Dichotomies of collectivism and individualism in bioethics: selective abortion debates and issues of self-determination in Japan and 'the West'

This article examines the dichotomies of collectivism and individualism in the debates on the selective abortion of disabled fetuses, which have occurred over the last four decades in Japan. Disagreements in debates on abortion in Japan have often revolved around the concept of self-determination (jiko-kettei). These debates usually focus on whether this 'foreign' concept is appropriate in a Japanese context, as the dominant Japanese discourse stereotypes the Japanese as making decisions in a harmonious manner. Both in public debates and in academic writing on abortion, the idea that the West is devoid of harmonious collectivism is often presented in an uncritical manner. In this article, we argue that the notion of 'self-determination' is borrowed from 'reverse Orientalist' and Occidentalist discourses that portray Westerners as individualistic or ego-centric and the Japanese as collectivist. The concept of 'self-determination' was remolded and projected onto Japanese public and academic debates on abortion. The relevance of this concept lies in the ways in which dichotomous views of 'Japan as harmonious' versus 'the West as individualistic' influence guidelines concerning prenatal testing and its daily practice. By critically analyzing the narratives of policy-makers and academic studies on self-determination and prenatal testing, this study traces these polarizing views back to the processes of national identity formation. These processes underlie political debates and academic work associated with the search for 'Japanese-ness'. This article further demonstrates that policy-makers' criticism of self-determination in prenatal testing derives from gender bias, which is also related to issues of Japanese identity. This article is based on both archival and field research materials collected between 1997 and 2008. We also refer to interviews with medical doctors, policy-makers, journalists, counselors, nurses, participants in various social movements and individuals undergoing prenatal testing, taken from a total of 180 interviews.