Current Institutional Affiliation
Visiting Researcher, Kennedy Institute of Ethics, Georgetown University

Eriko Sase is an award winning scholar in Health Science. She conducts her research on “Justice in End-of-Life Care: Bioethics and Human Rights in Aging Societies” as an Abe Fellow. She is a member of The Lancet Commission on the Value of Death (2018-2021) and studies the relationship between medicine and death/dying. 

Her 60+ publications include the articles from The Lancet and a book chapter in Gostin L.O. et al (eds.) Advancing the Human Right to Health from the Oxford University Press (2013). Her research encompasses social justice in health, global/public health, and healthcare policy. 

She received her Ph.D.  from The University of Tokyo, Japan, and was a Takemi Fellow in International Health at the Harvard T.H. Chan School of Public Health. She was the inaugural Director of the Global Health Systems Program in Wright State University. 

She currently holds multiple appointments; visiting researcher in the Kennedy Institute of Ethics at Georgetown University, adjunct faculty in the Graduate School of Medicine at The University of Tokyo, visiting professor at Saitama Prefectural University, and a member of the board of directors at the Global Health Research Center of Japan.

Award Information

Abe Fellowship 2018
Institutional Affiliation (at time of award):
Visiting Researcher, Kennedy Institute of Ethics, Georgetown University
Justice in End-of-Life Care: Bioethics and Human Rights in Aging Societies

Aging Societies: The world population aged over 60 will outnumber children by 2020. All countries face major challenges to ensure preparedness in health and social systems. Japan is the most advanced aging society in the world (28 % of the aging rate), with great pressure on national finance, e.g., an increase of $6.6 million primarily targeting the older population for the 2019 budget. Japan is shifting from a hospital-base to home-base health care delivery to prepare for an estimated 1.6 million deaths/yr. from 2035. Such rapid demographic change threatens individuals, communities, society, and the country. The US (15 % of aging rate) will have 78 million people aged over 65, exceeding the number of children. Hospices (over 6,100) outnumbered hospitals (5,723). Medicare Part A covers end-of-life care is estimated to be depleted by 2030. What is Unknown: Justice in end-of-life is little studied in general. The end-of-life care experts' experiences with dying patients were not well aggregated. Purpose of the Research: I will examine how justice (through a bioethics and human rights-based approach) may improve 'quality of life' and 'quality of death/dying' in end-of-life care by exploring achievements and challenges from a view of public policy. Research Questions: (a) How do bioethics, human rights, and evidence-based medicine effect end-of-life care? (b) What are the situations of the quality of life and the quality of death/dying in end-of-life care? (c) How does the WHO's definition of 'health' fit to the changing demographics/societies? (d) What are the implications for improving 'quality of life' and the 'quality of death/dying' in end-of-life care in the aging societies? Methods: (a) Qualitative research, a powerful instrument for little studied subjects, will be the central analytical methodology for this proposed research. For data collection, analysis, and developing a theory, I will employ grounded theory, established by scholars who studied processes and situations of death/dying, which is used in health care fields. I will target interviews with one hundred end-of-life experts in the primary countries (Japan and the US) and other related countries (the UK and South Korea). I will perform open coding, axial coding, and theoretical coding. Theoretical sampling will be performed to judge a theoretical saturation (where no more new codes are being formed). NVivo will be used as a supporting instrument. (b) Quantitative research (typology and taxonomy methods) on quantifiable data will be used to fortify the analysis and interpretation of the qualitative research. (c) Content analysis will also be performed by qualitative and/or quantitative methodologies by contrasting my research contents. The Value of the Research: A part of the proposed project will be conducted while serving as a coauthor of the Lancet Commission (2018-2019 scheduled). A synthesis of my analysis on end-of-life care, focusing on better life and a better death (with the Abe Fellowship Program and with the Lancet international project) will address the global threats of social and fiscal sustainability in aging societies. It will also showcase the important elements of interdisciplinary team-approaches, community/regional collaborations, and multi-sector partnerships.