Editorial: Where is the spirit of relief in Supreme Court ruling on A-bomb disease recognition?

Effects of radiation from the atomic bombings on human health are not yet fully understood. Several decades after the atomic bombings, scientific confirmation was made of a high incidence of certain blood disorders among A-bomb survivors. Based on that reality, how could the judiciary have made this decision?

Yesterday, the Supreme Court handed down its ruling against three plaintiffs for A-bomb disease recognition at a hearing appealing three cases involving the government’s decision to not recognize their health issues as being A-bomb diseases. The plaintiffs comprise three A-bomb survivors who are currently under medical observation by physicians.

Two conditions need to be met for A-bomb disease certification: Whether the disease is “radiation-induced” and whether it currently “requires medical treatment.”

Regarding the radiation-induced disease condition, the government revised certification criteria six years ago, proactively recognizing cases fulfilling certain conditions. The revision was the result of years of accumulated judicial rulings in favor of A-bomb survivors who had filed lawsuits against the government. The judiciary’s empathetic attitude toward A-bomb survivors may well have forced the foot-dragging administration into action.

This time, the point at issue was the other condition: whether the diseases required medical treatment. Until now, most applications for recognition were accepted so long as a medical certificate was submitted. To consider those who continue consulting with physicians as requiring medical treatment seems only natural.

However, the Supreme Court’s initial opinion regarding this issue was that A-bomb disease recognition for A-bomb survivors under medical observation “requires special circumstances such that the medical observation itself is indispensable to the treatment process and is part of an aggressive medical course of action that can be assessed.”

Previously, for cataracts as an example, some cases in which A-bomb survivors using eye medication prescribed by a physician were recognized as suffering from A-bomb disease if the survivors had met certain conditions related to distance from the hypocenter, and so on. In the future, government discretion could very well grow stronger when it comes to future determinations about whether medical treatment is required.

The Supreme Court handed down the opinion because three high courts gave disparate decisions on whether or not medical observation truly reflects “a situation that requires medical treatment.”

A-bomb survivors have seen other survivors suddenly pass away. Having concerns about their own health seems only natural.

The preamble to the Atomic Bomb Survivors Relief Law, which defines A-bomb diseases, describes that “A-bomb survivors are forced to live in anxiety with untreatable wounds and lingering aftereffects of radiation, despite surviving the atomic bombing.”

Based on the spirit of the law, the recognition of A-bomb diseases is premised on relief for people forced to live as “A-bomb survivors” after World War II. Although a line has to be drawn somewhere, the administration, naturally, and the judiciary as well are called on to grant recognition with a more proactive mindset.

In 2009, a written agreement with the aim of ending lawsuits was exchanged between the Japan Confederation of A- and H-bomb Sufferers Organizations (Nihon Hidankyo), a national A-bomb survivor association, and the national government. One sentence in the agreement reads: “In the future, regular consultations shall be held between the two parties to settle out of court toward eliminating the need for confrontation in the courtroom.” How much respect has the government for this sentiment?

Regular meetings were intended to provide an opportunity for the Japan Confederation of A- and H-bomb Sufferers Organizations to speak directly with the Minister of Health, Labour and Welfare. However, the ministry is a passive partner, insisting they “cannot make the time.” Consultations are held less than once a year, and even when they are convened, the minister merely reads a statement from a piece of paper prepared by the government bureaucracy as if for the sake of formality.

The ruling of the Supreme Court is disappointing, but there remain issues to be resolved by this administration. Aging survivors do not have much time left. It is simply unacceptable for the government to neglect this agreement.

(Originally published on February 26, 2020)