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Transcultural aspects

      Palliative care is not limited for patients with cancer. It aims to improve the quality of life of patients with life-threatening diseases. However, there are obvious policy lags in Japan, because the target diseases covered by the national medical insurance for palliative care and palliative care teams are cancer and AIDS only. It is obvious that palliative care for patients with neurological diseases such as ALS is necessary, but there are big differences in the situations between the developed Western countries and Asian countries.Due to economic problems, many Asian countries cannot provide palliative care itself, but even in some developed countries, cancer is still the only target. Also, the way people think about end of life is different in Western countries and Asian countries. Japan has a culture that values longevity and it influences when people have to decide whether or not to choose tracheostomy ventilator (VT) in ALS. In countries where the intention of the family is more strongly reflected in the decision than the person himself/herself, the rate of using TV seems higher. I will report the results of comparative research between Japan and the United States centered on ALS, survey results in the Pan pacific region, and previous research.
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