It is the pleasure for us to send you a mail and additional packet (send separately) of our report on "Iwaki Hospital Case" in Japan to which we are at the litigation on psychiatric open therapy and hospital responsibility to the homicide of a citizen by a psychiatry patient under do nothing medicine and nursing to voluntary accepted patient in mental disorder.

As we have explained to Dr GMR on 24th and 25th May 2013 at 109th Annual Meeting of the Japanese Society of Psychiatry and Neurology (JSPN) in Fukuoka Japan, that we admired the positive and earnest studies of JSPN psychiatrists in the development of medical science but we felt disappointment in their lack of attention into unhappy cases and of spirit to learn from tragedies and get lesson for improvement of clinical psychiatry and psychiatry judicial system and for achievement of equal and universal human right.

As we have explained to you in Fukuoka at JSPN forum, we do not wish your or any kinds of external powers to take influence into the litigation in Japan to which we are currently occupied. The homicide took place on 6th December 2005 and civil litigation was started on 23rd June 2006, successive to the criminal court judgment which sentenced and confirmed 25 years of psychiatry hospital jail service to Mr Junichi Nozu, with cooperation by the plaintiffs of victim and offender families, against psychiatry and doctor in charge who practiced psychiatry open therapy to the offender but with improper psycho-pharmaceutical prescriptions and non-performance in follow up observation and treatment interventions. After 6 years and 9 months deliberations, the local court judged victory, no legal fault responsibility, to the psychiatry and the doctor in charge. The judgment approved irresponsible psychiatry medical practices with absence in follow up observation and medical care to schizophrenia patient who had been withdrawn antipsychotic (Propitan: floropipamide hydrochloride) drug and simultaneously abrupt withdrawn antidepressant (Paroxetine) drug. The patient committed homicide while in 2 hour single outside hospital permission for community integration in psychiatric open therapy but was based without on risk assessment and risk management measures although he had past history in fire setting and violence and those information were spoken either by himself and by his parents to the hospital.

And the case has been brought up to the High Court both by the victim and offender families. However, as plaintiffs, we consider it is extremely difficult to get brighter judgment for us at higher levels, at High Court and may be at the Supreme Court. We know it is another time consuming process but with little favorable result possibility to plaintiffs. It has been the reality in Japan that all past efforts of civilian plaintiffs having asked responsibility of psychiatry to homicide cases at the judicial court were resulted in failure.

We consider psychiatry clinical medicine in Japan, psychiatry administration in Japan, and psychiatry and universal human right jurisdiction in Japan has got problems in needs of reviews. And without reformations to be introduced, it is unlikely for us to get favorable judgment at the judicial court. And for the purpose, the Plaintiff Yano has initiated and are projecting strategy to bring renovation into psychiatry medicine, administration and jurisdiction in Japan.

When we planned the civil litigation against psychiatry hospital in January to March in 2005, the time immediately after the homicide and before the start of criminal court litigation against the homicide of Makito Yano by a psychiatric patient, we made up our minds to ask for the cooperation of parents of the offender, for we considered litigation against the psychiatry by the victim family only should not be effective in the judicial court in Japan. We considered likelihood of accusation against us to forge, without evidence but by the loud voice, as if the litigation was aiming the stronger social security and was against wider social integration of mentally disabled. And it was actually said while in local court judicial process by the hospital and was effective to judges even with cooperation buy the patient family.

We believed offender family also had big reason to speak mal and unsatisfactory practices in psychiatry despite their hope of recovery from mental illness, and we learned in the past in Japan, patient families were not given enough chances to speak at the judicial court. Although offender family officially joined to the litigation on 17th November 2008 as addition of plaintiffs, we had kept communication with them and waited while in their preparation stage in 2 years and 5 months, and thus we have already maintained the relationship for more than 7 years of litigation. We are confident to maintain victim and offender cooperation for we believe it may have chance to open heavy door of the reformation in many aspects of psychiatry. We know we need public supports and understanding and victim and offender cooperation is the message from us to the society to tell the need of the next stage of psychiatry reformation for the achievement of universal human right to everybody irrespective of mental disorders.

After the local court judgment on 27th March 2013, we learned the need of information and facts to be known to the world with wider scopes. Looking back past big impacts on psychiatry reformation in Japan, social protection measures and increase in psychiatry beds was initiated by the Prof and Ambassador Edwin O. Reischauer assault case on 24th March 1964. Such strong policy initiation was said to have been motivated by the Japanese government consideration to the USA not to show political implications to the violence against their ambassador. Successively Japanese psychiatry was criticized of their inhuman nature by the Utsunomiya Hospital Case in 1984 and invited international criticism at the United Nations forum including the WHO. Based on international pressure Japan has changed psychiatry legal system and introduced psychiatry open therapy.

