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ロンドン・プロジェクト報告書【pdf】
䋨ਥ䋩⑼ቇ⎇ⓥ⾌䊒䊨䉳䉢䉪䊃㩷 ઍ ጊ↰ᵗሶ䋨ၮ⋚⎇ⓥ A䋩
Grant-in Aid for Scientific Research (A), Head Investigator: Yoko Yamada
ᄙᢥൻᮮᢿ䊅䊤䊁䉞䊑䊶䊐䉞䊷䊦䊄䊪䊷䉪䈮䉋䉎⥃ᐥᡰេ䈫ኻᢎ⢒ᴺ䈱㐿⊒
Methodology of clinical support and dialogical education
based on polyphonic narrative-fieldwork across multiple cultures
()㩷 ੩ㇺᄢቇ䌇䌃䌏䌅㩷 ᔃ䈏ᵴ䈐䉎ᢎ⢒䈱䈢䉄䈱࿖㓙ὐ
䊡䊆䉾䊃䌃 䇸ᔃ䈏ᵴ䈐䉎䊐䉞䊷䊦䊄ᢎ⢒䈫↢ᶦ⊒㆐䈱䉰䊘䊷䊃䈫䉲䉴䊁䊛䇹
䊨䊮䊄䊮䊶䊒䊨䉳䉢䉪䊃㩷
㵪ක≮䈫ᔃℂᡰេ䈱ᄙᢥൻ䊅䊤䊁䉞䊯ᣇᴺ䈱ត᳞㩷
LONDON PROJECT: The quest of narrative methodology for the medical
and psychological support in multiple cultures
ع႐ᚲ㧦ࠗࠡࠬ㧘ࡠࡦ࠼ࡦ
عᣣ⒟㧦2009 ᐕ 6 30 ᣣ㧔Ἣ㧕㨪2009 ᐕ 7 3 ᣣ㧔㊄㧕
ࡓࠣࡠࡊعⷐ
Day 1: Tuesday 30th June 9.30-17.00
Title: Narrative Skills for Clinical Teachers
Venue: Chartered Institute of Arbitrators, 12 Bloomsbury Square, London WC1A 2LP
Convenors: Dr. John Launer and Dr. Helen Halpern (London Deanery)
Facilitators: Dr. Lisa Miller and Dr. Sue Elliott (London Deanery)
Day 2: Wednesday 1st July 9.30-17.00
Title: Symposium on Narrative Research in Health and Illness
Venue:
a.m.: Council Room, University College London, Gower Street, London WC1N 6BT
p.m.: Lecture Theatre 1.03, Malet Place Engineering Building, London WC1E 7JE
Convenors: Prof. Trisha Greenhalgh (University College London), Prof. Brian Hurwitz (Kings
College London)
Presenters: Prof. Trisha Greenhalgh (University College London), Prof. Yoko Yamada (Kyoto
University), Prof. Seiji Saito (University of Toyama), Prof. Brian Hurwitz (Kings College
London), Dr. Takashi Yoshinaga (University of Toyama), Ms. Kazumi Takeya (Kyoto
University), Ms. Naoko Nishiyama (Kyoto University), Dr. Chizumi Yamada (Kyoto
University), Mr. Kazuma Takeuchi (Kyoto University), Dr. Neil Vickers (Kings College
London)
Day 3: Thursday 2nd July 9.30-17.00
Title: Narrative in Mental Health Care: Applications in Therapy and Training
Venue: Studio B, Tavistock Centre, 120 Belsize Lane, London NW3 5BA
Convenor: Dr. John Launer (Tavistock Clinic)
Presenters: Dr. Charlotte Burck (Tavistock Clinic), Ms. Yuko Yasuda (Kyoto University), Prof.
Akira Nakagawa (Osaka Sangyo University), Dr. Norifumi Kishimoto (Kyoto University),
Prof. Corinne Squire (Centre for Narrative Research, University of East London), Dr. Helen
Halpern (Tavistock Clinic), Dr. Hideaki Matsushima (University of Shiga-Prefecture)
Facilitators: Dr. John Launer, Dr. Helen Halpern, Dr. Hiroshi Amino, Dr. Hideaki Minagawa
(Tavistock Clinic)
Day 4: Friday 3rd July 13.00-15.45 (optional)
Title: Child psychotherapy and child psychotherapy training and research: an
introduction
Venue:
13.00: Anna Freud Centre, 12 Maresfield Gardens, London NW3
14.30: Tavistock Centre, 120 Belsize Lane, London NW3 5BA
Convenor: Ms. Junko Wakitani (Tavistock Clinic)
عෳട⠪
(Prof.) Yoko Yamada PhD. Professor, Graduate School of Education, Kyoto University.
(Developmental Psychology)
(Prof.) Seiji Saito MD, PhD. Professor, Centre for Healthcare and Human Sciences, University
of Toyama. (Clinical Medicine)
(Prof.) Akira Nakagawa MD. Professor, Department of Human Environment, Osaka Sangyo
University. (Clinical Medicine)
(Dr.) Norifumi Kishimoto MD. Associate Professor, Department of Community Network and
Collaborative Medicine, Kyoto University Hospital. (Clinical Medicine)
(Dr.) Hideaki Matsushima PhD. Associate Professor, School of Human Culture, University of
Shiga-Prefecture. (Clinical Psychology)
(Dr.) Chizumi Yamada MD, PhD. Department of Diabetes and Clinical Nutrition, Kyoto
University Graduate School of Medicine. (Clinical Medicine)
(Dr.) Takashi Yoshinaga, PhD. Research Associate Professor, Student Support Centre,
University of Toyama. (Knowledge Science)
(Ms.) Yuko Yasuda, Graduate School of Education, Kyoto University. (Clinical Psychology)
(Ms.) Kazumi Takeya, Graduate School of Education, Kyoto University. (Developmental
Psychology)
(Ms.) Naoko Nishiyama, Graduate School of Education, Kyoto University. (Developmental
Psychology)
(Mr.) Kazuma Takeuchi, Graduate School of Education, Kyoto University. (Educational
Psychology)
(Ms.) Midori Kawamoto, Kawasaki Medical College. (Psychotherapy)
Visit facilitator: Dr. Akira Naito, Imperial College, London. (Clinical Medicine)
ࡓࠣࡠࡊع㧝㧦Narrative Skills for Clinical Teachers
Day 1: Tuesday 30th June 9.30-17.00
Title: Narrative Skills for Clinical Teachers
Venue: Chartered Institute of Arbitrators, 12 Bloomsbury Square, London WC1A 2LP
Convenors: Dr. John Launer and Dr. Helen Halpern (London Deanery)
Facilitators: Dr. Lisa Miller and Dr. Sue Elliott (London Deanery)
Proposed programme:
9.30: Welcome by Prof. Neil Jackson, Dean of Postgraduate General Practice Education
9.45: Introduction: Conversations inviting change
11.15: Coffee
11.30: Interactive workshop 1: Skills practice
13.00: Buffet lunch
14.00: Interactive workshop 2: Skills practice
15.30: Tea
15.45: Review and closing plenary
17.00: End
Additional participants for Day 1: Ms. Liz Dahill (London Deanery), Dr. Robert Hoffman
(Rehovot, Israel), Dr. Yuriko Morino (Tokyo, TBC), Ms. Diana Kelly (Kings College,
London, TBC)
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London University is a confederate university
university.
It consists of probably fifty or sixty institutions
ranging from small specialist institutes to very
large colleges with several thousand students
each, that are really more like universities in
their own right. The central offices and many
of the important institutes and colleges of the
university are in this part of London called
Bloomsbury, but other parts of the university
are scattered all over London
London, and some are
over twenty miles from here.
The National Health Service is an enormous
organisation that covers the whole of the
United Kingdom, and is said to be the second
largest employer in the world. It consists of
thousands of different institutions from huge
hospitals with several hundred beds, to small
family practices with a single doctor and a
receptionist. Virtually all the health
professionals in the UK, including doctors and
mental health professionals
professionals, has been trained
by the NHS and works for it. It is funded
entirely by taxes, almost everyone in the
country uses it, and patients do not ever pay
for consultations or hospital
p
admissions.
Your host institution today
y is the London Deanery
y – the
short name for the London Department of Postgraduate
Medical and Dental Education. We are one of the specialist
institutes of London University, but all our funding and
management come from the National Health Service. They
pay us to organise all the postgraduate education for every
doctor and dentist in London from the day they qualify to
the day they finish their specialist training. We also train
the teachers – that is to say the senior doctors and dentists
who train the junior ones. Altogether we look after around
ten thousand trainees, in every specialty from family
medicine and psychiatry to organ transplantation, and we
also look after around five thousand of the doctors and
dentists who teach them. Our annual budget is around
£400 million – nearly half a billion. A very small amount of
training takes place at the Deanery headquarters which is
in Russell Square a hundred metres away. We also hire
other buildings like this one from time to time for special
events. However almost all the training goes on in
hospitals and practices around London, so we are in
charge of training at hundreds of different sites.
Tomorrow y
your host institution will be Universityy
College London, also close by in Bloomsbury, although
as you know there will also be some academics there
from King’s College London. Both University College
and King’s are among the largest colleges of London
University; as I mentioned they are almost like
universities in their own right. They each have many
different departments where undergraduates and
graduates can study anything from engineering to the
history of art. Each of them also has a major hospital
attached to it, where students can study medicine or
qualified
lifi d d
doctors
t
can complete
l t th
their
i specialist
i li t ttraining
i i
or do research. The hospitals are part of the National
Health Service, but the undergraduate medical schools
and research institutes within them are part of London
University and the specialist training is all supervised
by the London Deanery,
Deanery so that you can see that these
institutions are very closely linked in many ways.
On Thursday
yy
you will be at the Tavistock Clinic,, about three
miles away from here in north west London. Funnily
enough the Clinic was originally established in Tavistock
Square, just north of Russell Square, which is how it got its
name, but it moved north many years ago. It is the most
prestigious mental health clinic and training institution for
mental health professionals in the UK.
UK All the clinical
trainings there have a strong academic part to them and
the Clinic awards degrees in subjects like psychoanalysis
and family therapy, as well as clinical qualifications.
However the Tavistock has never been part of London
University and all its degrees are licensed by other
universities including Middlesex University. This is probably
because the Tavistock has always been unusual and
independent-minded and has never wanted to be part of a
huge London-wide university. However it does collaborate
with some of the institutes and colleges of London
University and in the last few years has built up some
University,
training links with the London Deanery. As you know I work
for both the Tavistock and the Deanery. I originally started
at the Tavistock in 1995 but started building up links with
the Deanery almost straight away, and now work for both
places.
I now want to say a few words about the way
that doctors and mental health professionals
are trained in the UK
The first p
point I want to make is that training
g in each
profession or speciality is standardised across the UK. For
example, if you train as a dentist, a family physician or a
dermatologist in the north of Scotland you will have a very
similar training to someone training in London or the south
coast. Every training is regulated and monitored by a number
of different agencies including the National Health Service
Service.
Every training is also governed by a specialist professional
body or a number of specialist bodies. For example, as a
doctor I am registered with the General Medical Council
which sets standards for doctors’ performance and
behaviour. As a family physician I belong to the Royal
College of General Practitioners and as a family therapist I
belong to the Association for Family Therapy. Each of these
bodies set the rules for my postgraduate qualifications, and it
would not be legal in the UK to call myself a GP or a family
therapist unless I had these. I know this is very different from
the situation in many other countries including Japan, where
thi
things
are nott so formalised.
f
li d IIncidentally,
id t ll mostt off th
these
trainings are also very extended. It took me five years to
qualify as a doctor and a further five years before I qualified
as a GP. My family therapy training, which I did later, took a
further four years.
The next p
point I want to make is that training
g as a
doctor, a dentist, a family therapist or any other health
professional is nearly always centred around clinical
experience. Although there is strong academic input
into our trainings, the emphasis is a practical one: on
the work with patients. Connected with this, there is
less emphasis on lectures than in many other countries
including Japan. Students in most of the health
professions and specialities are used to learning in
small groups, in formats including seminars or case
discussions. The atmosphere in these activities these
d
days
iis usually
ll non-hierarchical.
hi
hi l S
Senior
i d
doctors
t
iin
hospitals these days, for example, may dress and
behave fairly informally. Most young doctors training as
GPs would probably call their trainers by their first
names.
Let me now move on the topic of this week
week,
and of today. I know that many of you are
already very knowledgeable about narrative
ideas and narrative practices, but let me briefly
summarise my own understanding of these. In
the last twenty years or so there has been
what I see as a major revolution in thinking in
many fields. This has loved us away from
looking at how things are (or how we think
they are) towards an interest in how they are
being described – or, to put it another way, an
interest in the stories we tell each other about
what is happening and how we understand
this.
Here are two of my favourite quotes which to
me best capture the central idea of narrative
studies. The first is from the Canadian
philosopher Charles Taylor.
Here are two of my favourite quotes which to
me best capture the central idea of narrative
studies. The first is from the Canadian
philosopher Charles Taylor.
As you know ideas like these originally
became influential in areas like literary studies
and philosophy but they rapidly caught on in
the social sciences and by the 1990s they had
entered medicine as well. The turning point in
this respect, as you know, was the publication
in 1998 of ‘Narrative Based Medicine’ edited
by Trisha Greenhalgh and Brian Hurwitz whom
you will meet tomorrow.
Since then, narrative-based
narrative based medicine, or narrative
medicine as the American scholar Rita Charon calls
it, has expanded in all sorts of directions. It now
encompasses many different approaches. These
include studying literary texts, including great novels
and poetry,
poetry and looking at how these can heighten
our sensitivity as doctors; studying stories about
personal illness, written by historical or
contemporary patients, or by doctors who have also
been patients; encouraging doctors and medical
students to write stories and poems
poems, as a way of
expressing and learning about their professional
experiences; carrying out research into how patients
describe their illnesses when talking to doctors or to
each other;
Examining
g the way
y that doctors talk to each other about
their work (or write about it), and how they ‘construct’
medical knowledge in this way; studying the way that
patients and doctors talk to each other and hence
negotiate between their different accounts of illness;
training doctors and medical students to be more attentive
to patients’
patients stories and to collaborate with them in creating
more satisfactory ones. From this list it should be clear that
narrative medicine converges with many other disciplines.
These include medical ethics, anthropology and sociology,
as well as medical humanities. Narrative medicine also
overlaps with several aspects of medical training including
communication skills and professionalism. Not surprisingly,
people interested in narrative medicine are often interested
in other theories concerned with human relationships
including systems theory, complexity and psychoanalysis.
For all these reasons, one could be forgiven for
questioning whether narrative medicine is really one
identifiable approach with established boundaries and a
clear definition.
My own view is that there are at least two concepts
that distinguish narrative medicine and that hold it
together in all its different forms. One of these is the
way in which narrative medicine claims individual
stories as an a counterbalance to evidence-based
medicine Narrative medicine asserts the
medicine.
importance of lived experience, and the expression
of that experience, in the face of the dominant voice
in modern medicine – a voice that often creates the
impression that only abstract measurements
convey truths or carry meaning
meaning. At the same time
time,
everyone writing about narrative medicine has
emphasised that narrative is not a substitute for
evidence, nor does it stand in opposition to it. The
other unifying concern of narrative medicine is with
what Rita Charon describes as ‘narrative
narrative
competence’. Narrative competence encompasses
skills for listening and expression, but most of all for
empathic interaction through language.
Writing recently in the Permanente Journal
Journal,
Vera Kalitzkus and Peter Matthiessen list the
essential skills for narrative competence as
follows:[
- se
sensitivity
s
y to
o the
e co
context
e o
of the
e illness
ess
experience and the patient-centred
perspective
- establishing a diagnosis in an individual
context instead of merely
y in the context of a
systematic description of the disease and its
aetiology
- narrative communication skills such as
exploring differences and connections,
hypothesising [and] sharing power
-self-reflection
We can now come to the topic of today’s
today s
learning: a model of the medical consultation
and training that we call ‘Conversations
inviting change’. It was a model that I originally
developed at the Tavistock Clinic with my own
tutor and then colleague Dr Caroline Lindsey.
In the twelve years since we first explored the
ideas, the model has developed further
particularly with the help of Dr Helen Halpern
who is running this event with me today
today. We
have also had many other doctors working
alongside us, especially GPs, like Dr Lisa
Miller and Dr Sue Elliott who are also here to
help
p us today.
y
The fundamental principle of ‘Conversations
Conversations
inviting change’ is this idea. At the heart of
medicine is a search. The search may involve
a treatment or a cure, but almost without
exception it will also include a different kind of
search. It is the search for a story that has
coherence and usefulness for that patient, at
that moment. Of course, the same thing holds
true when doctors talk with each other as well.
We too are looking are looking for a story that
has coherence and usefulness for us as
professionals, at that moment.
From what I said earlier
earlier, you will realise that
we have developed our ideas and our
teaching against a background where doctors
were already very familiar with case
discussion, with working in small groups, and
with interactive and experiential learning. Most
of them already had experience of learning
models like the Balint approach or patientcentred medicine. What we brought that was
new was the introduction of narrative ideas
and skills to the consultation with patients.
