Engaged genomic science produces better and fairer outcomes: an engagement framework for engaging and involving participants, patients and publics in genomics research and healthcare implementation.

Genomic science is increasingly central to the provision of health care. Producing and applying robust genomics knowledge is a complex endeavour in which no single individual, profession, discipline or community holds all the answers.  Engagement and involvement of diverse stakeholders can support alignment of societal and scientific interests, understandings and perspectives and promises better science and fairer outcomes. In this context we argue for F.A.I.R.E.R. data and data use that is Findable, Accessible, Interoperable, Reproducible, Equitable and Responsible. Yet there is a paucity of international guidance on how to engage publics, patients and participants in genomics. To support meaningful and effective engagement and involvement we developed an Engagement Framework for involving and engaging participants, patients and publics in genomics research and health implementation. The Engagement Framework is intended to support all those working in genomics research, medicine, and healthcare to deliberatively consider approaches to participant, patient and public engagement and involvement in their work. Through a series of questions, the Engagement Framework prompts new ways of thinking about the aims and purposes of engagement, and support reflection on the strengths, limitations, likely outcomes and impacts of choosing different approaches to engagement. To guide genomics activities, we describe four themes and associated questions for deliberative reflection: (i) fairness; (ii) context; (iii) heterogeneity, and (iv) recognising tensions and conflict. The four key components in the Engagement provide a framework to assist those involved in genomics to reflect on decisions they make for their initiatives, including the strategies selected, the participant, patient and public stakeholders engaged, and the anticipated goals. The Engagement Framework is one step in an actively evolving process of building genomics research and implementation cultures which foster responsible leadership and are attentive to objectives which increase equality, diversity and inclusion in participation and outcomes.

[The three constituents of the idea of "medicine" in Hashida Kunihiko's thought].

According to Hashida's theory, the medical professions encounter not "a disease", but "the person who is suffering from his/her disorders". However, the medical professions cannot apply "I-GAKU" directly to him/her who exists as an individual and specific empirical fact because "I-GAKU" is nothing more than a "medical science", a theory based on a collection of scientific facts which are abstract and notional. Therefore, "I-JUTSU" is required to convert scientific facts to empirical facts. Then, "I-DOU" moves the medical professions into "I-JUTSU", and also it demands observance from not only the medical profession, but also from the person who undergoes "I-JUTSU". Ultimately, "Medicine" is realized when these three constituents works mutually.

[A study of Hashida Kunihiko's thought: the life history and thought of an "outcast thinker"].

Hashida Kunihiko, described and known as "an Outcast Thinker", was born in Tottori, in 1882. From his young age, he was taught oriental thought by his father Fujita Kenzo, a practitioner of Kampo medicine. While Hashida taught physiology as a faculty member at the Imperial University of Tokyo, he studied Dogen's Zen philosophy and developed his original philosophy of science to answer the question: "What is Life/Living?". After taking the oath of office as the 56th education minister of Japan from 1940 to 1943, he committed suicide in 1945, taking the responsibility for his policy-making of nationalistic education at time of the Second World War. Some previous studies on Hashida have focused on various aspects such as his work as a physiologist, a scientist, a scholar of Zen philosophy, and an educrat. He may be well known in each of these different disciplines, whereas how these different aspects are integrated in Hashida's thought as a whole has not been clarified yet. Taking the propositions in those previous studies on him into account to totally understand Hashida as a thinker, this note will focus on the potential perspective for his undiscovered aspect: "Hashida as Medical Philosopher". Hashida has perused and loved two classical texts on oriental thought and oriental medicine, which are "Chuan Xi Lu" and "Shang Han Lun", during his lifetime and learned many things about "Medicine". He has tried to implement his philosophy of medicine to set up and maturate "Japanese medicine". Hence, to dissert "Hashida as Medical Philosopher" may become a ground for argument to understand his thought as a whole from the genetic perspective on the process of thought formation of Hashida. Therefore this note can be characterized as a preliminary survey to develop the further studies on Hashida's thought.