Seven patients died between 2000 and 2005 at a hospital in Imizu, Toyama Prefecture, because doctors removed their respirators. Police have started an investigation. A 50-year-old chief surgeon responsible for taking the respirators from six of the patients said he acted on the will of the patients' family members. The incident points to the confusion and difficulty doctors and nurses experience due to the lack of clear guidelines on life-prolonging measures for terminally ill patients. Such guidelines are in order, but their formulation must be carefully discussed to ensure they are acceptable to all parties involved, including doctors, nurses, patients and their family members.

The seven patients -- four men and three women -- at the Imizu City Hospital were in their 50s to 90s and five of them were suffering from cancer. The deaths came to light after a nurse told the deputy director of the hospital in mid-October 2005 that the surgeon had ordered the removal of a patient's respirator. The hospital director rejected the surgeon's call to remove the respirator. The patient, suffering from a cerebral infarction, died nine days later with the respirator still attached. The hospital launched an in-house investigation committee and learned about the deaths of the seven patients. It notified police, thinking that there was something "unnatural" about the process leading to their deaths.

A statement by the hospital's director shows that the hospital was not well-prepared concerning a possible decision on whether to continue or terminate treatment designed to prolong the life of terminally ill patients. He said that his hospital does not have rules concerning treatment of terminal cases, including rules concerning termination of life-prolonging measures.