I want to make just two more point before we
get down to business. The first point is to say
that we originally worked just in the field of
consultation training but increasingly we have
moved towards using these narrative ideas
and skills in supervision – in other words, to
encourage medical teachers to use this
approach and this model in their conversations
with each other and with their trainees. This
shift happened particularly when we extended
our work from the Tavistock Clinic where it
began to the London Deanery.
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ࠛࡇ࠰࠼ࠍߍࠇ߫ޔකቇ↢ߩ㗃∛♖ޔ㒮ߦᆎߡቇߦⴕߞߚᤨߦ⺞ࠍ፣ߒߡ⥄ޔಽߪ♖
⑼කߦߪߥࠇߥߣᗵߓߚߎߣޔᐕ߆ᐕߦࡏࠬ࠽࠶ࠢ㧔࡙ࡦࠣᵷಽᨆኅ㧕వ↢ߩ࠼ࡓ
ࡢࠢߦೋߡෳടߒߚᤨ߽߆ߥࠅߩ∋ഭᗵ߇ᱷࠅߪࠄߜߎޔᐲᐲߣෳടߔࠆ߁ߜߦ∋ഭߒߥߊ
ߥߞߚߎߣ㧔ߣߪ߃ᐲ⋡ߩෳടߪᢙᐕߩ㑆ࠍߌ߹ߒߚ߇㧕ߥߤ߇ᕁᶋ߆߮߹ߔޕ⺣ߢߔ߇ޔ
ࡏࠬ࠽࠶ࠢవ↢ߩ࠼ࡓࡢࠢߦෳടߒߚᤨࠢ࠶࠽ࠬࡏޔవ↢߇ᴦ≮⠪ߩりᔕࠍᴦ≮ߦ↢߆
ߒߡ߅ࠄࠇࠆߩࠍ⍮ߞߡ⥄⑳ޔりߪ㕖Ᏹߦ㐿߆ࠇࠆᕁࠍߒ߹ߒߚޔߢߎߘޕ࿁ߩᤨᏅࡏࠤߩㆫ
ᑧ߽߆ᗧ߇ࠆߩߢߪߥ߆ߣᕁޔ⠨߃ࠍᎼࠄߖ߹ߔߣ⧷ࠅߪ߿ޔ࿖ߢᢙᣣ㑆⧷⺆ߣᣣᧄ⺆
ߩᷙวࠪࡖࡢࠍᶎ߮ߚߎߣ߇ᄢ߈ߩߢߪߥ߆ߣᗵߓߡ߹ߔޕ
⑳ߪ߽ߣ߽ߣࡢ࡚ࠢࠪ࠶ࡊߣ߁ᒻᑼߦ․ޔᢙੱߩࠣ࡞ࡊߢߒว߁ࠃ߁ߥᒻᑼߪ⧰ᚻߢߒ
ߚ߇ߒߢ⺆⧷߽ߢࠇߘޔว߁ߣ߁㔓࿐᳇ߢߪߐ߶ߤߩ㆑ᗵࠍᗵߓߕߦขࠅ⚵ߚߩߪ⑳ߦߣ
ߞߡᣂ㞲ߥ㛎ߢߒߚޕ㧔ࡠ࡞ࡊࠗߥߤ߽߆ߥࠅ⧰ᚻߢߔ㧕ޕ
೨ඨߢߪᣣᧄߩ⁁ᴫࠍ⺑ߔࠆߩߦޔකᏧߩ⁁ᴫߣᔃℂ≮ᴺኅߩ⁁ᴫߣ߇ᷙߒߡࡠ࠽వ↢
ߦવࠊߞߚߩߢࡠ࠽వ↢⥄り߽⸘ߦᷙੂߐࠇߚߩߢߪߥ߆ߣᗵߓ߹ߒߚ࠽ࡠޔߣࠇߘޕ
వ↢ߩߟߩࠦࡦࡊ࠻ࠍ⚫ߔࠆߩߦ⛗ࠍࠊࠇߚߩߪ⑳ߦߪߣߡ߽㛳߈ߣ߁߆ᣂ㞲ߢߣ⛗ޔ
⸒⪲ߩኻᲧޔ㍈ᗧ⺆ߣᣣᧄ⺆ࠍ߁ߎߣߩ㆑ߥߤߦᕁࠍᎼࠄߒߥ߇ࠄ೨ඨߩࠢ࠴ࡖߪ⡞߆
ߖߡ߽ࠄߞߡ߅ࠅ߹ߒߚޕ
࠺ࡕࡦࠬ࠻࡚ࠪࡦߢศ᳗వ↢ߣߩ߿ࠅขࠅߪ㕖Ᏹߦශ⽎⊛ߢߡߟ߆ޔศᎹᐘᰴ㇢వ↢ߢߒߚ
߆⇐ޔቇ↢ߦਛ࿖ผࠍ⻠⟵ߔࠆᤨߦޔศᎹవ↢ߩ⻠⟵߇ޟᐕߦ٤٤߇ߎߞߚ߇ߣߎ߁ߣޠᑧޘ
ߣ⛯ߊߩߢޔ⡬⻠ߒߡߚቇ↢߇ߦߩߚߞ⸒ߣޔߐߛߊߡߒߡߒ⚂ⷐߣߞ߽ޔኻߒߡߥ߆⚦ޔ
ታߩⓍߺ㊀ߨߎߘᱧผߥߩߛߣ߁ࠃ߁ߥߎߣࠍ╵߃ࠄࠇߚߣ߁ࠛࡇ࠰࠼㧔߆ߥࠅ߁ࠈⷡ߃
ߥߩߢ⑳ߥࠅߦടᎿߒߡߒ߹ߞߡࠆㇱಽ߇ᄙಽߦࠆ߅ߘࠇ߇ࠅ߹ߔߩߢߒඨಽߢฃߌขߞ
ߡߚߛߌࠇ߫ߣᕁ߹ߔ㧕߇ߥ߁ࠃߩߘޔᶋ߆ࠎߢ߈߹ߒߚޕศ᳗వ↢߇╵߃ࠄࠇߚࠃ߁ߥᒻ
ᑼߢߒ߆વ߃ࠄࠇߥ⌀ታ߽ࠆߩߛߣࠅ߿ࠎ߷ߣޔ⠨߃ߥ߇ࠄ࠺ࡕࡦࠬ࠻࡚ࠪࡦߩ߿ࠅขࠅ
ࠍ⡬ߒߡߚߣ߁ߎߣߢߔޕ
߹ߚߩࡓ࠴ޔㆇ༡߽ߒߡ߇࠳߫߃ߣߚޔวߞߡߡ⋡ޔᮡࠍߒߡߒ߁ߣޔ
ߞ߆ࠅߣ⛔วߐࠇߚ࠴ࡓࠍะߎ߁ߢߪࠗࡔࠫߐࠇࠆߩ߆߽ߒࠇ߹ߖࠎ߇ޔᲧセ⊛✭⚿วߢ㒙
๊ߩๆߢേߊࠃ߁ߥ࠴ࡓㆇ༡ߩᣇ߇ᣣᧄߢߪࠃࠅߥߓߺ߇ࠆࠃ߁ߦᕁࠊࠇ㧔ડᬺߥߤߢߪ
߆߽ߒࠇ߹ߖࠎ߇㧕ߩߘޔ႐วߦ⋡ᮡࠍ⏕ߦߒߡߒวߞߡᣇ㊎ࠍࠆߣ߁ࠃ߁ߥㆇ༡ߢߪ
ߥߊߩߘޔ႐ߘߩ႐ߢࠅߩ᭽ሶࠍߥ߇ࠄߥࠎߣߥߊ߹ߞߡߊ߫ࠊޔ႐ߩജߦࠃߞߡቯ
ߐࠇߡߊࠃ߁ߥᗵߓߢߔߩߢߩࡓ࠴ޔࠅᣇߩ㆑߇߆ߥࠅࠆߩߢߪߥ߆ߣᕁ߹ߒߚޕ
ᓟ⠪ߩࠃ߁ߥ࠴ࡓㆇ༡ࠍߒߡࠆᤨߦޔ೨⠪ߩ┙႐߆ࠄޟ٤٤ߦߟߡߒวߞߡ߹ߔ߆ߣޠ
߁ߢಾࠅㄟ߹ࠇࠆߩߪޔߘߩ߽ߩ߇ᓟ⠪ߩ࠴ࡓߩࠅᣇࠍᩮᧄ߆ࠄំࠆ߇ߖࠆജࠍᜬ
ߞߡࠆߚޔ㕖Ᏹߦ╵߃ߦߊߢߔߡߒߘޕ೨⠪ߩᣇ߇ᔟߢࠆߚޔᓟ⠪ߩ┙႐ࠍߣߞߡ
ࠆߣߣߥߊᒁߌ⋡ࠍᗵߓߡߒ߹߁ߣ߆ߥߪߢߩ߁߹ߒߡߞߥߦߣߎߥ߁ࠃ߁ߣޔᗵߓ߹ߒߚޕ
Ⱜ⿷ߥ߇ࠄ✭ޔࠤࠕ࠴ࡓߢࠍߒߡߡߩࡓ࠴ߩߘޔࠅᣇߪᲧセ⊛ᓟ⠪ߦㄭߩߢߔ
߇ޔ߇ߔߢߩࠃߢࠇߘߪᤨߊߊ߹߁ޔዋߒߕࠇᆎߚᤨߪ⸒⺆ൻࠍߒߡ⏕ߦߔࠆߣ߁ߎߣ
߽ᔅⷐߦߥࠆߩߢߪߥ߆ߣᡷߡᗵߓ߹ߒߚޕ
࠺ࡕࡦࠬ࠻࡚ࠪࡦߩᦨᓟߩ႐㕙ߢ࠽ࡠޔవ↢ߩޔᖚ⠪ߣศ᳗వ↢ߣߩ㑆ߢߎߞߡߚ
ߎߣ߇ߎߩ႐㕙ߢ߽ౣߐࠇߚߩߢߪࠍ࠻ࡦࡔࠦ߁ߣޔ⡞ߡߪ⑳ޔ㕖Ᏹߦශ⽎ߦᱷࠅ߹ߒߚޕ
ᢪ⮮వ↢߇ߜࠂ߁ߤ㓞ࠅߦ߅ࠄࠇߡޟ㕖Ᏹߦ㧔♖㧕ಽᨆ⊛ߢߔߨ߽⑳ߦᤨߚߚࠇࠊ⸒ߣޠหߓᗵ
ᗐࠍᜬߞߡߚߩߢࠃߊⷡ߃ߡࠆߩߢߔ߇ⷞߥ߁ࠃߩߎޔὐߪޔォ⒖ㅒォ⒖ߩജേࠍ⺒ߺขࠆ♖
ಽᨆ⊛ߥℂ⸃߇೨ឭߣߒߡࠆߩߢߪߥ߆ߣᗵߓࠄࠇޔ㕖Ᏹߦශ⽎ߦᱷࠅ߹ߒߚ♖ޕಽᨆߪ
ォ⒖ㅒォ⒖ߦߟߡߪ⼾߆ߥ⍮ࠍᜬߞߡ߅ࠅޔዋߒࠍᷓߊ⡞ߎ߁ߣߔࠆߣߚߞ߁ߎޔ⍮ߩ
ഥߌ߇ߥߣᘒ߇⚗♾ߒߡߒ߹߁ߎߣߪࠃߊࠆߩߢߪߥ߆ߣᗵߓߡ߹ߔ࠽ࡠޕవ↢ߪ
߽ߒ߆ߒߚࠄߎࠇࠄߩ⍮ࠍ㓐ᚲߦᗧ⼂⊛ήᗧ⼂⊛ߦᵴ↪ߒߡ߅ࠄࠇࠆㇱಽ߽ࠆߩߢߪߥ߆ߣ
ᗵߓ߹ߒߚޕ
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߽ᔅⷐߦߥߞߡߊࠆߣᕁ߹ߔ߇ޔታ㓙ߩ⥃ᐥߦ߅ߡߪߥ߆ߥ߆৻╭✽ߢߪ߆ߥߎߣࠍᣣޘ
⚻㛎ߒߡ߅ࠅ⥄⑳ޔりߪࠍޔ⡞ߊߣ߁ߎߣࠍㅊ᳞ߔࠆߩߢࠇ߫⎇ⓥߣ߁ᣇᴺ⺰߇ᔅⷐ
߆ߥߣᡷߡᗵߓ߹ߒߚޕ
ࡠ࠽వ↢ߪޔකᏧߦ߽ߞߣ⡞ߡ߽ࠄ߁ࠃ߁ߦߥࠆߚߦ࠽࠹ࠖࡉࠕࡊࡠ࠴ࠍ߁ߩߛ
ߣ⸒ࠊࠇ߹ߒߚ߇⥄⑳ޔりߪ⺆⸒ߥ߆߿⚦߈ޔൻࠍⴕ߁ߢ࠽ࡠޔవ↢ߩࠕࡊࡠ࠴߇㕖Ᏹ
ߦෳ⠨ߦߥࠆߣᗵߓߚߎߣ߽ශ⽎⊛ߢߒߚޕ
߁߹ߊ߹ߣ߹ࠄߕޔ㔎ᑼߩᗵᗐߦߥߞߡᕟ❗ߢߔ߇ᦨޔᓟߦޔᣣᧄ⺆ߣ⧷⺆ߩ᭴ㅧߩ㆑߇
ᕁ⠨᭽ᑼߦᓇ㗀ࠍਈ߃ࠆㇱಽߪ㕖Ᏹߦᄢ߈ޔήⷞߢ߈ߥߩߢߪߣᕁ߹ߒߚޕᣣᧄ⺆ߢᕁ⠨ࠍ
ߔࠆ႐วޔਥ⺆ߪ৻ߟߩᢥߩਛߢߒ߫ߒ߫ࠇᦧࠊࠅ߫ߒ߫ߒ߽߆ߒޔ␜ߐࠇߥߩߢޔᕁ⠨ਥ
߿ⴕേਥ߇⏕ߢߪߥߊޔ႐ߘߩ߽ߩ߇⠨߃ߚࠅേ߆ߒߚࠅߣ߁ᗵߓߦ⥄ὼߣߥߞߡߊߩ
߆ߥߣᕁ߹ߒߚޕᕁᶋ߆ࠎߛߎߣࠍᢿ┨ߩࠃ߁ߦਗߴߡᕟ❗ߢߔ߇ߏෳ⠨ߦߒߡߚߛߌࠆߣ
ߎࠈ߇ࠇ߫ᐘߢߔޕ
ڎጊ⋥ሶ㧔੩ㇺᄢቇ㧕
੩ㇺᄢቇᄢቇ㒮ᢎ⢒ቇ⎇ⓥ⑼ߩጊ⋥ሶߣ↳ߒ߹ߔޔߪ⑳ޕቇㇱ↢ߩ㗃߆ࠄ߿߹ߛవ↢ߩߏᜰዉ
ߩ߽ߣߢ⎇ⓥࠍ⛯ߌߡ߅ࠅޔߪߢ⎇⑼ߩߎޔ೨࿁ߩ࠙ࠖࡦࡊࡠࠫࠚࠢ࠻ߦᒁ߈⛯߈ߩߎޔᐲߩࡠ
ࡦ࠼ࡦࡊࡠࠫࠚࠢ࠻ߦ߽ෳടߐߖߡߚߛ߈߹ߒߚޔߪ⑳ޕකᏧߢ߽⥃ᐥኅߢ߽ߥᧂᾫߥ৻ቇ↢
ߦߔ߉߹ߖࠎ߇ޠߥࠄߐߞ߹ޟߩ߃ࠁࠇߘޔ᳇ᜬߜߢޔᗵߓߚߣߎࠈࠍ₸⋥ߦㅀߴߐߖߡߚߛߌ
ࠇ߫ߣᕁ߹ߔޕ
ᣣߩ࠹ࡑߪ̌0CTTCVKXG5MKNNUHQT%NKPKECN6GCEJGTU̍ߣ߁ߎߣߢ ੱ߶ߤ߇㓸߹
ࠅ ߪߕ߹ޔ.CWPGT వ↢ߩ KPVTQFWEVKQP ߆ࠄᆎ߹ࠅ߹ߒߚޕ0*5
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ᓥ᧪ߩකቇᢎ⢒ߩ․ᓽޔ0$/
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ࠊࠇࠆታ⠌ߩ EQPVGZV㧔ᢥ⣂㧕ࠍℂ⸃ߔࠆߎߣ߇ߢ߈߹ߒߚޕ
ߘߩᓟޔભᙑߦࠆ೨ߦ*̌ޔQYHCTYQWNFOGFKECNVGCEJGTUKP,CRCPJCXGVJGUCOGRTQDNGO
KP
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ࠅߥߺޔ᭽ߦޘᕁࠍᎼࠄߖߥ߇ࠄࠄ߇ߥߌ⛯ࠍ⺰⼏ޔඦᓟߩ߭ߣߣ߈ࠍㆊߏߒ߹ߒߚޕ
ߘߒߡޔඦᓟߩㇱ߇ߪߓ߹ߞߚߣߎࠈߢ⊒ߖࠄࠇߚ̌ޔ9JGTGCTG[QWPQY!
