Basic Attitude of the Japanese Medical and Dental Practitioners for the Improvement of Medical Care (Hodanren) toward Medical Care

This declaration was adopted by the Japanese Medical and Dental Practitioners for the Improvement of Medical Care (Hodanren) in January 1989, after a four-year discussion. It expresses the determination to improve future medical care and describes what should be done, and proposes what medical specialists, patients and communities should do in order to widely promote dialogue on the issues stipulated in this declaration.

In January 1998, the fifth item in the declaration, “Record of Consultation and Treatment”, was modified at Hodanren’s 36th general meeting.


Medical and Dental Practitioners have long been at the forefront of medical care, contributing to community heath care in all parts of Japan.

The average life expectancy of the Japanese people has now been extended remarkably. At the same time, rapid changes and distortions in the economic, working and environmental conditions of national life have increased the incidence of adult diseases and given rise to new, previously unknown kinds of mental and physical disorders. People of all generations, young and old alike, are increasingly concerned and anxious about their health.

In this situation, the role of medical and dental practitioners has been questioned. They are now urged not only to be responsible for day-to-day medical care, but also to respond to various tasks ranging from the prevention of diseases to environmental improvement, based on their specialized knowledge and technology.

At the same time, modern democratic ideas of people’s sovereignty and respect for human rights proposes new agendas for us, including human relations in medical care and the question of medical ethics and progress in medical science.

To meet these expectations and requirements, it is essential for medical practitioners to try to fully understand what their patients and the community want of them, pursue their studies in search of new medical science and techniques, constantly review their own medical services and endeavor to develop new skills.

Although Japan is known as an ”economic power”, its people do not benefit from it. Rather, the social security system, which has been built up through the efforts of the people, is increasingly cut back as the nation’s military budget expands and the “mobilization of the private sector” is emphasized. Further, environmental disruption on a global scale and threats of nuclear weapons are bringing real danger to the very survival of the human race.

In the face of these realities and in search of ideal medical practices for the 21st century, we hereby issue the following declaration:

1. Medical Care for the Whole Being

We shall not only try to find proper treatment for every disease, but also endeavor to provide comprehensive medical care to patients in their totality, taking into consideration their mental and physical conditions, family situations and living environments.

2. Importance of Dialogue

Medical care is a joint action by patients and doctors, based on their mutual confidence. Through a respectful dialogue with patients, doctors shall provide their special knowledge and techniques to help patients themselves make the best and most informed decision.

3. Community Medicine

Being close to the people in the community, we are directly responsible for their day-to-day health care. Each practitioner shall also play an active role in tackling problems of local public health, preventive medicine, rehabilitation, public welfare, environmental protection and industrial pollution.

4. Partnership with Other Medical Institutions

We shall make every effort to work smoothly with other medical practitioners and institutions through exchanging information on diagnostic functions and everything necessary, so that the most appropriate medical care can be given to the people. At the same time, giving due consideration to the role of other medical and welfare workers, we shall try to work in close cooperation with them for patient-centered care.

5. Record of Consultation and Treatment

It is a doctor's important duty to keep an accurate record of medical consultations. We shall try on a daily basis to provide information necessary for patients’ recovery and meet in good faith patients’ requests for treatment information. In providing information about their treatment, we shall strictly observe doctors' duty of confidentiality concerning their patients and protect their privacy and human rights.

6. Lifelong Learning

We shall continue deepening our knowledge in medical science and art, as well as in other relevant academic fields, and aim to create, practice and develop front-line medical care and science, so that patients and people in the community can benefit from the best medical achievements of the day.

7. Enforcement of Self-Governance
We shall strictly distance ourselves from any medical practices that would undermine the trust of patients and local people. We shall be open to constructive criticism from others and endeavor to conduct self- and reciprocal checks on our day-to-day medical practices.
8. Social Security

Medical care must not conform to the dictates of the market, which by definition pursue profits. It is a duty of a modern state to assure social security for all people, so that they can receive sufficient medical care and welfare benefits. We shall make efforts together with the people to defend and improve social security.

9. Monitoring Advanced Technologies
Rapid progress in science and technology confers great benefits on humanity, while misuse may cause serious concern about the possible destruction of the ecosystem. We must remain vigilant and speak out about advanced technologies that could adversely impact on the future of humankind and the Earth.
10. Desire for Peace

Doctors, whose task is to defend human life, reject wars of any kind. Learning from history and acting on the principles of the Constitution of Japan, we shall oppose all moves to threaten peace and confirm that it is the social responsibility of all doctors today to work for the prevention of nuclear war and the elimination of nuclear weapons.
January 1998


Hodanren (Japanese Medical and Dental Practitioners for the Improvement of Medical Care) was established in 1969 with the aim of protecting medical and dental practitioners, to enhance medical care for the people and to improve the national health insurance system. Hodanren represents 64,968 medical doctors and 39,210 dentists as of June 1, 2013. Hodanren’s local chapters are organized in all 47 prefectures of Japan.