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Kazuya Matsuishi

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As a Lawyer Involved in Medicine

Kazuya Matsuishi
Lawyer, Takada & Koumi Law Office

I entered the Department of Law in the Chuo University Faculty of Law in 1999. At the time that I enrolled at Chuo University, that section of the Tama Monorail had not begun operation. Therefore, I commuted to school by taking a bus from the Tama-Center Station. The Tama Monorail was completed when I was in my second year at university, and I remember being very happy at how convenient access to university had become. Afterwards, in 2004, I entered the advanced course in the Chuo Law School as a member of the first graduating class of the School (The Chuo Law School is located in the Akebonobashi, neighborhood of Shinjuku City). After passing the new bar examination and performing my legal apprenticeship, I entered employment at the Takada & Koumi Law Office. Today, under the guidance of lawyer Masakatsu Koumi, I mainly work as a representative of medical organizations in medical disputes. I also teach a class entitled “Medicine and Law” at my alma mater, the Chuo Law School.

Work of a lawyer involved in medicine

The main medical field in which law is involved is medical disputes (medical malpractice cases). However, there are also a variety of other fields including labor issues, uncollected medical expenses, legal consultation on issues such as disclosing medical records and protection of personal information, business succession for medical organizations, ethical review of clinical research, and serving as an instructor during study sessions and training at medical institutions. Furthermore, legal professionals now have more opportunities to become involved in medical safety due to the start of the Medical Accidents Investigating System, which began operation on October 1, 2015 in accordance with the amended Medical Care Act. In 2016, district courts throughout Japan received 834 new cases of medical litigation. In the past few years, the number of such cases has hovered around 800. Recently, there seems to be an increase in medical litigation related to dentistry. At district courts in urban areas such as Tokyo and Osaka, departments focusing on medical litigation have been established, and efforts are being made for increased efficiency and streamlining of such cases. Although medical litigation is commonly viewed as requiring a long time to process, the average trial period for medical litigation in Japanese district courts in 2016 was 24.2 months, about 2 years. Furthermore, the rate of witness testimony was 43.9% and the rate of expert examination was 7.7%[1]. Another notable feature is that, in the majority of medical litigations, both parties to the lawsuit are represented by legal counsel, and about half of all cases end in settlement.

My discussions with doctors and nurses have caused me to recognize how, particularly in urban areas, the number of patients has increased due to rapid aging of the population. Also, due to the advancement of medicine and an increase in the number of patients who have an underlying disease, the amount of medical resources used for each patient is increasing. By 2025, the baby boom generation will have reached the age of 75 and older (classified as latter-stage elderly in Japan) and the number of patients is forecasted to increase even more. Consequently, there is little chance that the tight conditions at medical institutions will be improved any time soon. Another issue is the overwork of healthcare workers. As a lawyer involved with medical institutions, my duties include resolving medical disputes quickly and accurately, and thinking together with medical professionals about the various new problems faced by medical institutions. Through these duties, I provide support which enables doctors, nurses, and other healthcare workers to focus on their true profession of medicine, which I believe is important for benefiting both medical institutions and patients.

Lawyers and doctors have a different way of thinking. There are times when lawyers and doctors use the same language to express different meanings and nuances (for example, the phrase “cannot be denied”). One role of lawyers when representing medical institutions in medical litigation is to serve as an interpreter that facilitates communication between doctors and judges. I realize that mutual understanding between the medical profession and legal profession is important during litigation. For example, documents submitted to the court are naturally written using large amounts of specialized medical terminology. Every day, I struggle to find ways to create documentation which will enable judges to understand the true condition of medical practices.

An episode while enrolled at the Chuo Law School

Initially, I was overcome with uneasiness when I first enrolled at the Chuo Law School thirteen years ago. However, cooperating with my classmates and instructors to start the history of the law school was a unique and meaningful experience. Everything was done through trial-and-error. My instructors were so committed to their tasks that they assigned an enormous amount of assignments to be completed before class, and I had trouble preparing in time for classes (today, I hear that the amount of pre-class assignments is more reasonable). At that time, no one knew what type of questions would appear on the new bar examination, so students formed their own seminars and studied a vast amount of material in an attempt to predict examination questions. Actually, lawyer Masakatsu Koumi, director of the Takada & Koumi Law Office where I am employed at, once worked as a specially-appointed professor in the Chuo Law School, and in fact, he taught the classes “Medicine and Law” and “Lawyering” when I was a student in the law school. I learned a great deal in those classes, and today I have the good fortune to work as a lawyer under the instruction of lawyer Koumi.

Working as a concurrent lecturer at my alma mater

The class “Medicine and Law” in the Chuo Law School covers legal issues related to medicine from both a theoretical and practical perspective. This format aims to achieve the university’s founding philosophy of “Fostering the Ability to Apply Knowledge to Practice,” thus enabling the production of legal professionals who will be useful to society. The main themes covered in class are methods of proceedings for medical litigation and legal precedents related to medical accidents. However, I also discuss the details of medical issues in medical practices and explore how legal professionals should be involved in the future of medicine. For example, although the anticancer drug OPDIVO is a revolutionary new medicine, the cost of that medicine has caused policy dispute. There is intense debate regarding how the burden of increased medical expenses in conjunction with an aging population and advanced medical techniques should be accepted and allocated by society, as well as how new medical technology should be implemented. There is no correct answer to these questions. However, today, law school graduates have an increasingly wide range of career options which include working at government agencies and corporations. Accordingly, I conduct my classes based on the desire for each student to possess broad awareness towards medicine and the ability to apply this awareness to their future fields of work. Some of my students have experience working in the medical field as employees of pharmaceutical companies or licensed professionals of medical institutions. As a result, I also learn a great deal from discussions with my students. While remembering the compassionate method which I learned from my instructors at university, I am working my hardest to serve as an instructor myself. Although 10 years have passed since I was registered as an attorney, I am still overwhelmed by how much I do not know and how much I need to study. Moving forward, I will continue to apply myself fully and sincerely to every single aspect of my work.

  1. ^ General Secretariat of the Supreme Court: 7th Report on Verifying the Expediting of Trials
Kazuya Matsuishi
Kazuya Matsuishi was born in 1981.
He graduated from the Department of Law in the Chuo University Faculty of Law in 2003.
He graduated from the Chuo Law School in 2006.
He passed the new bar examination in 2006.
He was registered as a lawyer in 2007.
He served as an instructor in the Chuo Law School from 2008 to 2015.

Concurrent Lecturer in the Chuo Law School
Concurrent Lecturer in the Chuo University Faculty of Law