߹ߥߚߪߤߎߦ
ࠆߩ㧫㧩߹ߤࠎߥߎߣࠍ⠨߃ߡࠆߩ㧫̍ߣ߁ .CWPGT వ↢ߩ߆ߌ߆ࠄޔෳട⠪ߘࠇߙ
ࠇ߇ᕁߞߡࠆߎߣࠍ⥄↱ߦߒޔᛂߜߌࠄࠇࠆ㔓࿐᳇߇⧘↢߃ߚࠃ߁ߦᕁ߹ߔޕ
ߘߎߢࠃࠃޔ⢄ᔃߩታ⠌ߦࠆߦߚߞߡ*ޔGNGP*CNRGTP వ↢ߩᣇ߆ࠄ߅߆ߚߥߤޟක⠪ߐ
ࠎࠆߪᔃℂ⥃ᐥߦ៤ࠊࠆੱߢޔ⥄ಽ߇ᛴ߃㗡ࠍᖠ߹ߖߡࠆ㗴ࠍߩߎޔ႐ߢߣߒߡ
ឭଏߒߡߊࠇࠆੱߪߥߢߒࠂ߁߆߅ߩߣޠ㗿߇ߐࠇ߹ߒߚ߇ߥߺޕਅࠍะߡ߁ߟߊߥ
߆ޔศ᳗వ↢߇ᨐᢓߦ߽ᚻࠍߍߡߏ⥄ಽߩࠍᒁ߈วߦߒߡߊߛߐࠆߎߣߦߥࠅ߹ߒߚޕ
ታ⠌ߪޔศ᳗వ↢߇ *GNGP వ↢ߣะ߈วߞߡᐳࠅޔ.CWPGT వ↢ߪߘߩੑੱߩߘ߫ߢ *GNGP వ↢ߦ
ኻߒߡഥ⸒ߔࠆ߁ߣޔᒻߢߪㅴࠎߢ߈߹ߒߚޔߚ߹ޕౝ⮮వ↢߇ศ᳗వ↢ߩ㓞ߢㅢ⸶ࠍߨ
ߡߘߩ߿ࠅขࠅࠍᡰ߃ߡ߅ࠄࠇ߹ߒߚޕ㧔ߎߩㄝࠅߩߎߣߪޔታ㓙ߦߘߩ႐ߦߚੱߢߥߌࠇ߫ᗐ
߇ߟ߈ߦߊ߆߽ߒࠇ߹ߖࠎ߇⺑ߊ߹߁ޔߢ߈ߕߏࠎߥߐޕ㧕
ศ᳗వ↢߇ ENKGPV ߐࠎߣߩ㑆ߦᛴ߃ߡࠄߞߒ߾ࠆ㗴ߩ⢛᥊ࠍℂ⸃ߔࠆߚߦߎߚߞ߁ߤޔ
ߣ߇ߎߞߡࠆߩ߆ߚߞ߁ߤޔߢߘߩ ENKGPV ߐࠎߦะߞߡࠆߩ߆ߩߘޔߩߥ߆ߢߩ
ศ᳗వ↢⥄りߩᓎഀ߿┙ߜ⟎ߪߤߩࠃ߁ߥ߽ߩߥߩ߆̖ߣߞߚߚߊߐࠎߩ⾰߇ *GNGP వ↢߆
ࠄߐࠇ߹ߒߚ߇ޔᱜ⋥ߦ⸒ߞߡߩߘޔߪ⑳ޔ႐ߢⴕࠊࠇߡࠆߎߣ߇৻ߥߩ߆߇ߟޔᆎ߹
ࠅߢߟ⚳ࠊࠅ߇ߊࠆߩ߆ޔUWRGTXKUG ߩ UWRGTXKUG ߪ৻ߤߎߩ᭴ㅧࠍᜰߔߩ߆ߖ߹ࠅ߆ࠊ⋡⊝ޔ
ࠎߢߒߚޕ
ߘߩࠃ߁ߥߥ߆ߢ⊒ߖࠄࠇߚޟศ᳗వ↢ߣ ENKGPV ߐࠎߣߩ㑆ߦ↢ߓߡࠆᾚ߹ߞߚ⁁ᴫߤ߁
ߦ߽ᘒ߇േߡ߆ߥ߽ߤ߆ߒߐ߇߹߹ߩߘࠅߊߞߘޔศ᳗వ↢ߣ *GNGP వ↢ߣߩ㑆ߦ߽ࠇ
ߡࠆࠃ߁ߛߨ ߁ߣޔޠ.CWPGT వ↢ߩࠦࡔࡦ࠻ߪߩ⑳ߣࠅߊߞߒ߽ߡߣޔ⢷ߦ㗀߈߹ߒߚޕ
ߘߒߡߩߘޔታ⠌ࠍ⚳߃ߡዋੱᢙߩࠣ࡞ࡊߢᝄࠅࠅࠍⴕߞߚߣ߈ޔਛᎹ᥏వ↢ߦᢎ߃ߡ߽ࠄ
ߞߡೋߡߩߘޔታ⠌ߩ᭴ㅧࠍℂ⸃ߔࠆߎߣ߇ߢ߈߹ߒߚޕታ⠌ߩ㑆ޔߪ⑳ޔศ᳗వ↢ߩ UWRGTXKUG
ࠍ *GNGP వ↢߇*ޔGNGP వ↢ߩ UWRGTXKUG ࠍ .CWPGT వ↢߇߿ߞߡ߅ࠄࠇࠆߩߛߣ߫߆ࠅᕁߞߡߚ
ߩߢߔ߇ޔߊߥߪߢ߁ߘޔ.CWPGT వ↢ߪ QDUGTXGT ߣߒߡߘߩ႐ߦ⥃ߺޔᔅⷐߦᔕߓߡ *GNGP వ↢ߦ
ഥ⸒ࠍਈ߃ࠆ┙႐ߦ߅ࠄࠇߚߩߛߣ߁ߎߣ߇ޕߚߒ߹ࠅ߆ࠊߣߞ߿ޔ㧔ਅ࿑ෳᾖ㧕
1DUGTXGT
5WRGTXKUQT
&T.#70'4
&T.#70'4
5WRGTXKUGG
5WRGTXKUQT
5WRGTXKUQT
/T;15*+0#)#
&T*'.'0
&T*'.'0
5WRGTXKUGG
%NKGPV
%NKGPV
/T;15*+0#)#
࿑㧝㧚ታ⠌ਛߩ⑳ߩℂ⸃
࿑㧞㧚⚳ੌᓟߩ⑳ߩℂ⸃
߆ࠄ⠨߃ࠆߣߪ߈ߣߩߘޔ߇ߛ߆ࠊ߆ࠄߥ߹߹ߦߘߩ႐ߦりࠍ߅߈ޔUWRGTXKUG ߩ߿ࠅข
ࠅࠍ⌑ߡࠆߛߌߢߞߚߎߣޔߩᚑࠅⴕ߈ࠍࠆߒ߆ߥ߆ߞߚߎߣ߇ޔᨐߚߒߡࠃ߆ߞߚ
ߩ߆ߤ߁߆ޔታ⠌ߩ⋡⊛ߦㆡߞߡߚߩ߆ߤ߁߆߹ޟߦ⋥⚛ޔࠄߚߒ߆ߒ߽ޕࠎߖ߹ࠅ߆ࠊޔ
߇ߎߞߡࠆ߆ࠄ߆ߥࠄ߆ࠊޔᢎ߃ߡ߶ߒߣޠჿࠍߍߚ߶߁߇ࠃ߆ߞߚߩ߆߽ߒࠇ߹ߖࠎޕ
ߚߛ߭ߣߟߛߌ⸒߃ࠆߩߪߩߥߺޔ೨ߢ⾰ࠍᛩߍ߆ߌߡࠬ࠻࠶ࡊࠍ߆ߌࠆߎߣߪߢ߈ߥߊߡ߽ޔ
ዋੱᢙߩࠣ࡞ࡊߢߒวߞߚࠅᗧࠍߒว߁ᤨ㑆ࠍ⸳ߌࠆߎߣߦࠃߞߡޔ㗴ࠍߒߚࠅ⇼
ࠍ⸃ߒߚࠅߢ߈ࠆߩߢߪߥ߆ߣ߁ߎߣߢߔోޔࠅߪ߿ޕߩㅴⴕࠍ㇎㝷ߒߡߪ↳ߒ⸶ߥ
ߣߩᕁ߆ࠄ⾰ޔࠍᏅߒߪߐߩߪߚࠄࠊࠇࠆ߽ߩߢߔߢߎߘޕാ᳇ࠍߒߡჿࠍߍࠆߩ߽
৻ߟߩᚻߢߔ߇ޔ㓞ߩੱߣᗧࠍ឵ߒߚࠅዊߐߥࠣ࡞ࡊߢߒวߞߚࠅߔࠆᯏળ߇ࠆߣ⥄ޔ
↱ߦᗧࠍㅀߴ߿ߔߊߥࠆߩߢߪߥ߆ߣᕁ߹ߒߚޕ
ᦨᓟߦ↳ߒߍߚߩߪߩߎޔᣣߛߌߢߥߊਃᣣ㑆ߩࡊࡠࠫࠚࠢ࠻ࠍㅢߒߡޔ.CWPGT వ↢ࠍߪߓ
ߣߒߚߺߥߐ߹ߩ᷷߆߽ߡߥߒߩᔃ߇ߊߚ߇ࠅ߽ߡߣޔᗵߓࠄࠇߚߣ߁ߎߣߢߔ⧯ޕヘ⠪
ߩᗧߦ߽⡊ࠍߌޔሽࠍฃኈߒޔዅ㊀ߒߡߊߛߐߞߚߎߣ߇߁ࠇߒߊߡޔᗵ⻢ߩ᳇ᜬߜߢߞ
߬ߢߔޕ
ߎߩࠃ߁ߥ⾆㊀ߥᯏળߦෳടߐߖߡߚߛߚߎߣ߅ߣ߹ߐߥߺޔ⍮ࠅวߦߥࠇߚߎߣ߽ߣޔ
ߦታ⠌ߦขࠅ⚵ࠎߛߎߣޔ᭽ᧄߡߞߣߦ⑳߇ߡߴߔޔߣߎߚ߈ߢߒ߅ߡߟߦࠢ࠶ࡇ࠻ߥޘᒰߦ
ᄢಾߥᕁߢߔ߅ޕߦߥߞߚߺߥߐ߹ᧄޔᒰߦࠅ߇ߣ߁ߏߑ߹ߒߚޕ
᧻ڎ᎑⑲㧔ṑ⾐⋵┙ᄢቇ㧕
㧝◲ޣනߥ⥄Ꮖ⚫ޤ
᧻᎑⑲ߢߔޕṑ⾐⋵┙ᄢቇߢ⥃ᐥᔃℂቇߩᢎຬࠍߒߡ߹ߔߢ߹ࠇߎޕ㕖ⴕዋᐕߩᦝ↢ㆊ⒟ࠍ
ߪߓߣߒߡޔᕁᤐᦼޔ㕍ᐕᦼߦࠆੱ߇ޘਇㆡᔕ߆ࠄ߆ߦ┙ߜ⋥ࠆߩ߆ߦ⥝ࠍᜬߞߡ߈߹ߒ
ߚߣޕหᤨߦޟࠆࠁࠊޔ㗴ࠆࠇߐߣޠኻ⽎ߦኻߒߡ⥃ߩߢ߹ࠇߎޔᐥℂ⺰ߣߪ⇣ߥࠆࠕࡊࡠ
࠴ࠍߒߚߣᗵߓߦ࠴ࡠࡊࠕࡉࠖ࠹࠽ޔ㝯߆ࠇߡ߈߹ߒߚޕߪޔዊቇᩞޔਛቇᩞߦ߅ߌ
ࠆ⥃ᐥᵴേࠍࡌࠬߦߒߡߕࠄࠊ߆ޔሶߤ߽ߩ㗴߇ߤߩࠃ߁ߦ᭴ᚑߐࠇߡߊߩ߆ࠍត᳞ߒ
ߡ߹ߔޕ
㧞㧚㧟ޣᣣߩታ⠌ߢߤߩࠃ߁ߥߎߣ߇ߎࠅ㧘ߥߚߪߤߩࠃ߁ߥ㛎ࠍߒߚ㧫ޤ
ᦨೋߦ.CWPGTవ↢ߣࠆࠃߦࡃࡦࡔߩࡓ࠴ߩߘޔPCTTCVKXGߦߟߡߩၮᧄ⊛ߥᔨߩࠢ࠴ࡖ
߇ࠅ߹ߒߚޕᅢᄸᔃࠍ߽ߞߡੱߩࠍ⡬ߊߎߣߢ⪲⸒߁ߩޘੱࠆߊߡߒ࠻࡞ࠨࡦࠦޔNKPMKPI
ߔࠆߎߣޔ%TGCVKXKV[ࠍ⊒ើߔࠆߎߣ⋧ޔᚻߦ%QPHTQPVKPIߢߪߥߊࠈߒޔEJCNNGPIKPIߢࠆߎ
ߣ⋧ߡߒߘޔᚻߩዅ෩ࠍ߹߽ࠆߎߣ߇࠽࠹ࠖࡉࠍ⡬ߊߥ߆ߢ㊀ⷐߢࠆࠍࠇߘޔPCTTCVKXG
EQORGVGPEGߣ߱ߣߞߚࠢ࠴ࡖߛߞߚߣᕁ߹ߔޕ
ඦᓟߦߪPCTTCVKXGࠬࡄࡧ࡚ࠖࠫࡦߩታṶ߇ࠅ߹ߒߚ⸳ޕቯߪ6QO#PFGTUGPߩTGHNGEVKPI
VGCO߇ᕁ߁߆߽߱ߩߢߒߚޕਥߚࠆࡃࠗࠩࠍ*GNGP*CNRGTPవ↢߇ߟߣޔ.CWPGTవ↢߇*GNGP
వ↢ߦࡈࠢ࠻ߔࠆߣ߁ᒻᑼߢߔ*ޕGNGPవ↢ߪศ᳗వ↢ߣળߔࠆ߇ߣࠆ߹߈ⴕޔ.CWPGTవ
↢ߦࡈࠢ࠻ࠍ᳞ࠆߎߣ߇ߢ߈ࠆޕ.CWPGTవ↢ߣศ᳗వ↢ߪߦળߢ߈ߥ߇*ޔGNGPవ↢
ߣ.CWPGTవ↢ߩળߪޔศ᳗వ↢ߦ߽ෳᾖน⢻ߥ߆ߚߜߢឭ␜ߐࠇߡࠆߩߢ*ޔGNGPవ↢ߛߌߢߥ
ߊศ᳗వ↢߽ߘߩળࠍᇦߣߒߡળࠍߍߚࠅޔᕁ⚝ࠍᷓߚࠅߢ߈ࠆࠃ߁ߦ⸳⸘ߐࠇߡߚ
ߩߢߪߥߢߒࠂ߁߆ޕ
ࠤࠬౝኈߦߟߡߪޔ⒁⟵ോ߽ࠅ߹ߔߩߢࡐ࠻ߩㇺวߩᦨૐ㒢ߦߣߤߚߣᕁߞ
ߡ߹ߔ߇ޔߪߩ߁ߣࠬࠤߚࠇߐߢߎߘޔศ᳗వ↢߇ᄙ⡯⒳ߩ࠴ࡓߢදߒߟߟ⋧⺣ߦ㑐
ࠊࠆߥ߆ߢ߅ળߐࠇߚ᧪⺣⠪ߩ߅৻ੱߦߟߡߩ߽ߩߢߒߚ⺣᧪ߩߎޕ⠪߇ᛴ߃ࠆ㗴ߪ࠴ޔ
ࡓߩ⺕߽߇⦟ዷᦸࠍߺߛߒߦߊ߽ߩߢࠅޔศ᳗వ↢ߪ᧪⺣⠪ߣߩ㑐ࠊࠅ߇ⴕ߈߹ࠅࠍᗵ
