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"Petition: Request for the legalization of humane end-of-life options (so-called euthanasia)" *Notes and additional information regarding documents to be sent

["Petition: Request for the legalization of humane end-of-life options (so-called euthanasia)" *Notes on documents to be sent and additional information]


The documents to be placed in the envelope are listed in order from top to bottom.


① Cover letter

② An opening sentence that is appropriate for the intended recipient + main text

* Write the opening sentence in your own words after carefully researching the characteristics of the member of parliament .

③ Supplementary documents

④ Summary (※This is optional, but we will include it)


It will be.

Put together ① and ② into one bundle, then ③ and ④ into three bundles (not staples) and fasten them together with clips .


Use paperclips, not staples, to write petitions to lawmakers

Clips actually purchased by our club (click on the image to go to the Amazon site)


Below is an example created using Representative Tsumura.

I would be happy if you could use this as a reference.



cover letter:



Greetings regarding the submission of a request for the establishment of a system for end-of-life medical care and humane end-of-life choices (euthanasia)


Member of the House of Representatives, Keisuke Tsumura


Dear Sir/Madam,

We would like to express our sincere respect for your ongoing efforts in formulating policies regarding end-of-life care, dignified death, and patients' right to self-determination.

The stance that Mr. Tsumura has taken in parliamentary debates and lectures, that "we should openly discuss how final moments should be," has become an extremely important guideline for many people involved and medical professionals.


Now, we at Rest in Peace with Dignity (RiP:D) - a group aiming to legalize euthanasia - have organized the following points and are:


Institutional gaps in end-of-life care in Japan (Supplementary Material ①)

An internationally established and safe institutional model (Supplementary Material ②)

Risks associated with the introduction of the system and preventative measures (Supplementary Material 3)


We have compiled a proposal requesting the necessary legislative considerations toward the "legalization of humane end-of-life options (euthanasia)."

This proposal is


Even in Japan's palliative care, approximately 20% of patients die while still suffering

Main text Supplementary material ①

- Under the current legal system, patients, their families, and medical professionals are all struggling with legal ambiguity.

Main text Supplementary material ①

- Internationally proven systems such as those in the Netherlands have strict review and reporting mechanisms to prevent abuse.

Main text Supplementary material②

・Effective risk countermeasures to anticipated concerns when the system is introduced

Main text Supplementary material ③


The report outlines the above evidence-based issues and demonstrates the feasibility of building a Japanese version of the system.


We believe that the time has come in Japan to consider a system that respects the dignity and self-determination of patients while balancing safety and social acceptability.

We apologize for bothering you during your busy schedule, but we hope that this proposal will be of use in future policy discussions.


Finally, I would like to sincerely wish Mr. Tsumura continued success and good health.


Sincerely,


Rest in Peace with Dignity (RiP:D)

Association for the Legalization of Euthanasia




Sentence to be inserted at the beginning of the proposal:



In Japan, patients who suffer from "unbearable pain" and "loss of dignity" in the terminal stage

There remains a serious institutional vacuum in which people have no legal means to choose their own end of life based on their own self-determination.

Under the current system, the only option is to discontinue life-sustaining treatment and rely on palliative care.

There are no clear criteria for judgment regarding the patient's wishes, the family's concerns, and the legal responsibility of medical professionals.


In Europe and North America, there are strict application conditions and highly transparent inspection and audit systems.

"Humaneine end-of-life choices (euthanasia and physician-assisted death)" have been institutionalized,

It has a proven track record of working properly.


Furthermore, in Japan, palliative care

International survey results suggest that approximately 20% of patients die in pain.

It is clear that palliative care alone cannot relieve the suffering of all patients and has its limitations.


In light of this issue, we

Based on respect for self-determination, transparency in medical care, and thorough protection of the weak

Towards the legalization of the "Japanese version of the Humanitarian End of Life Choice System (tentative name)"

We strongly request that bipartisan discussions begin in the Diet as soon as possible.


※⇩

Continued in the main text




Petition summary (2 pages) :


1. Current situation in Japan: Institutional vacuum leaves no one unprotected

Japan does not have a legal system for euthanasia or physician-assisted death.

Patients, families, and medical professionals are all in a legal gray area.

  • Previous court cases have suggested that the requirements are "unbearable pain," "imminent death," and "personal wishes," but the legal basis is unclear.

  • Because it relies on legal precedents and guidelines, the criteria for judgment in the medical field are vague and cause anxiety.


→ As a result, the pain and anxiety of the parties involved and the legal risks to medical professionals are not resolved.


2. The Limits of Palliative Care: Approximately 20% of Patients Die in Pain

Supplementary Material ① shows international data:


  • Even with the highest level of palliative care, " 21% will die in pain "

  • Similar trends in other developed countries

  • Japan's medical technology is not much different, and is estimated to be at the same level (approximately 20% of deaths are painful).


→ Palliative care alone is structurally unable to relieve all suffering.


3. The international model: strict systems work while preventing abuse

Countries such as the Netherlands, Belgium, Switzerland and Spain have established "highly transparent and strict systems" that have been in operation for over 40 years.


Main conditions

  • The patient's voluntary and deliberate wishes

  • Diagnosis by multiple doctors

  • Independent Review Body

  • Documentation, reporting requirements, and publication of annual statistics (Supplementary Material ②)


Operational track record

  • Over the past 40 years, no evidence has been found that the system has driven the weak into a corner. (Supplementary Material 3)

  • The "slippery slope" is a poorly supported hypothesis and has not been empirically confirmed. (Supplementary Material 3)


→ Humanity and safety can be achieved simultaneously, and there is ample international evidence.



4. Framework of a possible system proposal for Japan (from the main text and supplementary materials ②③)


① Clearly stipulate strict application conditions

  • Unbearable physical/mental pain

  • Voluntary and repeatedly confirmed will

  • Diagnosis and interviews with multiple doctors (including independent doctors)

② Establishment of a third-party review organization

  • Post-examination (Dutch method)

  • Mandatory annual reporting and statistical disclosure

③ Rules for protecting the vulnerable

  • Eliminating economic and social pressure

  • Clarifying the criteria for assessing capacity to consent

④ Phased introduction (trial system)

  • Start with terminal illness only

  • After verification, evaluation and improvement are carried out step by step.

⑤ Coexistence with palliative care

  • Positioning euthanasia as an "additional option"

  • Strengthening palliative care itself is also being implemented in parallel


→ It is possible for Japan to build a safe and transparent system that meets international standards.


5. Request to the Diet Members (Chapter 4 of the main text)

(1) Consideration of private member's bills

  • Based on this proposal, we have requested the formulation of a "Humanitarian End of Life Choice System (tentative name)."

(2) Beginning of formal bipartisan discussions

  • End-of-life care is a national issue that transcends party lines

(3) Holding public hearings and public dialogues

  • Reflecting the voices of patients, families, and medical professionals in system design

(4) Budgeting for research, verification, and investigation

  • Strengthening palliative care, system trials, and securing international research


Conclusion: Japan has already reached a stage where discussions can no longer be postponed


  • The limits of palliative care (approximately 20% of deaths are painful)

  • The earnest voices of those involved (cases where a system is not available in Japan and so people move overseas) (Supplementary Material ①)

  • Strict and safe systems are becoming commonplace internationally

  • Ageing society increases pain, isolation, and fear


In order to protect patients' self-determination and dignity, the time has come to legislate "humanitarian options" at the end of life in Japan as well.



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