However in the Iwaki Hospital Case, the hospital and psychiatrist performed psychiatry open therapy to voluntary admitted patient Mr Junichi Nozu on the idea with no intervention and do nothing psychiatry care, by saying his spiritual independence, despite critical situation of patient after withdrawals of psychotropic agents. But judgment was no fault responsibility to homicide of Makito Yano in the psychiatry medicine and care even with non-performance and mistaken psychiatry pharmacy prescriptions. Thus, we believed psychiatry system in Japan was in need of next impact to force the inescapable changes. And for the purpose, we considered the continued need of victim and offender mutual cooperation to achieve the result initiated by the citizen. In reality it was heavy burden to ask for cooperation to people whose son deprived the life of our son. But without our determination we knew it was impossible to put impact on established beliefs in psychiatry academy, psychiatry administration, psychiatry jurisdiction and in media authorities in psychiatry and mentally disabled.

We considered the Iwaki Hospital Case was a problem of a psychiatry and a psychiatrist, however, a university professor expert reporter representative of Iwaki Hospital said that the litigation was a risk to a common psychiatrist at a common psychiatry and accused us saying the litigation should collapse the psychiatry medicine in Japan. It was a big surprise to us for we had been understood, poor and mistaken understanding in psychiatry medical science, mistaken pharmacological prescription and ignorance to the danger information written on pharmaceutics addendum note, indifference and denial to get information in patient with personal history, absence of risk assessment and management to the patient under psychiatric open therapy, non-performance of follow up observation to the patient under predictable serious condition, failure of team psychiatry by nurse, pharmacist and psychiatrist, absence of daily observation of patient at face by nurse, continued permission of outside hospital activity without confirmation of patient with the morbid conditional changes, and no appropriate medical examination and intervention after the big scale prescription changes in psychotropic agents, were the exceptional case of a poor psychiatrist at a poor psychiatry. But to our surprise and disappointment, local court judgment accepted fault irresponsibility by the reason of the common benefit of a common psychiatrist at a common psychiatry. And we consider, if it is the common feature of psychiatry in Japan as asserted by the university professor expert reporter and judged accordingly, then, it should be corrected for the benefit of common and universal welfare of people especially who are diagnosed in mental illness.

Plaintiff Yano, victim parent, believe it is also their responsibility to say for the benefit of psychiatric patients for they are under cooperation with Plaintiff Nozu, offender parents, who has never expected serious dissocial behavior to their son as the result of psychiatrist and psychiatry mal practice to have broken hospital treatment contract.

We asked Dr GMR at the JSPN forum to accept our reports and information in Iwaki Hospital Case as gateway to the WHO and international organizations for the purpose to inform the fact and evidence of what happened in Japan to the professionals in the maintenance and improvement of the world psychiatry system. It is aimed improvement of psychiatry application to civil life and welfare of the people. Civil litigation is concerned, it is our job inside Japan and we will do our best efforts to get achievement by us together with cooperation from the offender family and their legal representative, and we believe in the best result will only be achieved by our efforts inside judicial court in Japan. However, the purpose of our approach to let information be known to the WHO and international community is expected their understandings and supports to reformation tasks in the psychiatry of Japan for the benefit of people of all kinds.

We will be appreciated, if the information and evidence we offer may result in the greater co-habitation of the people regardless of any kinds of disabilities in human nature.

Yours Sincerely

Mr Keiji Yano and Mrs Chie Yano
Parents of Late Makito Yano, a Citizen of Japan and UK

【P.S.】

1. We believe in the improvement of the social task and achievement in the better human cohabitation is only one which Makito Yano can expect with the sacrifice of his own life, and also it may be a sole possible contribution of Mr Junichi Nozu in his life. As parents, together with Mr and Mrs Nozu, we believe in their value of their lives and the contribution.


2. We entrust our reports to Dr GMR and WHO in the value of our reports and the utilization.


3. We enclose print out copy in book type, copy original, and IC memory, and send additional packet of book type set copies of the following information;

Japan-Yano -(1) Makito Yano Street Homicide and Psychiatry Open Therapy
General description of Iwaki Hospital Case and tasks and problems
Japan-Yano -(2) Takamatsu High Court Appeal Text (13th May 2013)
Japan-Yano -(3) Takamatsu Local Court Civil Judgment (27th March 2013)
Japan-Yano -(4) Iwaki Hospital Case Expert Reports
Iwaki Hospital side and plaintiff side expert reports presented to local court
Japan-Yano -(5) Iwaki Hospital Medical Records and Investigation Records