ߓ⥄ޔಽߩߎࠇ߹ߢߩ㑐ࠊࠅߢࠃߩߛࠈ߁߆ߣᖠࠎߢ߅ࠄࠇߚࠃ߁ߦ⸥ᙘߒߡ߹ߔ㧔ታ㓙ߦߪ
㆑ߞߚ߆߽ߒࠇ߹ߖࠎ㧕ޕ
ቇᩞ႐㕙ߢޔవ↢ᣇߣ㑐ࠊࠅߟߟᡰេࠍߒߡࠆ⑳ߦߪޔศ᳗వ↢߇ߐࠇࠆౝኈߪޔ㕖Ᏹߦり
ㄭߦᗵߓࠄࠇ߹ߒߚޕ⍮ࠄߕߒࠄߕߩ߁ߜߦ*GNGPవ↢ߩ┙႐ߦりࠍ߅ߡ࠺ࡕࡦࠬ࠻࡚ࠪࡦࠍ
⡞ߡ߹ߒߚߦ߆ߥߩ⑳ߢߎߘޕᶋ߆ࠎߛ߭ߣߟߩᗵᗐߪޔศ᳗వ↢߇᧪⺣⠪ߦኻߒޔ㧔࠴ࡓ
ߢ㑐ࠊߞߡߪࠆ߇㧕⚿ᨐ⊛ߦ㧝ੱߢߥࠎߣ߆ߒࠃ߁ߣᅗ㑵ߒߡࠆߣ߁߽ߩߢߒߚޕᓟ߆ࠄ⠨
߃ࠇ߫ߊోޔߩ߽ߩ߆߽ߒࠇߥߩߦߢ߹ࠇߎ߇⑳ޔ㑐ࠊߞߚߣߛ߱ࠄߖ⥄ޔὼߦޔ⸥ߩ
ࠃ߁ߥࠬ࠻ߢ㧞ੱߩળࠍℂ⸃ߒߡ߹ߒߚࠍ࠻ࠬߩߎߪ⑳ޕศ᳗వ↢ߦࠢࠗࡉޔ
ᤨߦ߅ߒߚࠃ߁ߦᕁ߹ߔ߇ޠ࠻ࠬߩߟߣ߭ޟߪࠇߘߡߞߣߦ⑳ޔߦߤ߶ࠇߘޔએߩ
ታࠍ߽ߞߡ߹ߒߚޕ
߽߁߭ߣߟ⑳ߩ㗡ߦᕁᶋ߆ࠎߛߩߪ*ޔGNGPవ↢߇ศ᳗వ↢ߩ⸷߃ࠍߟ߆ߺߋߨߡޔᄙᣇ㕙ߦ
✂ࠍᛩߍࠇࠆࠃ߁ߦ⾰ߥࠈࠈޔࠍ➅ࠅߒߡࠆߣ߁߽ߩߢߒߚޕᤨ߆ࠄߪߓߚߩ
߆ಽ߆ࠄߥߩߢߤࠇߊࠄᤨ㑆߇ߚߞߚߩ߆ᱜ⏕ߦߪࠊ߆ࠄߥ߆ߞߚߩߢߔ߇⥄ޔಽߩ⣨ᤨ⸘ࠍ
ߺߡᤨࠎ߱ߛޔߊ߆ߦߣޔ㑆ࠝࡃࠍߒߡࠆߎߣߪ⏕߆ߥࠃ߁ߦᗵߓࠄࠇ߹ߒߚޔߡߒߘޕ
ߎߩળߪߟߤߩࠃ߁ߦߒߡ⚳ࠊࠆߩߛࠈ߁ߣ߁ߎߣ߇ߣߡ߽᳇ߦߥߞߡ߹ߒߚޕએ೨ޔቇ
ᩞߢߩࠣ࡞ࡊࠦࡦࠨ࡞࠹࡚ࠪࡦߩ႐ߢޔవ↢ߩࠍ⡬߈ߥ߇ࠄ߇ߐߞ߬ࠅߟ߆ߕޔዷᦸࠍ
߽ߡߥ߹߹ߦ⾰ࠍ➅ࠅߒޔળ⼏ߩᤨ㑆ࠍࠝࡃߒߣ߁ࠈߛߩࠃࠄߚߣ߹߁ߤޔὶߞߡ
ߚ⥄ಽߣ߽㊀ߨࠊߖߡߚࠃ߁ߥ᳇߇ߒ߹ߔ㧔ታߦਇ㆖ߥශ⽎ߢߔߨ㧕ޕ
ߎߩࠃ߁ߦᗵߓߡߚߎߣ߽ߞߡ.CWPGTవ↢߇ࡈࠢ࠻ߒߚ⸃㉼㧔ࡃࠗࠫߣࡃࠗࠩߩ㑐
ଥᕈ߇⺣⋧߇ࠫࠗࡃޔ⠪ߩ㑐ଥߣหᒻᕈࠍ߽ߞߡࠆߣ߁߽ߩ㧕ߪߪߡߞߣߦ⑳ޔ⣤ߦ⪭ߜࠆ
߽ߩߢߒߚߣޕหᤨߦ⥄ޔಽ߇ߎࠇ߹ߢߩࠦࡦࠨ࡞࠹࡚ࠪࡦߥߤߦ߅ߡߦ߁ࠃߩߤߦ⊛⚳ᦨޔ
߹ߣࠆߩ߇⦟ߩ߆ߣ߁ߎߣࠍ⠨߃ࠆߩߦኾᔃߒߡߚߎߣߦ߽᳇ߠ߆ߐࠇ߹ߒߚޕ.CWPGTవ
↢ߩ⸃㉼߽ޔవ↢⥄り߇ޟ⺑ߛߌߤߣޠᢿߞߡ߅ࠄࠇߚࠃ߁ߦޟࠆࠁࠊޔᱜ⸃ߢߌࠊ߁ߣޠ
ߪߥ߽ߩߢߔޕඦ೨ਛߩࠢ࠴ࡖߢߪPCTTCVKXGࠬࡄࡧ࡚ࠖࠫࡦߢߪ⸃ࠍߛߔߩߢߪ
ߥߊⷞߚߞߥ⇣ޔὐߢ⽎ࠍߺࠆߎߣ߇ߢ߈ࠆࠃ߁ߦߥࠆߎߣ߇ផᅑߐࠇߡߚߣᕁ߹ߔ߇ޔ
.CWPGTవ↢߇ޟ⺑ߣࠆߢޠᒝ⺞ߒߟߟߐࠇߡߚߎߣߪ⥄ޔಽߩឭߔࠆࠕࠗ࠺ࠕ߇ᱜ⸃ߣ
ߒߡฃߌขࠄࠇࠆߎߣࠍㆱߌߡ߅ࠄࠇߚߩߢߪߥ߆ߣᕁ߹ߔⷞޔߛߚޕὐࠍᄌ߃ࠆߣ߁ߎߣ
ߪⷞޔὐࠍឭ␜ߔࠆ߇ൎᚻߦዉߊߎߣߪߢ߈ߕ⋧ޔⴕὑ⊛ߦ㆐ᚑߐࠇߥߌࠇ߫ߥࠄߥ߽ߩߛ
ߣ⠨߃ࠆߣޔ
⺑ߣߪߞߡ߽ޔෳട⠪ߩᗧ࿑ߦࠃߊᴪߞߡ߅ࠅ߇߽⺕ޔฃߌࠇࠄࠇࠆ߽ߩߢߞߚࠃ߁ߦ
ᕁ߹ߒߚޕ.CWPGTవ↢߇ߎࠇ߹ߢߩળࠍ⡬ߡޔฃߌࠇน⢻ߥࠬ࠻ࠍឭ␜ߐࠇߚߩߢ
ߪߥ߆ߣᗵߓ߹ߒߚޕ
ߣߎࠈߢ*߇⑳ޔGNGPవ↢߇ᕁߞߚࠃ߁ߦ㕙ធࠍߔߔࠄࠇߡߥߩߢߪߥ߆ߣ߁ශ⽎ࠍ߽
ߞߚߩߪ*ޔGNGPవ↢⥄りޔ.CWPGTవ↢ߦࡈࠢ࠻ߔࠆ㓙ޔ⡬߈ߚߎߣ߇ߚߊߐࠎࠅߔ߉ࠆߣ
ߞߚߎߣࠍ߅ߞߒ߾ࠅߚߞ߹ߚ߇ࡦ࡚ࠪ࠻ࠬࡈޔ᭽ሶߛߞߚߎߣ߆ࠄዉ߆ࠇߚߩ߆߽⍮ࠇ
߹ߖࠎᦨޕᓟߦ.CWPGTవ↢߇ߚߞߣޠ߆߁ࠄ߽ߡߒߦࠅࠊ⚳ߡߞ⻢ޟ⺑ࠍߛߐࠇߚߎߣߢ⥄ޔ
ಽߩශ⽎߇ᓟઃߌ⊛ߦᒝࠄࠇߚ߆߽ߒࠇ߹ߖࠎޕඦ೨ਛߩࠢ࠴ࡖߦ߅ߡPCTTCVKXGࠬࡄ
ࡧ࡚ࠖࠫࡦߪߪࠫࠗࠔࡧߣࠩࠗࠔࡧޔਅߢߪߥߊ᳓ᐔߥ㑐ଥᕈࠍ⚿߱ߩߛߣᒝ⺞ߐࠇߡ߹
ߒߚ߇*ߢࠣࡦࠖ࠹࠶ߩࡦ࡚ࠫࠖࡧࡄࠬߩߎޔGNGPవ↢ߣ.CWPGTవ↢ߩᭉደⵣߩࠃ߁ߥળ߇
⊝ߦ߃ߡߚߎߣ߇ࠍߣߎߩߘޔน⢻ߦߒߡߚࠃ߁ߦᕁ߹ߔޕ
ߣߎࠈߢߦࡦ࡚ࠪ࠻ࠬࡦࡕ࠺ޔᒁ߈⛯ߡߣ⺆⧷ޔᣣᧄ⺆ࠍޔㅢ⸶ࠍߒߡࠦࡒࡘ࠾ࠤࠪ
࡚ࡦߔࠆߎߣߩࡔ࠶࠻㧛࠺ࡔ࠶࠻ߦߟߡ࠺ࠖࠬࠞ࠶࡚ࠪࡦߒ߹ߒߚ߇ߢ߆ߥߩߘߪ⑳ޔਛᎹ
వ↢߇߅ߞߒ߾ߞߚࠕࠗ࠺ࠕ߇㝯ജ⊛ߦᗵߓ߹ߒߚߢ⺆⧷ޔࠅ߹ߟޕવ߃ࠃ߁ߣ৻↢ ߦߥߞߡ
⠨߃ߚ߆ࠄߎߘߦ߁ࠃߩߎޔ⍴ᤨ㑆ߢᄌൻ߇߽ߚࠄߐࠇߚߩߢߪߥ߆ߣߞߚ߽ߩߢߔޔߒ߽ޕ
ᣣᧄ⺆ߢߒ߾ߴߞߡߚࠄ߇ߣࠅߐߞޔㅢߓߡߒ߹߁ߚߦ⥄ޔಽߩᛴ߃ߡࠆ㗴ߦ᳇ߠߌ
ߥ߆ߞߚߩߢߪߥ߆ߣ߁ߎߣߛߞߚߣᕁ߹ߔޕ
ࡈࡠࠕߩ⼏⺰ߢߪޔPCTTCVKXGߩࠗࡦ࠲ࡆࡘ߇ࠍߦ↱⥄ޔ⡬ߊߎߣࠍද⺞ߒߡࠆߣߟߟޔ
ߘߩ৻ᣇߢ㕖Ᏹߦߒߞ߆ࠅߣߒߚᨒ⚵ߺࠍ߽ߟߎߣ߇⹏ଔߐࠇߡ߹ߒߚޕᣣᧄߢߪోߊ⥄↱ߦ
ࠍ⡬ߊߣ߃߫߅ޔᅢ߈ߦߤ߁ߙߣ߁ᗵߓߦߥߞߡߒ߹߁ߎߣ߇ᛕ್⊛ߦ⺆ࠄࠇߡ߹ߒߚޟޕ⡬
ߊޟߪߦߣߎޠ⡊ࠍߌࠆޟߣޠℂ⸃ߔࠆ߁ߣޠ㧞ߟߩ㕙߇ࠆߩߛߣᕁ߹ߔ߇ޔᣣᧄߢᛕ
್⊛ߦ⺆ࠄࠇࠆޟ⡬ᛛᴺޟߩߎޔߪߦߩ߽߁ߣޠℂ⸃ߔࠆ߁ߣޠ㕙߇߅ߑߥࠅߦߥߞߡ
ࠆߣ߁ߎߣ߆ߥߣᕁ߹ߒߚޕ
⡬ߣ߁ߎߣߢෳᾖߐࠇߚ᧪⺣⠪ਛᔃ≮ᴺߪޔ4QIGTUߩߣࠕࡠࠣޡ㧟ੱߩࡇࠬ࠻ߺࠍޢ
ࠆߣޔᓐ߇ߔߏߊ㓶ᑯߦ⺆ߞߡࠆߎߣ߇⊒ߢ߈߹ߔޕ4QIGTUߦߒߡ߽♖߁ߥߎ߅ߩࠄ⥄ޔಽ
ᨆ≮ᴺߩⴕ߈߹ࠅ߆ࠄ᧪⺣⠪ਛᔃ≮ᴺࠍߞߚߣ߁⚻✲߇ࠅޔ⸥ߩࡆ࠺ࠝߢ߽♖ಽᨆࠍ
ᗧ⼂ߒߚ႐㕙߇ࠅ߹ߔޔ߫߃ޕᓐߪࠣࡠࠕ߆ࠄޟవ↢ߩࠃ߁ߥੱ߇ῳⷫߛߞߚࠄࠃ߆ߞߚߩ
ߦߣޠℂᗐൻߐࠇߚߩߦᔕ߃ߡࠍߚߥ߽⑳ޟᆷߩࠃ߁ߦᗵߓߡ߹ߔࠃߣޠߒߡ߹ߔߩߎޕ
ࡆ࠺ࠝߩ⸃⺑ߦ߅ߡࡠࠫࡖࠬߪߎߩ႐㕙߇♖ಽᨆߥࠄޟォ⒖㧛ㅒォ⒖ߩޠᨒ⚵ߺߢ⸃㉼ߐࠇ
ࠆߣߎࠈߛ߇ߦ߁ࠃߩߘߪߣߎࠆߡߞߎߢߎߎޔℂ⸃ߐࠇࠆߴ߈ߢߪߥߣജ⺑ߒߡ߹ߔޕ
ߎߩࠃ߁ߦ߭ߣߟߩᛛᴺߦ߽ࠇߘޔએ೨ߦⴕࠊࠇߡߚߚߊߐࠎߩᛛᴺߥࠅℂ⺰ߥࠅߦࠃߞߡߟߊ
ࠄࠇߚࠦࡦ࠹ࠢࠬ࠻߇ࠆࠊߌߢޔPCTTCVKXG߇ߢߡ߈ߚࠦࡦ࠹ࠢࠬ࠻߽ߡℂ⸃ߔࠆᔅⷐ߇ࠆ
ߣࠄߚߡᗵߓ߹ߒߚޕ
㧠㧚ࠄ߆ޣ⠨߃ࠆߣ㧘ߥߚ⥄りߎ߁ߔࠇ߫ࠃ߆ߞߚߣ߁ߎߣ߇ࠅ߹ߔ߆㧫߽ߒࠆߣߔࠇ
߫ߘࠇߪߤ߁߁ߎߣߢ㧘ߤߩࠃ߁ߦߔࠇ߫ࠃ߆ߞߚߩߢߒࠂ߁߆㧫ޤ
߃ߡ߃߫߁߽ޔዋߒാ᳇ࠍ߽ߞߡࠤࠬࠍߒߡࠇ߫ࠃ߆ߞߚߣ߁ߎߣߢߒࠂ߁߆ߒޕ
߆ߒߦߣߎ߁ߣߔߢ⺆⧷ޔാ᳇߇ߞߚߣ߁ߎߣߛߌߢߥߊߡߒߦ⺆⧷ߑޔ⏕ߦવ߃ࠃ
߁ߣ⠨߃ᆎࠆߣޔ߇㗴ߥߩ߆ࠃߊࠊ߆ࠄߥߊߥࠅߥߊߥࠄ߆ࠊ߆ߩࠃߡߒߦ߁ࠃߩߤޔ
ࠆࠤࠬ߇㗡ࠍ߆ߌߋߞߡߚ߆ࠄߢ߽ࠅ߹ߔ⥄ޕಽߩߥ߆ߢ㗴߇߁߹ߊᢛℂߐࠇߡߥ
ߣ߁ߎߣ߽ᗵߓ߹ߒߚޕ
㧡㧚ߩߎޣታ⠌㛎߆ࠄឭߐࠇࠆ㗴ὐ߿⇼ὐߪߥࠎߢߔ߆㧫ޤ
PCTTCVKXGࠬࡄࡧ࡚ࠖࠫࡦߦᱜ⸃ߪߥߩߛࠈ߁ߒ߇ߜߚ⑳ޔᗵߓߚࠬ࠻߽ޔ.CWPGTవ
↢*ޔGNGPవ↢߇ᗵߓߡߚߎߣ߽ߤߜࠄ߽․ᮭൻߐࠇࠆ߽ߩߢߪߥߣߪᕁ߁ߩߢߔ߇ޔవ↢ᣇߪ
࠶࡚ࠪࡦਛߤߩࠃ߁ߥߎߣࠍ⠨߃ߡߚߩ߆⡬ߡߺߚ᳇߇ߒ߹ߔޕ
㧢㧚ߩߎޣታ⠌ߩ㛎߆ࠄߥߚ߇ቇࠎߛࡐࠗࡦ࠻ߪߥࠎߢߔ߆㧫ޤ
