Japan Updates Guidelines on Ending Life-Sustaining Treatment

Tokyo, March 17, 2026 – The Japanese Association for Acute Medicine, along with three other academic societies, has proposed revised guidelines for determining when to end life-sustaining treatment for patients. Public comments on the proposed changes are being accepted until March 27.

Background on the Guidelines

The current guidelines, initially established in 2014 by the Japanese Association for Acute Medicine, the Japanese Society of Intensive Care Medicine, and the Japanese Circulation Society, provide a framework for defining the “end of life” in emergency and treatment settings. These guidelines emphasize that decisions to conclude life-sustaining treatment should be based on the patient’s expressed wishes and sound medical judgment.

Reasons for Revision

Advances in medical technology have expanded the ability to support seriously ill patients. However, these advancements have also led to situations where continued support may not align with a patient’s preferences. Recognizing this, the Japan Society for Palliative Medicine joined the effort to revise the guidelines.

Key Changes in the Proposed Guidelines

Unlike the previous guidelines, which attempted to define the “end of life,” the proposed revisions focus on the process of deciding whether to continue treatment. The new recommendations emphasize discussions with patients and their families, and state that medical teams – including nurses – should make decisions based on a careful consideration of the patient’s will and prior intentions.

Emphasis on Continued Care

The proposed guidelines also highlight the importance of ongoing care, such as pain relief, for patients and support for their families, even after treatment is concluded. They advocate for minimizing unnecessary examinations and refraining from cardiopulmonary resuscitation in cases of cardiac arrest.

Concerns Raised by Patients

Some patients with intractable diseases have voiced concerns about the proposed changes, expressing fears that treatment may be discontinued for the convenience of hospitals or families. Hitomi Sakai, a patient with amyotrophic lateral sclerosis, stated, “I feel a strong sense of crisis because they promote the choice to die rather than the choice to live,” at a news conference on March 6.

Annual Meeting of the Japanese Society of Intensive Care Medicine

The 53rd Annual Meeting of the Japanese Society of Intensive Care Medicine will be held in Yokohama from March 5-7, 2026, at PACIFICO Yokohama. The meeting will be presided over by Naoki Sato, MD, PhD. More information can be found on the JSICM website.

About the Japanese Association for Acute Medicine

The Japanese Association for Acute Medicine (JAAM) is an academic clinical society dedicated to the field of acute medicine, encompassing a wide range of clinical areas related to acute illness. Learn more about JAAM.