A private community, such as a family, has priority over an individual. A child is not regarded as an individual, but as a family member for whom the parents are responsible. Because of this, and a recent remarkable decline in Japan’s birthrate, parents are more likely to be overprotective of their child. Furthermore, the extensive use of nonverbal and indirect communication is a unique cultural feature in Japan. For the Japanese, who for centuries communicated in
one language on a small group of islands, there may be some truth in the idea that understanding is possible without having to put everything into words. Vague expressions are usually preferred, even in cases where the children are informed of a cancer diagnosis. From a critical viewpoint, Japanese communication seems to be illogical and contain insufficient
explanation; overprotecting a child can usurp
the child’s autonomy, and few Japanese
pediatricians believe that they are responsible
for communicating with a child about his or
her illness.2