ࠬࡄࡧ࡚ࠖࠫࡦ㧔ࠦࡦࠨ࡞࠹࡚ࠪࡦ㧕ߪޔᜰ␜ኻ⽎ߣߥߞߡࠆࠤࠬ߇ߤ߁ߥߩ߆ߣ߁
ߎߣߢߪߥߊࠍࠬࠤޔᛴ߃ߡᖠࠎߢࠆੱߣߩ㧨߹ߎߎ㧪ߢߩળࠍᄢߦߔߴ߈ߛߣ߁
ߎߣࠍౣ⏕ߒ߹ߒߚޕ
㧣㧚ߦ߆߶ޣઃߌട߃ࠆࠦࡔࡦ࠻߿⾰߇ࠇ߫ߥࠎߢ߽ߤ߁ߙޤ
ߎߩࠃ߁ߥᯏળࠍਈ߃ߡߊߛߐߞߚߺߥߐࠎߌࠊࠅߣޔㅢ⸶ߩഭࠍߣߞߡߊߛߐߞߚౝ⮮వ↢ߦᗵ
⻢ߒ߹ߔޕ
ڎ↰ሶ㧔੩ㇺᄢቇ㧕
㧝◲ޣනߥ⥄Ꮖ⚫ࠍߒߡߚߛߌࠆߣ߁ࠇߒߢߔޤ
੩ㇺᄢቇᄢቇ㒮ᢎ⢒ቇ⎇ⓥ⑼ᢎ⢒ᣇᴺቇ⻠ᐳ⊒㆐ᢎ⢒ಽ㊁ߦ☋ߒ㧘ᢎോࠍߟߣߡ߅ࠅ
߹ߔ↰ሶߢߔ⥃ޕᐥᔃℂቇߥࠄ߮ߦ↢ᶦ⊒㆐ᔃℂቇࠍኾ㐷ߣߒߡ߹ߔޕਇᅧᴦ≮ࠍ⚻㛎ߒߚ
ᅚᕈߦࠗࡦ࠲ࡆࡘࠍⴕ㧘ᓐᅚߚߜߩሶߤ߽ࠍ߽ߟߎߣߦ㑐ߔࠆㆬᛯߣ⚻㛎㧘ߘߒߡ↢ᶦ⊒㆐ߩ
ࠅ᭽ࠍᬌ⸛ߔࠆߎߣࠍ⋡⊛ߦ㧘⾰⊛⎇ⓥࠍⴕߞߡ߹ߔߚ߹ޕ㧘⥃ᐥᔃℂ჻ߣߒߡ㧘ቇᩞ႐ߥ
ߤߢ㧘ሶߤ߽㧘⼔⠪㧘ᢎ⡯ຬߥߤࠍኻ⽎ߣߒߚ⋧⺣ᵴേߦᓥߒߡ߹ߔޕᔃℂ⥃ᐥታ〣ߦ߅ߌ
ࠆ࠽࠹ࠖࡧߣ⎇ⓥᵴേߦ߅ߌࠆ࠽࠹ࠖࡧߣߩⷫᕈ߿࠽࠹ࠖࡧߩน⢻ᕈߦᗖ߈ߟߌࠄࠇ㧘ቇ
߮ࠍ⛯ߌߡ߈߹ߒߚޕ
㧞 ޣᣣߩታ⠌ߢߤߩࠃ߁ߥߎߣ߇ߎࠅ㧘ߥߚߪߤߩࠃ߁ߥ㛎ࠍߒ߹ߒߚ߆ޕ
HKTUVRGTUQPPCTTCVKXGߩᒻᑼࠍ↪ߡ㧘ߢ߈ࠇ߫ᤨ㑆ࠍㅊߞߡ⸥ㅀߒߡߊߛߐޤ
߹ߕ㧘ࡢ࡚ࠢࠪ࠶ࡊࠍㅢߒߚߩޠ⑳ޟᄙ㕙ᕈߣߘߩᄌൻߦߟߡㅀߴ߹ߔߢࡊ࠶࡚ࠪࠢࡢޕ
ߪ㧘 ߟߩ߇ޠ⑳ޟሽߒߡߚ㧘ߣ߁ߎߣ߇ߢ߈ࠆߣᕁ߹ߔߪࠇߘޕ㧘Ԙޟᔃℂ⥃ᐥߦ៤ࠊࠆ
⠪ߣߒߡ㧘ࡢ࡚ࠢࠪ࠶ࡊࠍㅢߒߡ߇ߒ߆ߩࠬࠠ࡞ࠍቇ߮ขࠈ߁ߣߔࠆ⑳ޠ㧘ԙࠣࡦ࠾ࠬޟജ
ߦ⥄ା߇ߥߊ㧘ߤߎ߹ߢౝኈࠍℂ⸃ߢ߈㧘ߤߩ⒟ᐲታ⾰⊛ߦࡢ࡚ࠢࠪ࠶ࡊߦෳടߔࠆߎߣ߇ߢ߈
ࠆ߆ࠍਇߦᕁ㧘߅ߤ߅ߤߒߡࠆ⑳ޠ㧘Ԛޟ㧔ࠬࡄࡃࠗࠫߩ┙႐߆ࠄ㧕ᔃℂ⥃ᐥࠍ߁߹
ߊㅴࠆߚߩ UWRGTXKUKQP ߩലᨐ⊛ߥฃߌᣇࠍቇ߷߁ߣߔࠆ⑳ޠ㧘ԛޟ㧔ࠬࡄࡃࠗࠩߩ┙
႐߆ࠄ㧕UWRGTXKUKQP ߩㅴᣇࠍቇ߷߁ߣߔࠆ⑳ޕߔߢޠ
Ԙߩߣޠ⑳ޟԙߩߪޠ⑳ޟ㧘ࡢ࡚ࠢࠪ࠶ࡊߩᦨೋ߆ࠄ㧔㐿ᆎߐࠇࠆ೨߆ࠄ㧕ሽߒߡ߹ߒߚޕ
ࡢ࡚ࠢࠪ࠶ࡊ߳ߩะ߈วᣇߣߒߡߪ㧘ԘߪⓍᭂ⊛ߢࠆ৻ᣇߢ㧘ԙߪᶖᭂ⊛ߢࠆߣ߁ࠃ߁
ߦ㧘ኻᲧ⊛ߥ߇ޠ⑳ޟหᤨߦ૬ሽߒߡߚ㧘ߣ߁ߎߣ߇ߢ߈߹ߔߒߛߚޕ㧘ԙߩߪޠ⑳ޟ㧘ࡢ
࡚ࠢࠪ࠶ࡊోࠍㅢߒߡ㧘ࡢ࡚ࠢࠪ࠶ࡊߩౝኈࠍౝ⮮వ↢ߦ⚦ߦㅢ⸶ߚߛߊߎߣ߇ߢ߈ߚߚ
ߦ㧘Ყセ⊛ᣧ߁ߜ߆ࠄዊߐߊߥࠅ㧘ℂ⸃ߢ߈ߥߐߦኻߔࠆ߅ߘࠇߩࠃ߁ߥ߽ߩߪߥߊߥߞߡ
߈߹ߒߚߛߚޕ㧘ԙߩ߇ޠ⑳ޟዊߐߊߥࠅߪߒߚ߽ߩߩ㧘ࠦࡒࡘ࠾ࠤ࡚ࠪࡦߩ࿎㔍ߐ߇߽ߚࠄߔ
ࠆ⒳ߩ✕ᒛᗵ㧔ߚߣ߃߫㧘ࡢ࡚ࠢࠪ࠶ࡊ߿ࠣ࡞ࡊࡢࠢߩߥ߆ߢ㧘⧷⺆ߢᗧࠍ᳞ࠄࠇࠆ
ߎߣ߳ߩ੍ᦼਇ㧕ߪଐὼߣߒߡࠅ߹ߒߚߡߒߘޕ㧘߰ߣ㧘ߎ߁ߒߚࠊ߆ࠄߥߐߦኻߔࠆਇᗵ
߿✕ᒛᗵߪ㧘ᔃℂ⥃ᐥߩ႐㕙ߦ߅ߡ㧘ೋߡ᧪⺣ߔࠆࠢࠗࠛࡦ࠻ߩᗵᖱࠍℂ⸃ߔࠆ߁߃ߢ㧘ߘ
ߒߡ㧘ࠞ࠙ࡦߣߒߡߘ߁ߒߚࠢࠗࠛࡦ࠻ߦ߆ߦ㈩ᘦߒะ߈ว߁߆ࠍ⠨߃ࠆ߁߃ߢߩ㧘߭
ߣߟߩᄢ߈ߥᚻ߇߆ࠅߦߥࠆࠃ߁ߦ߽ᕁ߹ߒߚߪߦࠄߐޕ㧘ࠣࡠࡃ࡞ൻ߇ㅴߥ߆ߢ㧘ߘߩ࿖
ߩㅢ⺆㧔ᣣᧄߢߥࠄᣣᧄ⺆㧕ࠍᲣ࿖⺆ߣߒߥࠢࠗࠛࡦ࠻ࠍኻ⽎ߣߒߚ⋧⺣ߩ႐ߩᢛߩᔅⷐ
ᕈ߇∩ᗵߐࠇ߹ߒߚޕዋߒ⊛߇ᄖࠇߡߒ߹߁ߎߣ߆߽ߒࠇ߹ߖࠎ߇㧘ⷐߔࠆߦ㧘ԙߩࠍޠ⑳ޟㅢߒ
ߡ㧘ળ߇ᚑࠅ┙ߟߛࠈ߁߆㧘ℂ⸃ߒߡ߽ࠄ߃ࠆߛࠈ߁߆ߣਇߦᕁ߁ࠢࠗࠛࡦ࠻ߩ᳇ᜬߜࠍ㧘
ᄙዋߥࠅߣ߽⇼ૃ㛎ߔࠆߎߣ߇ߢ߈ߚࠃ߁ߦᕁߞߚᰴ╙ߢߔޕ
ࡢ࡚ࠢࠪ࠶ࡊߩᦨਛ㧘ԙߩ߇ޠ⑳ޟዋߒߕߟዊߐߊߥߞߡߊߦߟࠇ㧘⋧ኻ⊛ߦ㧘Ԙߩޠ⑳ޟ
߇ో㕙ߦߡ߈߹ߒߚߡߒߘޕ㧘.CWPGT వ↢ߦࠃࠆࠢ࠴ࡖߩߥ߆ߢ㧘̌%QPXGTUCVKQPUKPXKVKPI
%JCPIG̍߇㊀ⷐߢࠆߎߣ߇ㅀߴࠄࠇ㧘ߎߩ⸒⪲ߦᄢߦ㑐ᔃࠍ߽ߜ߹ߒߚᦨޕೋ㧘
̌%QPXGTUCVKQPU
KPXKVKPI%JCPIG̍ߣ߁߽ߩ߇㧘ౕ⊛ߥࠬࠠ࡞ߣߒߡሽߔࠆߩߛࠈ߁߆㧫㧔ߘߒߡߎߩࡢࠢ
࡚ࠪ࠶ࡊߢቇ߱ߎߣ߇ߢ߈ࠆߩߛࠈ߁߆㧫㧕 ߘࠇߣ߽㧘̌%QPXGTUCVKQPUKPXKVKPI%JCPIG̍ߪ
ࠊࠁࠆޟ⡬߆ߩߥߩ߽ࠆࠇߐࠄߚ߽ߢ߆ߥࠆߔࠍޠ㧫ߣ߁⇼ࠍᛴ߈߹ߒߚޕᚒߥ߇ࠄ㧘ࠇ
߆ߎࠇ߆ߣߞߚੑ㗄ኻ┙⊛ߥ⇼ߛߥߣᕁߟߟߢߒߚߦࠇߘޕኻߒߡ㧘߽ࠄߜߤߪࠇߘޟ
ࠅ߁ࠆߎߣߢࠆߪ⑳ޕⓍᭂ⊛ߦ SWGUVKQPKPI ࠍߒߡࠆࠍ⸒⊒ߏߥ߁ࠃ߁ߣޠ㧔ߤߥߚߩ⊒⸒
߆ࠃߊⷡ߃ߡ߹ߖࠎ߇㧘.QPFQP&GCPGT[ ߩవ↢߆ࠄ㧕ߚߛ߈߹ߒߚᤨߩߘޕ㧘⸒ࠊࠎߣߐࠇ
ߡࠆߎߣࠍߚߛṼὼߣℂ⸃ߒߚߛߌߢߒߚ߇㧘ߕࠇߦߒߡ߽⑳ߪ̌SWGUVKQPKPI̍ߣ߁⸒⪲ߦ
㑐ᔃࠍ߽ߜ߹ߒߚߡߒߘޕ㧘ߎߩࡢ࡚ࠢࠪ࠶ࡊࠍ⚳߃ߚߣ߈ߦ㧘
̌%QPXGTUCVKQPUKPXKVKPI%JCPIG̍
߇ߤߩࠃ߁ߥ߆ߚߜߢりߦߟߡࠆߛࠈ߁߆㧫 ⑳⥄り̌%QPXGTUCVKQPUKPXKVKPI%JCPIG̍ࠍ㧔ੑ
㗄ኻ┙⊛ߢߪߥߊ㧕ߤߩࠃ߁ߦℂ⸃ߔࠆߎߣ߇ߢ߈ߡࠆߛࠈ߁߆㧫ߣ㧘⥄ಽߩᄌൻࠍᭉߒߺߦᕁ
߹ߒߚޕ.CWPGT వ↢ߪ㧘ࡢ࡚ࠢࠪ࠶ࡊߩߥ߆ߢ㧔ᓟㅀߔࠆ㧘UWRGTXKUKQP ߩ࠺ࡕࡦࠬ࠻ࠪ
࡚ࡦࠍᆎࠆ⋥೨ߢߞߚߣ⸥ᙘߒߡ߹ߔ㧕߆ߔ߹ߦߎߤߪߚߥޟ㧫ߘߒߡ㧘 ಽᓟߦ
ߥߚ⥄りߤߎߦࠆ߆ࠍ㧘ߥߚߪߤߩࠃ߁ߦߒߡࠊ߆ࠆߢߒࠂ߁߆㧫㧔߇㆑ߞߡࠆ߆߽ߒ
ࠇ߹ߖࠎ߇̖㧕߇ߚߒ߹ࠇࠄߌ߆ࠅ⺆ߦߜߚ⑳ࠍߣߎ߁ߣޠ㧘ߎߩߎߣߪ㧔ᕁ߃߫ߢߔ߇㧕㧘
̌%QPXGTUCVKQPUKPXKVKPI%JCPIG̍ߩដߌߩ߭ߣߟߢߞߚࠃ߁ߦᕁ߹ߔޕ
ࠢ࠴ࡖߩߥ߆ߢ㑐ᔃࠍ߽ߞߚߎߣߪߊߟ߆ࠅ߹ߒߚޕએਅ㧘ࡔࡕߦߒߚ߇ߞߡᦠ߈ㅴ
ߡ߈߹ߔޕ
߹ߕ㧘ޟSWGUVKQPKPI ߪ㧘㗴ߦኻߔࠆᣂߒℂ⸃ࠍតߔߚߩ߽ߩߢࠆߦߣߎ߁ߣޠ㑐ᔃࠍ
߽ߜ߹ߒߚޕᣣᧄߢߪ㧘ᔃℂ⥃ᐥߩߏߊၮᧄ⊛ߥᘒᐲߣߒߡޟ⡬߇ޠᄢߢࠆߣߐࠇ߹ߔߒޕ
߆ߒ㧘႐ߢߩታ〣ߦ߅ߡߪ㧘නߦ⡬߫߆ࠅߒߡߡߪၖ߇߆ߕ㧘ౕ⊛ߦߨࠆߎߣࠍߒ
ߡߊࠊߌߢߔ߇㧘ߘߩ㓙㧘ߢ߽ߨࠇ߫ߣ߁߽ߩߢ߽ߥߢߒࠂ߁ޕ.CWPGT వ↢ߪ㧘⛯
ߌߡ㧘⥄ޟಽߩᅢᄸᔃࠍᄢߦߔࠆߡߒߘޕ㧘⋧ᚻ߇ߞߡࠆ⸒⪲ߢࡦࠢߒߡߊߣ߽ߣ߽ޕ
߽ߞߡߚ⺑߇ᱜߒߊߥߌࠇ߫ߔߋߦᝥߡߡߊࠍߣߎ߁ߣޠㅀߴࠄࠇߚࠊߌߢߔ߇㧘ߎߩߎ
ߣߪ㧘SWGUVKQPKPI ߩࠛ࠶ࡦࠬߢࠆࠃ߁ߦᕁ߹ߒߚޕ
߹ߚ㧘ⶄ߇ࡦ࡚ࠪࠢࡀࠦߥޘ⦡ߪߦ⺆‛ޟ㔀ߦ⛊߹ߞߡࠆⶄޕ㔀ᕈ߿ਇ⏕߆ߥߎߣ߇น⢻ᕈࠍ
ᐢߍࠆޕ⍮ࠄߥߣߎࠈߢ⍮ࠄߥߎߣ߇ߎࠆޕዊߐߥߎߣ߇ᄌൻࠍ߽ߚࠄߔޕEQPHWUKQP ߆ࠄᄙ
ߊࠍቇ߽߱ߦߣߎ߁ߣޠ㧘ᗖ߈ߟߌࠄࠇ߹ߒߚޕታ㓙㧘⺆ࠅߦߪ㧘ࠊ߆ࠄߥߐ߇ᄙಽߦలߜḩߜ
