Aging society and the adult guardianship system

Abstract

Prior to recent revisions, civil law in Japan had established a system of interdict and quasi‐incompetency. This system was begun in 1898 and, up until the revisions of April 2000, it had spanned more than 100 years without undergoing any major changes. Statistically, there has been a steady increase in the number of pronouncements and retractions of incompetency in recent years. A 1980 survey showed that these cases most commonly involved people aged between 20 years and 40 years, and that the proportions of psychiatric disorder, mental retardation, and dementia in these cases were of nearly the same level. A 1996 survey, in contrast, showed a greater proportion of elderly, with about half these cases relating to dementia or a vegetative state. The new adult guardianship system was revised for the purpose of harmonizing the conventional idea of protection and new ideas including respect for self‐determination, practical use of remaining abilities, and normalization. The new adult guardianship system currently in place, as well as a voluntary guardianship system, was established together with the change from the interdict/quasi‐incompetency system to create a system of assistance, curatorship, and guardianship. The voluntary guardianship system is defined as follows. Users themselves, during the period in which they maintain sound judgment ability, can entrust receivers with some or all of their affairs related to care and management of property. The system becomes valid when the superintendent of the voluntary guardian is appointed. The care insurance system that was put into effect at the same time shifted from the earlier enforcement system to a contract system, so the judgment ability of a person to enter a contract at the time of a decision has become an issue. Finally, in dealing with people with dementia, especially mild dementia, problems arise as to the best method of informed consent, including notifying people of their specific disease, and determining who should decide the treatment for incompetent people with dementia.