clinical trials. Public leadership has also been slow to provide funding and resource allocation to institutions engaged in clinical research.
However, there are currently growing initiatives to better educate the Japanese public in the merits of clinical trials. The Japan Pharmaceuticals Manufacturers Association (JPMA) Public Affair Committee produced a television documentary on clinical trials entitled “Creating and Developing New Drugs: Supporting tomorrow’s healthcare through clinical trials.” Informational websites have also been created to provide general information about clinical trials, different diseases, and specific clinical trials that are available to eligible patients.