ߡ߹ߔߡߒߘޕ㧘ᔃℂ⥃ᐥߩታ〣႐㕙ߦ߅ߡ㧘⺆ࠄࠇࠆ㗴ߦኻߔࠆℂ⸃߇ㅴ߹ߕ㧘ᘒ߇⤔
⌕ߒߡߒ߹ߞߚࠃ߁ߥ࠶࡚ࠪࡦ߇⛯ߊߣ㧘ࠞ࠙ࡦ߇ߤ߁ߒࠃ߁߽ߥߊ∋ᑷߒߡߒ߹߁㧘
ߣ߁ߎߣ߇ࠆߢߒࠂ߁ߒ߆ߒޕ㧘⸥ߩߎߣࠍℂ⸃ߒߡࠇ߫㧘ࠊ߆ࠄߥߐ߿ਇ⏕߆ߥߎߣ߽㧘
ᄌൻࠍ߽ߚࠄߔน⢻ᕈߦḩߜߚ߽ߩߣߒߡ⼂ߔࠆߎߣ߇ߢ߈ࠆࠊߌߢߔ߽ߣߎߩߎޕ㧘
̌%QPXGTUCVKQPUKPXKVKPI%JCPIG̍ߩ߭ߣߟߣߒߡℂ⸃ߔࠆߎߣ߇ߢ߈߹ߒߚޕ
ട߃ߡ㧘߇ੱࠆߡ߈↢ߢ߆ߥߩࡓࡈࠆޟ㧘ߘߩࡈࡓࠍᄖߔߎߣߩ࿎㔍ߐߡߟߦޠ㧘
ᤋࠬࠗ࠼ࠍ↪ߡߖߡߚߛߚߎߣ߽㧘ߣߡ߽ශ⽎⊛ߢߒߚޕᤋࠬࠗ࠼ߪ ᨎ⛯߈ߦ
ߥߞߡ߹ߒߚ ޕᨎ⋡ߩࠬࠗ࠼ߪ㧘ࠆ↵ᕈ߇㧘ᓟࠈࠍᝄࠅࠆߣหᤨߦ㧘ࡂ࠶ߣᖱࠍߎࠊ߫
ࠄߖりࠍ⎬⋥ߐߖࠆࠃ߁ߥᤋ ޕᨎ⋡ߩࠬࠗ࠼ߢߪ㧘ࠆ⒟ᐲߩᤨ㑆ࠍ߽ߞߡᤋߒߐࠇ㧘
⧯↵ᕈ߇ోജ∔ߢ㧘೨ᣇߦࠆ↵ᕈ㧔 ᨎ⋡ߩࠬࠗ࠼ߦᤋߐࠇߚ↵ᕈ㧕ߦ⓭ㅴߒߡߊᤋޕ
ᨎ⋡ߩࠬࠗ࠼ߢߪ㧘㧔 ᨎ⋡ߩࠬࠗ࠼ߦᤋߐࠇߚ㧕↵ᕈߩࠆ႐ᚲ߇㧘ࠆ⒟ᐲߩ㜞ߐࠍ߽ߞ
ߡᤋߒߐࠇ㧘↵ᕈߩ㗡ߢᑪ‛ߩࡦࠟߩࠃ߁ߥ߽ߩ߇࠼ࠨ࠶ߣ፣ࠇߡߊࠆ⍍㑆ߩᤋߢߒߚޕ
ߟ߹ࠅ㧘ߎࠇࠄߩ ᨎߩ৻ㅪߩࠬࠗ࠼ߪ㧘↵⧯ޟᕈ߇㧘೨ᣇᢙࡔ࠻࡞వߢᑪ‛ߩࡦࠟ߇፣
ࠇ߆ߌߡࠆߩߦ᳇߇ߟ߈㧘ߘߩᑪ‛ߩ⌀ਅߦߚ↵ᕈࠍࠆߚߦ㧘ోജߢߞߡㄭߠ߈㧘↵ᕈ
ࠍߘߩ႐߆ࠄ㧔ᒰߚࠅߔࠆ߆ߩࠃ߁ߦߒߡ㧕ㆱ㔍ߐߖߚޠᤋߛߞߚߩߢߔޕ
⑳ߪ㧘 ᨎ⋡ࠍߚߣ߈㧘↵ᕈ߇⓭ὼࠄ߆ߩ࠻ࡉ࡞ߦᏎ߈ㄟ߹ࠇߚᤋߢࠆߣᕁ߹ߒߚޕ
ߘߒߡ ᨎ⋡ࠍߚߣ߈㧘⧯↵ᕈ߇ᓟࠈ߆ࠄ⓭ㅴߒ㧘ࠆ↵ᕈࠍೝߒߚᤋߛߣᕁ߹ߒߚߘޕ
ߒߡ ᨎ⋡ࠍߚߣ߈㧘⸥ߩࠃ߁ߦ㧘ᤋߩౝኈ߇ߔߞ߆ࠅℂ⸃ߢ߈ߚࠊߌߢߔ ߩߎޕᨎߩࠬ
ࠗ࠼ᤋߦࠃࠅ㧘⥄ޟಽߩࡈࡓ߇ሽߔࠆߎߣ⥄ޟ߿ޠಽߩࡈࡓࠍᄖߔߎߣߩ࿎㔍ߐޠ
ߣߣ߽ߦ㧘⥄ޟಽߩࡈࡓࠍᄖߒߡ㧘‛ߩ EQPVGZV ࠍᝒ߃㧘߹ߚ‛ࠍᄙⷺ⊛ᄙ㕙⊛ߦᛠី
ߔࠆߎߣߩ㊀ⷐᕈࠍޠ㧘ታᗵࠍߞߡౣ⼂ߔࠆߎߣ߇ߢ߈߹ߒߚࡈޟߡߞ߿߁ߤߪߢࠇߘޕ
ࡓࠍᄖߔ߆߁ࠂߒߢߩࠆ߈ߢ߇ߣߎޠ㧫⛯ߡߩࠢ࠴ࡖߢߪ㧘ETGCVKXKV[ ߩ㊀ⷐᕈ߇ㅀߴࠄࠇ
߹ߒߚࠍࡓࡈޟޕᄖߔ ߪߦޠETGCVKXKV[ ߇ᔅⷐߢࠆߎߣ㧘ߘߒߡ ETGCVKXKV[ ߽߹ߚ㧘ኻ
⥄ߩ WPEGTVCKPV[㧔ਇ⏕߆ߐ㧕ߩࡊࡠࠬ߆ࠄ↢߹ࠇࠆ㧘ߣ߁ߎߣߢߒߚޕ
ߐࠄߦ㧘ࠍࠬࠗࡃ࠼ࠕޟㅜਛߢਈ߃ߥ㧔㧩SWGUVKQPKPI ߇ᄢߢࠆ㧕ޟޠዅᢘ߿ዅ෩㧘⋧ᚻߣ
ߩ CITGGOGPV ࠍᄢಾߦߒ㧘߅߇ YQTMQP ߢ߈ߡࠆࠤࠕ߇ᄢߢࠆⷐߩ߆ߟߊ߁ߣޠὐ
߇ㅀߴࠄࠇ߹ߒߚ߽ࠄࠇߎޕ㧘̌%QPXGTUCVKQPUKPXKVKPI%JCPIG̍ߢࠆߣℂ⸃ߒ߹ߒߚޕ
ߘߒߡ㧘ߎ߁ߒߚᵹࠇߩਅߢ㧘ޟRGGTUWRGTXKUKQP ߇ᄢߢࠆ߇ߣߎ߁ߣޠવ߃ࠄࠇ߹ߒߚޕ
ߎߎߢ⑳ߪ㧘⸥ߩߊߟ߆ߩⷐὐ߇㧘ࠞ࠙ࡦࡦࠣߦ߅ߡ⺆ࠅࠍℂ⸃ߔࠆᤨߩߺߥࠄߕ
UWRGTXKUKQP ߦ߅ߡ߽↪ߢࠆߎߣ㧘ߘߒߡ㧘ߎ߁ߒߚⷐὐࠍቇࠎߛ⠪ห჻ߢߩ UWRGTXKUKQP
߇ലߢࠆߎߣࠍ㧘ℂ⸃ߒ߹ߒߚޕUWRGTXKUKQP ߪ㧘⚻㛎ࠍᄙߊⓍࠎߛᾫ㆐⠪ߦଐ㗬ߔࠆ߽ߩߢ
ࠆߣᕁߞߡߚ⑳ߪ㧘RGGTUWRGTXKUKQP ߩലᕈน⢻ᕈࠍવ߃ࠄࠇ㧘ࡂ࠶ߣߒ߹ߒߚߣޕหᤨߦ㧘
⎇ⓥߦ߅ߡ߽ RGGTTGXKGY ߥߤ߇ലߢࠆߎߣ߇㗡ߦᶋ߆߮㧘UWRGTXKUKQPࠍ RGGT ߢⴕ߁ߎߣ
ߩലᕈน⢻ᕈߦߟߡ㧘⚊ᓧߔࠆߎߣ߽ߢ߈߹ߒߚޕ
ߘߩᓟ㧘UWRGTXKUKQP ߩ࠺ࡕࡦࠬ࠻࡚ࠪࡦߦߞߡߞߚߩߢߔ߇㧘ߎߩㄝࠅ߆ࠄ㧘Ԙߩޟᔃ
ℂ⥃ᐥߦ៤ࠊࠆ⠪ߣߒߡ㧘ߥߦ߇ߒ߆ߩࠬࠠ࡞ࠍቇ߮ขࠈ߁ߣߔࠆ⑳ߪޠ㧘Ԛߩޟ㧔ࠬࡄࡃࠗ
ࠫߩ┙႐߆ࠄ㧕ᔃℂ⥃ᐥࠍ߁߹ߊㅴࠆߚߩ UWRGTXKUKQP ߩലᨐ⊛ߥฃߌᣇࠍቇ߷߁ߣߔࠆ⑳ޠ
߳ߣ㧘⥄ὼߣ⒖ⴕߒߡ߈߹ߒߚߪࠇߘޕ㧘ศ᳗వ↢߇ㅀߴࠄࠇߡߚ㧘ᧄޟᒰߦ╵߃߇ߥߊߡ
࿎ߞߡࠆߦኻߒߡ㧘ߤ߁߿ߞߡߘߩࠍ⍮ࠄߕ㧘߆ߟ⥄りࠍഥߌࠃ߁ߣߒߡߊࠇߡࠆੱ
ߦߔ߆ࠍߩ߽ߥ߁ࠃߩࡑࡦࠫ߁ߣޠ㧘ߘࠇ߹ߢߦታ㓙ߦ⚻㛎ߒߡߚ߆ࠄߛߣᕁ߹ߔޕ
UWRGTXKUKQP ߪ㧘㕖Ᏹߦࠁߞߊࠅߣㅴⴕߒߡ߈߹ߒߚ㧔ߘߩ⚦ߪ㧘ઁߩవ↢ᣇߩߏႎ๔ߣ㊀ⶄ
ߒ߹ߔߩߢ㧘ഀᗲߚߒ߹ߔ㧕ߛߚޕ㧘⑳ߪ㧘ߘ߁ߒߚࠁߞߊࠅߣߒߚᵹࠇ߇㧘ߒ߆ࠆߴ߈߽ߩߛ
ߣᕁߞߡ߹ߒߚ߫ࠄߥߗߥޕ㧘ࠬࡄࡃࠗࠩߣࠬࡄࡃࠗࠫߣߩ㑆ߦ➅ࠅᐢߍࠄࠇࠆ
ᓔᓳ߽ߩ⚦߿߆ߥ߿ࠅߣࠅߎߘ߇ SWGUVKQPKPI ߢࠅ㧘ߘߩࡊࡠࠬࠍ㧘࠺ࡕࡦࠬ࠻࡚ࠪࡦߢ
ߺߖߡߊߛߐߞߡࠆ߽ߩߣᕁߞߡߚ߆ࠄߢߔޕታ㓙ߦߪ㧘UWRGTXKUKQP ߇ࠁߞߊࠅߒߚዷ㐿ߢ
ߞߚߎߣߩේ࿃ߦ㧘⸒⺆ߩ㆑߇߽ߚࠄߔ⺖㗴߇⛊ࠎߢߚߩ߆߽ߒࠇ߹ߖࠎߒ߆ߒޕ㧘ߚߣ߃ห
ߓ⸒⺆ࠍ↪ߡⴕ߁ UWRGTXKUKQP ߢߞߡ߽㧘ࠬࡄࡃࠗࠩ߇⏕ߦߩ⚦ࠍᛠីߔࠆߎ
ߣ߇ߢ߈ࠆࠃ߁ߦߥࠆ߹ߢߦߪ✺ኒߥ߿ࠅߣࠅ߇ᔅ㗇ߢࠅ㧘ℂ⸃ߦ⥋ࠆ߿ࠅߣࠅߎߘ߇
SWGUVKQPKPI ߢࠆߣℂ⸃ߒߡߚࠃ߁ߦᕁ߹ߔޕ
ߎߩࠃ߁ߦℂ⸃ߒߡߚߎߣ߽ߞߡ㧘.CWPGT వ↢ߣ *CNRGTP వ↢ߣߩ㑆ߢߥߐࠇߚ㧘ߩߎޟ
UWRGTXKUKQP ߇ᄬᢌߦ⚳ࠊࠅߘ߁ߛ߁ߣޠળ߇ࠄ߆ߦߐࠇߚߣ߈㧘ߘߩࠃ߁ߦࠬࡄࡃࠗࠫ
㧔ߣߘࠇࠍߡࠆ⑳ߚߜ㧕ߦવ߃ࠆߎߣ߽߹ߚ㧘UWRGTXKUKQP ߦ߅ߌࠆᚢ⇛ߩ৻⒳߆ߣᕁߞߚࠅ
߽ߒ߹ߒߚࠅ߹ߟޕ㧘ࠬࡄࡃࠗࠩߩ㧘㗴߇ᛠីߢ߈ߥߎߣߦኻߔࠆਇ߿ὶࠅ㧔ߚߛ
ߒᄬᢌߣ߹ߢߪᕁߞߡߥ㧕ࠍ㧘ࠬࡄࡃࠗࠫߦ₸⋥ߦવ߃ࠆߎߣߦࠃߞߡ㧘UWRGTXKUKQP
ߦᄌൻࠍଦߒ゠ୃᱜߔࠆߎߣࠍᝪ߃ߚដߌߢࠆ߆ߣᕁߞߚߩߢߔޕ㧔ታߩ UWRGTXKUKQP
ߢ㧘.CWPGT వ↢ߩࠃ߁ߥ┙႐ߩᣇ߇ࠄߞߒ߾ࠄߥ႐ว㧘ࠬࡄࡃࠗࠩߢࠆ *CNRGTP వ↢
⥄り߇₸⋥ߦᗵߓߚߎߣߣߒߡ㧘ޟᄬᢌߦ⚳ࠊࠅߘ߁ࠗࡃࡄࠬ߇ߣߎ߁ߣޠߥࠄ߆ࠊޟޠ
ࠫߦવ߃ࠄࠇࠆߎߣߦߥࠆ߆ߣᕁ߹ߔ㧕ޕ
ߎߩᲑ㓏ߢߪ㧘߽߁߭ߣࠅߩޠ⑳ޟ㧘ߟ߹ࠅ㧘ԛޟ㧔ࠬࡄࡃࠗࠩߩ┙႐߆ࠄ㧕UWRGTXKUKQP
ߩㅴᣇࠍቇ߷߁ߣߔࠆ⑳ߦ߁ࠃߚ߈ߡࠇ߽ޠᕁ߹ߔߛ߹ߪ⑳ޕ߆߁ࠂߒߢߗߥߪࠇߘޕᔃℂ
⥃ᐥߩ UWRGTXKUKQP ࠍߒߚ⚻㛎ߪࠅ߹ߖࠎ߇㧘᧪⊛ߦߔࠆน⢻ᕈ߇ࠆ߆߽ߒࠇ߹ߖࠎߚ߹ޕ㧘
㧘ቇᩞ⥃ᐥߩ႐ߢߪ㧘ࠬࠢ࡞ࠞ࠙ࡦߣߒߡ㧘ቇᩞߩవ↢ߦኻߒߡࠬࡄࡃࠗࠩ
⊛ߥ㑐ࠊࠅࠍߔࠆߎߣ߇ࠅ߹ߔ┙ߚߒ߁ߘޕ႐ࠍታ㓙ߦ⚻㛎ߒ㧘ࠬࡄࡃࠗࠩ⊛ߥ㑐ࠊࠅ
ࠦࡔࡦ࠻ߩ㔍ߒߐࠍታ㓙ߦᗵߓߡߚ߆ࠄߎߘ㧘ԛߩ߇ޠ⑳ޟߡ߈ߚߩߢߪߥ߆ߣᕁ߹ߔޕ
ޟUWRGTXKUKQP ߇ᄬᢌߦ⚳ࠊࠅߘ߁ޟޠUWRGTXKUKQP ߩⴕᣇ߇ࠊ߆ࠄߥߪ⸒⊒ߥ߁ࠃ߁ߣޠ㧘
ࠬࡄࡃࠗࠩߩ⌀ߥᆫߣߒߡᅢᗵࠍ߽ߟߎߣ߇ߢ߈㧘߹ߚߘߩࠃ߁ߦ₸⋥ߦࠊ߆ࠄߥߐ
ࠍࠄ߆ߦߔࠆߎߣߪ㧘UWRGTXKUKQP ߦ߅ߡታ⾰⊛ߦ߽ᔅⷐߢࠆߩ߆߽ߒࠇ߹ߖࠎ߁ߎߒ߆ߒޕ
ᕁ߁৻ᣇߢ㧘ߘߩࠃ߁ߥᗧౝኈࠍߥߦ߇ߒ߆ߩ߆ߚߜߢવ߃ߚᓟߦ㧘ࠬࡄࡃࠗࠩߣߒߡ
ߤߩࠃ߁ߦኻᔕߔࠆߎߣ߇ߢ߈ࠆߩ߆㧘ࠆߪ㧘ߥߦ߆ዷᦸ߇ߞߡ㧔ߟ߹ࠅᚢ⇛ߣߒߡ㧕ߘߩ
ࠃ߁ߦ⸒ߞߡࠆߩ߆㧘ࠃߊࠊ߆ࠅ߹ߖࠎߢߒߚߡߒߘޕ㧘⑳߇ቇᩞ⥃ᐥߩ႐ߢ㧘ᢎ⡯ຬ߆ࠄ⋧
⺣ࠍฃߌߚߣ߈ߦ㧘⥄ಽߛߞߚࠄࠍޠߐߥࠄ߆ࠊޟὼߣߔࠆߎߣ߇ߢ߈ࠆߛࠈ߁߆㧫ߔ
ࠆߣߔࠇ߫㧘ᰴߩᄌൻࠍߒߚ߁߃ߢߒ߆㧘ߔࠆߎߣ߇ߢ߈ߥߛࠈ߁ߥ㧘ߣ߁ᕁ߽ᛴ߈
߹ߒߚ⇼ߩߎ߽ޕ㔀ᗵࠍᛴ߃ߡ߹ߔޕ
㧟㧚ޣታ⠌ࠍ㛎ߒߡࠆᤨ㧘ߤߩࠃ߁ߥߎߣࠍᗵߓ߹ߒߚ߆㧫㧔 ߩਛߢㅀߴߡߊߛߐߞߡ߽߆
߹߹ߖࠎ㧕ޤ
㧞ߣಾࠅಽߌࠆߎߣ߇ߢ߈߹ߖࠎߢߒߚߩߢ㧘㧞ߢ৻✜ߦㅀߴ߹ߒߚޕ
㧠㧚ࠄ߆ޣ⠨߃ࠆߣ㧘ߥߚ⥄りߎ߁ߔࠇ߫ࠃ߆ߞߚߣ߁ߎߣ߇ࠅ߹ߔ߆㧫߽ߒࠆߣߔࠇ
߫ߘࠇߪߤ߁߁ߎߣߢ㧘ߤߩࠃ߁ߦߔࠇ߫ࠃ߆ߞߚߩߢߒࠂ߁߆㧫ޤ
⑳⥄りߩࠬ࠾ࡦࠣജߩૐߐߪ㧘⥋ࠆߣߎࠈߢࡂࡦ࠺ࠖࠠࡖ࠶ࡊߣߥߞߡ߹ߒߚࠣࡦ࠾ࠬޕ
ജࠍ㜞ࠆߎߣߪ㧘⑳ߦߣߞߡߣߡ߽ᄢ߈ߥ⺖㗴ߢߔޕ
ߚߛ㧘࿁ߩࡢ࡚ࠢࠪ࠶ࡊߢߪ㧘.CWPGT వ↢ࠍߪߓ .QPFQP&GCPGT[ ߩవ↢ᣇ߇㧘ߕ߱ࠎߣ
㈩ᘦࠍ߽ߞߡࠊ߆ࠅ߿ߔࠃ߁ߦࠁߞߊࠅߣ߅ߊߛߐߞߚࠃ߁ߦᕁ߹ߔߒ㧘߹ߚ㧘ౝ⮮వ↢߇
⚦ߦㅢ⸶ࠍߒߡ߽ߊߛߐ߹ߒߚߢߩߔߢޕ㧘ࠬ࠾ࡦࠣജߩૐߐ߫߆ࠅ߇ቯ⊛ߥ㓚ოߢߞ
ߚߣ⸒߃ߥࠃ߁ߦ߽ᕁ߹ߔ߁ߘޕ⠨߃ߚߣ߈㧘⡊ߦߞߡߊࠆߥ߆߆ࠄ㎛ߣߥࠆߣᕁࠊࠇࠆ⸒
⪲ࠍᝒ߃㧘ߘߩ⸒⪲ࠍὐߦߒߡℂ⸃ߔࠆࠃ߁ߦᗧ⼂⊛ߦߥࠇ߫⦟߆ߞߚߩ߆߽ߒࠇߥ㧘ߣ߽ᕁ
ߞߚࠅߒߡ߹ߔߡߒߘޕ㧘ߎߩߎߣߪ㧘.CWPGT వ↢߇ࠢ࠴ࡖߩߥ߆ߢ߅ߞߒ߾ߞߚ㧘⥄ޟಽ
ߩᅢᄸᔃࠍᄢߦߔࠆߡߒߘޕ㧘⋧ᚻ߇ߞߡࠆ⸒⪲ߢࡦࠢߒߡߊ ࠄ߆ߎߘޕSWGUVKQPKPI
ࠍⴕ߁ޠ㧔ߢᣢㅀ㧕ߎߣㅢߓࠆߎߣߢߪߥߛࠈ߁߆㧘ߣᕁߞߡࠆᰴ╙ߢߔޕ
㧡㧚ߩߎޣታ⠌㛎߆ࠄឭߐࠇࠆ㗴ὐ߿⇼ὐߪߥࠎߢߔ߆㧫ޤ
ࠢ࠴ࡖߚߛߚߥ߆ߢ㧘ߪࠬࠗࡃ࠼ࠕޟㅜਛߢਈ߃ߥ㧔㧩SWGUVKQPKPI ߇ᄢߢࠆ㧕ޠ
ߣ߁ߎߣ߇ࠅ߹ߒߚߪࠇߎޕ㧘ࠞ࠙ࡦࡦࠣߦ߅ߡߣߡ߽㊀ⷐߥߎߣߛߣᕁ߁ߩߢߔ߇㧘
ߘߩ৻ᣇߢ㧘ࠢࠗࠛࡦ࠻ߣߘߩ㊀ⷐᕈࠍ߁߹ߊߔࠆߎߣ߇ߢ߈ߥߌࠇ߫㧘ࠞ࠙ࡦࡦࠣ߇
ᄬᢌߦ⚳ࠊࠆߎߣ߽ࠆࠃ߁ߦᕁ߹ߔ㧔ࠢࠗࠛࡦ࠻ߦ㧘߽ᢎ߃ߡߊࠇߕߨࠆ߫߆ࠅߩࠞ࠙
ࡦߛ㧍ߣߞߚℂ⸃ࠍߐࠇߡߒ߹߁㧕ࠃࠅࠃޕᄌൻࠍᒁ߈ߎߔߚߩ SWGUVKQPKPI ߢ
ࠆߎߣࠍ㧘ࠞ࠙ࡦࠢࠗࠛࡦ࠻㑆ߢߤߩࠃ߁ߦߤߎ߹ߢߔࠆߎߣ߇ߢ߈ࠆ߆㧘ߣ⠨߃ߡ
߹ߔޕ
㧢㧚ߩߎޣታ⠌ߩ㛎߆ࠄߥߚ߇ቇࠎߛࡐࠗࡦ࠻ߪߥࠎߢߔ߆㧫ޤ
⒳̌ߩޘ%QPXGTUCVKQPUKPXKVKPI%JCPIG̍ߢߔޕᄌൻࠍଦߔߚߩࠞ࠙ࡦߣߒߡߩᘒᐲߩ
ࠃ߁ߥ߽ߩࠍ㧘ౣ⏕ߔࠆߎߣ߇ߢ߈ߚࠃ߁ߦᕁ߹ߔޕหᤨߦ㧘⥄ಽߩᒙὐߢ߈ߡߥߐ߽㧘
ౣ⼂ߔࠆߎߣ߇ߢ߈߹ߒߚޕᓟ㧘ᔃℂ⥃ᐥታ〣ߩߥ߆ߢᗧ⼂⊛ߦ↪ߥ߇ࠄ㧘りߦߒߺߎ߹
ߖߡ߈ߚߣ⠨߃ߡ߹ߔޕ
㧣㧚ߦ߆߶ޣઃߌട߃ࠆࠦࡔࡦ࠻߿⾰߇ࠇ߫ߥࠎߢ߽ߤ߁ߙޤ
UWRGTXKUKQP ߩ࠺ࡕࡦࠬ࠻࡚ࠪࡦ߇㧘ඨ߫ᤨ㑆ಾࠇߩࠃ߁ߥ⚳ࠊࠅᣇࠍߒߚࠃ߁ߦᕁ߹ߔޕ
㧞ߢㅀߴߚߎߣߣ㊀ⶄߒ߹ߔ߇㧘ߘࠇ߇ᄬᢌߢߞߚߣߪ⑳ߣߒߡߪᕁߞߡ߹ߖࠎ߇㧘߽ߒ߽߁
ዋߒᤨ㑆ߦ߇ࠇ߫㧔ߚߣ߃߫㧘ᦨೋ߆ࠄޟᣣᧄ⺆ㅢ⸶⧷⺆ߔࠍࠅߣࠅ߿ߢߜߚ߆߁ߣޠ
ࠆߥߤࠅ߿ߚߒ߁ߘޕᣇ߇㧘UWRGTXKUKQP ࠍㅴࠆߢലߢߞߚ߆ߤ߁߆ߪ㧘㗴߆߽ߒࠇ߹
ߖࠎ߇㧕㧘ߤߩࠃ߁ߥ߆ߚߜߢ UWRGTXKUKQP ߇⚳߃ࠄࠇߡߚߩߛࠈ߁߆㧘ߣᕁߞߚࠅߒߡ߹ߔޕ
߹ߚ㧘UWRGTXKUKQP ߇߁߹ߊ߆ߥ߆߽ߒࠇߥߎߣࠍ㧘ࠬࡄࡃࠗࠩ߇વ߃ߚ႐ว㧘ߘߩ
ᓟߤߩࠃ߁ߥዷ㐿߇ࠆߩ߆ࠍ㧔ᚢ⇛⊛ߦߘ߁વ߃ࠆߎߣߢ㧘ᄌൻࠍଦߘ߁ߣߒߡࠆ႐ว߽
ߡ㧕㧘ߡߺߚߣᕁ߹ߒߚޕ
ᧄࡢ࡚ࠢࠪ࠶ࡊߪ㧘⑳ߦߣߞߡ߹ߚߣߥᄢᄌ⾆㊀ߥ⚻㛎ߢߒߚޕෳടߐߖߡߚߛߊߎߣ߇
ߢ߈㧘ᷓߊᗵ⻢ߒߡ߅ࠅ߹ߔᧄޕᒰߦߤ߁߽ࠅ㔍߁ߏߑ߹ߒߚޕ
ڎศ᳗ፏผ㧔ንጊᄢቇ㧕
㧝◲ޣනߥ⥄Ꮖ⚫ࠍߒߡߚߛߌࠆߣ߁ࠇߒߢߔޤ
ศ᳗ፏผ㧔;15*+0#)#6CMCUJK㧕ޔንጊᄢቇቇ↢ᡰេࡦ࠲ߦᚲዻߒߡ߹ߔޕኾ㐷ߪ⚻༡ቇ㧔․
ߦ࠽࠶ࠫࡑࡀࠫࡔࡦ࠻㧕ߢߔޕߪਥߦ⊒㆐㓚ኂߩࠆቇ↢ߩߚߩቇౝᡰេߠߊࠅࠍ
ㅢߓߚታ〣⎇ⓥߦ࠴ࡖࡦࠫߒߡ߹ߔ㧔ታ㓙ߦ⊒㆐㓚ኂߩࠆቇ↢ߩ⋧⺣ᬺോ߽ⴕߞߡ߹ߔ㧕ޕ
㧞ޣᣣߩታ⠌ߢߤߩࠃ߁ߥߎߣ߇ߎࠅߥ߁ࠃߩߤߪߚߥޔ㛎ࠍߒ߹ߒߚ߆ޕ
HKTUVRGTUQPPCTTCVKXGߩᒻᑼࠍ↪ߡᤨ߫ࠇ߈ߢޔ㑆ࠍㅊߞߡ⸥ㅀߒߡߊߛߐޤ
ඦ೨ਛߪ&ޔT.CWPGTߦࠃࠆࠢ࠴ࡖߛߞߚߣ⸥ᙘߒߡ߹ߔ߇ޔౝኈߪಽ߆ࠅ߿ߔߊ߽⺆⧷ޔ
ߢࠕ࡞࠲ࠗࡓߦ⡬߈ขࠆߎߣ߇ߢ߈ߕߩ࠼ࠗࠬޔᢥሼߣౝ⮮వ↢ߩㅢ⸶ࠍ߽ߣߦޔᔅᱫߦߥߞ
ߡℂ⸃ߦദߡߚࠃ߁ߦ⸥ᙘߒߡ߹ߔߩߘޕਛߢ߽ශ⽎ᷓ߆ߞߚߎߣߣߒߡޔUWRGTXKUKQPߩ⠨
߃ᣇ߇⑳ߩਛߢ⏕ߦߥߞߚߎߣ߇ߍࠄࠇ߹ߔޕ.CWPGTవ↢߇߅ߞߒ߾ࠆPCTCVVKXG߇ࡌࠬߣߥ
ࠆUWRGTXKUQP߿RGGTUWRGTXKUKQPߪ⎇ߢ߹߇⑳ޔⓥߩࡈࠖ࡞࠼ߣߒߡ߈ߚ⎇ޔⓥ㐿⊒⚵❱ߦ߅
ߌࠆมߣㇱਅࡃࡦࡔ❱⚵ߪߒߥޔ㑆ߩࠦࡒࡘ࠾ࠤ࡚ࠪࡦࠬ࠲ࠗ࡞ߣ㕖Ᏹߦૃߡࠆߎߣߦ
᳇ઃߚߩ߇ߘߩℂ↱ߢߔޕ
⎇ⓥ㐿⊒⚵❱ߢߪޔᱜ⸃ࠍ⺕߽ߒࠄߥࠍ┙ߡࠍ⺰⼏ߡߟߦࠄࠇߘޔㅴߡ߈߹ߔߘޕ
ߎߢߪޔมߦߚࠆੱߪޔㇱਅࠍࠦࡦ࠻ࡠ࡞ߒࠃ߁ߣߔࠆࠃࠅߪߒࠈޔㇱਅ߇ᣂߚߥ᳇ߠ߈
ࠍᓧࠆߚߩࠨࡐ࠻ߦദ߹ߔߩ࡞ࠠࠬࡦ࡚ࠪࠤ࠾ࡘࡒࠦߥ߁ࠃߩߎޕ㜞ᣇ߇⎇ⓥ㐿⊒ࡑࡀ
ࠫࡖߦߥߞߡߊߩߢߔ߇ޔ߇ߣߎߩߘޔ.CWPGTవ↢߇ߏ⚫ߦߥߞߚޔ0CTTCVKXG%QORGVGPEG
ߩߟߢࠆޔPCTTCVKXGEQOOWPKECVKQPUMKNNUߩࠦࡦࡊ࠻ߣߒߡߩޔ%QPXGTUCVKQPUKPXKVKPI
EJCPIGߣߟߥ߇ߞߚߩߢߔߥ߁ࠃߩߤޕEJCPIG߇ᦸ߹ߒߩ߆ߪߩߘޔ႐ߩEQPVGZVߦࠃࠆߣᕁ߁
ߩߢߔ߇ߚߒߢ߹ߎߘޔߢEJCPIGࠍߊߩ߆ߩߘޔ߽ߣࠇߘޔ႐ߩળߢEJCPIGߩᣇะᕈࠍޔ
UWRGTXKUQTߣUWRGTXKUQPࠍฃߌࠆੱ㧔ࠬࡄࡃࠗࠫ㧫㧕߇දߒߡ᭴▽ߒߡߊߩ߆ࠄߜߤޔ
ߥߩ߆ಽ߆ࠅ߹ߖࠎ߇㧔߅ߘࠄߊࠤࠬࡃࠗࠤࠬߛߣᕁ߁ߩߢߔ߇㧕ޔ߽ߡߒ߹ߒߦࠇߕޔ
EQPVGZVߦߞߚEJCPIGߩᣇะᕈࠍߒߡߊ⢻ജߣߒߡߪ߇⑳ޔᰴߩᣣߦ⊒ߒߚࠕࠬ࠻࠹
ࠬߩRJTQPGUKU㧔RTCEVKECNYKUFQO⾫ޔᘦ㧕ߦㅢߓࠆߩߛࠈ߁ߥߣޔᕁ߹ߒߚޕ
߹ߚޔKPVGTRTGVCVKQPߦ㊀߈ࠍ߅ߊߩ߆ޔ߽ߣࠇߘޔNKUVGPKPIߦ㊀߈ࠍ߅ߊߩ߆ߦߣߎ߁ߣޔ
⸅ࠇࠄࠇߡߩߘޔੑ㗄ኻ┙ࠍਸ਼ࠅ߃ࠆᣇᴺߣߒߡޔ⡞ߊߚߦߔ㧔⾰ߔࠆ㧕ߣ߁ߎߣߩ㊀
ⷐᕈ߇ޔ⣤ߦ⪭ߜߚࠃ߁ߥ᳇߇ߒ߹ߒߚ┻ޔ߆⏕ޕౝߐࠎ߇⾰ߐࠇߚߎߣߣߒߡޔ⡬ߣPCTTCVKXG
DCUGFUWRGTXKUKQPߩࠦࡦࡊ࠻ߩ㆑ߪ߆㧫ߣ߁ߏ⾰ߦ㑐ㅪߒߚౝኈߛߣᕁ߹ߔ߇㧔߽
ߒߏ⾰ߩ⿰ᣦ߇㆑ߞߡࠇ߫↳ߒ⸶ࠅ߹ߖࠎ㧕߽⑳ޔቇ↢⋧⺣ߩታ〣ߩਛߢޔⓍᭂ⊛ߦޟ⡞ߊ
ߚߩ⾰ߩߘޕߔ߹ߡߞⴕࠍޠ㛎ߣߩᾖࠄߒวࠊߖߦࠃߞߡߩ⑳ޔਛߢޔPCTTCVKXG
DCUGFUWRGTXKUKQPߦኻߒߡⷫߒߺࠍⷡ߃ࠆࠃ߁ߦߥࠅ߹ߒߚޕ
߹ߚ⁁ߥ߁ࠃߩߤޔᴫߢ߅ߞߒ߾ߞߚ߆ߤ߁߆ⷡ߃ߡߥߩߢߔ߇ߞߡ⇐߈ᦠߦ࠻ࡁޔ
ߚᢥ┨ࠍߘߩ߹߹ᒁ↪ߒ߹ߔߣޔ
⚿ߥ߁ࠃߩߤޟᨐߦߥࠆ߆ߪಽ߆ࠄߥ㧔ᦼᓙߒߥ㧕߇⚿ࠃ߇ࠇߘޔᨐߦߥࠆߢࠈ߁ߣାߓ
ߡޔ㧔ㆡಾߥ㧕EJCPIGߦะ߆ߞߡ߆ߌࠍߒߡߊޠ
ߣ߁⸒⪲ߦാ᳇ߠߌࠄࠇ߹ߒߚޕวὐ߇ߊߣ߁ࠃࠅߪࠍ⪲⸒ߩߘࠈߒޔ⡞ߡᅗ┙ߞߚޔ
ߣ߁⸒⪲ߩᣇ߇⑳ߩਛߢߎߞߚ㛎ߣߒߡߪㄭߣᕁ߹ߔޕታ㓙ߦቇ↢ᡰេࠍߒߡࠆߣޔ
৻ߤߎ߇ᡰេߩ⋡ᮡὐߦߥࠆߩ߆ޔಽ߆ࠄߥߊߥࠆߎߣ߇ࠅ߹ߔ㧔ߘ߽ߘ߽ᦨೋ߆ࠄಽ߆ࠄ
ߥ߹߹ޔታ⾰⊛ߦᡰេ߇ࠬ࠲࠻ߔࠆߎߣ߽ࠅ߹ߔ㧕ߩߘޕਛߢޔᡰេ⠪ߣⵍᡰេ⠪߇දหߒ
ߡࠃࠅࠃޟޔᄌൻߣޔߛࠎࠆߌߡߒߎࠍޠାߓࠆߎߣߪߣߡ߽ᄢߢߔߒߢ߃ߐߎߘޔ
߈ࠇ߫ޔታ㓙ߩᡰេߪ߆ߥࠅࠬࡓ࠭ߦߥࠆߣᕁ߹ߔޕᄢߥߩߪߦ✜৻ޟࠍࠇߘޔାߓߡߌ
ࠆߩߚޠ㑐ଥᕈࠍߤߩࠃ߁ߦ᭴▽ߔࠆ߆ోߦࠇߘޔࠅߦޔജࠍዧߊߔᔅⷐ߇ࠆߩߛߥߣޔᕁ
߹ߒߚޕ
ࡦ࠴ߩߣޔឭଏߩ㓸߇ࠅ߹ߒߚޕPCTTCVKXGDCUGFUWRGTXKUKQPߩ࠺ࡕࡦࠬ࠻ࠪ
࡚ࡦࠍߔࠆߚߢߔ⪲⸒ޕㅢࠅߢߪߥ߆߽ߒࠇ߹ߖࠎ߇ޟޔឭଏߩ᧦ઙߪ߇⺰⚿ޔߡߥ
㗴ߢߟ߆ޔ㧔ᡰេ⠪㧕ߩߥߚ߇ᛴ߃ߡࠆࠫࡦࡑߦߟߡ⚫ߢ߈ࠆ߽ߩߢߩ߽߁ߣޠ
ߒߚ⺣⋧ߩߟߦߋߔޔߦ߈ߣߚࠇࠊ⸒ޕ㧔ㅴⴕਛߢ⊒ޔ㆐㓚ኂߩ⇼ߩࠆᣢත⠪ߩዞ⡯
ᡰេ㧕ࠍᕁߒ߹ߒߚߗߥޕᕁߛߒߚ߆ߣ߁ߣޔᷰ⧷ᓟ߽⋧⺣ࠍฃߌߡࠆᣇ߆ࠄߩㅪ⛊߇
ࠅߩߘޔㅪ⛊ߪ߹ࠅᦸ߹ߒ߽ߩߢߪߥߊߡߟߦࠇߘޔዋߥ߆ࠄߕ⪭⢙ߒߡߚ߆ࠄߢߔޕ
ߎߩߦ߅ߡߚ߈ߡߞⴕߢ߹ޔߪ⑳ޔᐕ߆ߦ߽߱ᡰេ߇߹ߞߚߊߩή㚝ߛߞߚߩߢߪ
ߥ߆⇼߁ߣޔᔨࠍขࠅᛄ߁ߎߣ߇ߢ߈ߥߊߥߞߡ߹ߒߚޕ
ߣߪ߃⥄ޔりߩ⧷⺆ജߩߥߐߦߟߡߪ㊀ޘᛚ⍮ߒߡߚߩߢޔᚻࠍߍࠆߎߣߪߒߥ߆ߞߚ
ߩߢߔ߇ޔឭଏߩࠝࡈࠔ߇ߞߡ߆ࠄߩߊࠄ߫ߒޔ㑆ᴉ㤩߇ࠅ߹ߒߚߘࠃ߅߅ޕಽߊࠄ
ߛߞߚߣᕁ߹ߔ߇⥄ޔߢߣߎߩߘޔὼߦᚻࠍߍߡޠߚߒ߹߹ߒޟ
࠺ࡕࡦࠬ࠻࡚ࠪࡦߢߩUWRGTXKUQTߪ&ޔT*CNRGTPߢߒߚޔߢߎߎޕౝ⮮వ↢ࠍㅢ⸶ߦߪߐࠎ
ߢޔߪ⑳ޔߒ߆ߒޕߚߒ߹ࠅߥߦߣߎ߁ⴕࠍࡦ࡚ࠪ࠻ࠬࡦࡕ࠺ޔUWRGTXKUQTߣะ߆วߞߚ⍍
㑆ࠅ߆ߞߔࠍߣߎࠆߢࡦ࡚ࠪ࠻ࠬࡦࡕ࠺߇ࠇߎޔᔓࠇߡߒ߹ߊߚߞ߹ޔ㆑ߞߚ⇇ߦߞ
ߚ߆ߩࠃ߁ߦߥߞߡߒ߹߹ߒߚߒߘޔߣߎࠆߢޠࡦ࡚ࠪ࠻ࠬࡦࡕ࠺ޟߢ߹ߊޔࠅ߹ߟޕ
ߡޔࠅߩੱ߇ࠆߎߣࠍߔߞ߆ࠅᔓࠇߡߒ߹ߞߚߩߢߔޕ
&T*CNRGTPߪ߇⑳ޔឭଏߒߚߦߟߡࠍ࠻ࠬࠠ࠹ࡦࠦߩߘޔࠄ߆ߦߒࠃ߁ߣദࠄࠇߡ
ߚߩߢߔ߇ߦࠇߘޔኻߒߡߦ߁ࠃߩߤޔߢ⺆⧷ߒߤߚߤߚޔᱜ⏕ߦવ߃ࠇ߫ࠃߩ߆ࠍ⠨߃ߥ߇
ࠄߒ߹ߒߚߣߚߞߛࠬࡍߚߒߣࠅߊߞࠁߤ߶ߒࠈߘ߅ޔߊࠄߘ߅ޕᕁ߹ߔߒ߭ޔ߽߆ߒޔ
ߤߊᢿ ⊛ߛߞߚߣᕁ߹ߔ㧔ጯᧄవ↢ߩߏႎ๔ㅢࠅߢߔ㧕ޕ
ߎߩߣ߈ߪޔUWRGTXKUQT߇᳞ߡࠆߎߣߦᔕ߃ࠃ߁ߣᔅᱫߢޔㆡᒰߦⷐ⚂ߔࠆߣ߆߁ࠃߩߘޔ
ߥߎߣߪ⠨߃߽ߒߥ߆ߞߚߩߢߔ㧔߽ߒߘ߁ᕁߞߚߣߒߡ߽ߢ߈ߚ߆ߤ߁߆ᕋߒߢߔ߇㧕⚿ޕᨐ
ߣߒߡޔ㗴ߩᩭᔃߦ⥋ࠆ೨ߦޔᄙߊߩᤨ㑆ࠍᄬߞߡߒ߹ߞߡ߹ߒߚޕ
ߤ߁߿ࠄ߇ޠࡦ࡚ࠪ࠻ࠬࡦࡕ࠺ޟߩߎޔᄬᢌߦ⚳ࠊࠆ߆߽ߒࠇߥߎߣ߇ࠎߚߞޔਛᱛߒ
ߡޔUWRGTXKUQTߩࠨࡐ࠲ᓎߩ&T.CWPGTߣ&T*CNRGTPߣߩߎߩ࠺ࡕࡦࠬ࠻࡚ࠪࡦߩࡊࡠࠬ
ߦߟߡߩߒว㧔ߎߩౝኈ߽ෳട⠪ߦࠪࠚࠕߐࠇߚߎߣߪ⥝ᷓ߆ߞߚߢߔ㧕ߦࠃߞߡࠄ߆
ߦߥࠅ߹ߒߚߥ࡞ࠞ࠾ࠢ࠹ޕᡷༀὐߣߒߡࠄ߆⺆⧷ࠍ⺆⸒↪ߩ⑳ޔᣣᧄ⺆ߦߔࠆߎߣߢᤨ㑆ߩ⍴
❗ࠍ࿑ࠆߎߣޔߡߒߘޔᱷࠅߟߩ⾰ߦߣߤࠆߎߣ᧦ࠍޔઙߦ࠺ࡕࡦࠬ࠻࡚ࠪࡦ߇ౣ㐿ߐࠇ
ߚߩߢߔ߇ޔᱜ⋥ߥߣߎࠈ߇⑳ޟޔឭଏߒߚߎߣ⥄߇㑆㆑ߛߞߚߩߢߪߥ߆߁ߣޠ᳇
ᜬߜߦߥߞߡߒ߹ޔߣ߫ߨߖ߆ߣࠎߥ߽ߢࠇߘޔ߇ߔߢߩߚߞߥߦࠢ࠶࠾ࡄߚߒߣߞࠂߜޔᰴߩ
⾰ߦ⡊ࠍߌ߹ߒߚޕ
ߎߩߟߩ⾰߇ߛߞߚ߆ޔታߪ⑳ߪᱜ⏕ߥߣߎࠈࠍⷡ߃ߡ߹ߖࠎ㧔߽ߒࡔࡕߐࠇߡࠆᣇࠄ
ࠄߞߒ߾ߞߚࠄ߭ߗޔᢎ߃ߡߊߛߐ㧕⾰ߩߎޔߒߛߚޕߦᔕ߃ࠃ߁ߣ⠨߃ࠆ߁ߜߦߣߪ⑳ޔ
ߡ߽㊀ⷐߥߟߩ᳇ߠ߈ࠍᓧߚߩߢߒߚޕ
㧔㧝㧕ߘߩᣇߩᡰេߩߚߦቇౝᄖߩㅪ៤ࠍߣࠆߴߊ⹜ⴕ㍲⺋ࠍ⛯ߌߡ߈ߚ㧔ߒޔታ㓙ߦℂᗐ
⊛ߥㅪ៤ࠍ᭴▽ߢ߈ߚ㧕߇⚿ޔዪߪ⥄ಽੱߢᛴ߃ㄟࠎߢࠆߎߣޕ
㧔㧞㧕ߘߩᣇߩ⦟ߣߎࠈࠍតߔߚߩദജࠍߟߩ㑆ߦ߆ߒߥߊߥߞߡࠆߎߣޕ
㧔㧝㧕ߦߟߡߪޔቇౝᄖߩㅪ៤వߣߪߩߎޔᡰេߩࠧ࡞ߦߟߡ߈ߜࠎߣߒߞߡߥߎ
ߣ߇᳇ߠ߆ߐࠇ߹ߒߚ߅ߪࠇߎޕ߇ߐ߷ߞߡࠆߩߢߪߥߊߩߘࠈߒޔᣇ߇ߕߞߣዞ⡯ߢ߈
ߥ㧔ߥߒߪޔዞ⡯ߒߡ߽⛯߆ߥ㧕ߎߣߦߟߡߩᕟᔺߦࠃࠆ߽ߩߛߣ߁ߎߣ߇ࠊ߆ࠅ߹ߒ
ߚޕ㧔㧞㧕ߦߟߡߪߩ⺣⋧ޔೋᦼߪߩߘޔᣇߩ⿰ߦߟߡࠃߊࠍ⡞ߡߚ߽ߩߢߔ߇ߎޔ
ߎߒ߫ࠄߊߪ߶ߣࠎߤߘߩࠍߒߡ߹ߖࠎߢߒߚߥࠈࠈߪ߆ߚߞ߆ߥߒࠍߗߥޕᖱ߇
ࠆߩߢߎߎߢߪᦠ߈߹ߖࠎ߇ߩߘޔߊ߆ߦߣޔᣇߩߚ߈ߡ⟎ࠍࠬࠞࠜࡈߦޠࠈߎߣߥ߈ߢޟ
ߎߣ߇ಽ߆ࠅ߹ߒߚޕ
ߎߩ߶߆ߦߩߎޔᣇߩᡰេࠍ㧔ᣢත⠪ߢࠆߦ߽߆߆ࠊࠄߕ㧕⑳߇ߒߡࠆߎߣ߳ߩࡕ࠴ࡌࠪ
࡚ࡦߩᚲࠍ߁⾰߇ࠅߣޠޕߥࠃߥߪࠇߘޟߪᤨߩߘޔᕁߞߚߩߢߔ߇㧔ᣣᧄߢߪ߅ޔ
ߘࠄߊߘࠇࠍ⸒ߞߚࠄ߅ߒ߹⾰ߥ⊛ޔ㧕ࠍߎߘߡ߃ޔࠊࠇࠆߎߣߢޔ೨Ბߩޟᕟᔺߦޠޠ
ߟߡߩ᳇ߠ߈ࠍࠃࠅᓧࠄࠇ߿ߔ߆ߞߚߣᕁ߹ߔޕ
ߎߎ߆ࠄߪᓟᣣ⺣ߦߥࠆߩߢߔ߇ޔ㧔㧝㧕ߦߟߡߪޔㄭ߁ߜߦᡰេ㑐ଥ⠪ห჻ߢߒวࠍ
߽ߣ߁ߣᕁߞߡ߹ߔޔߚ߹ޕ㧔㧞㧕ߦߟߡߢߔ߇ߊߚߞ߹ޔὼߢߪࠅ߹ߔ߇ޔᏫ࿖⋥ᓟߩ
ߘߩᣇߣߩ㕙⺣ߢ⿰ߩ߇ߡߣߞߓߦߩߘޔ⡊ࠍߌࠆᯏળࠍᓧࠆߎߣ߇ߢ߈߹ߒߚޕ
ߘߩߣޔߡߟߦࡦ࡚ࠪ࠻ࠬࡦࡕ࠺ߩߎޔዊࠣ࡞ࡊߦಽ߆ࠇߡ⼏⺰ߒߡ߹ߒߚߪ⑳ޕ
ឭଏ⠪ߥߩߢ․ޔቯߩࠣ࡞ࡊߦߪዻߖߕࠍߩࡊ࡞ࠣߩߡోޔ⡞ߡ࿁ࠅ߹ߒߚߢߎߎޕ
⺆ࠄࠇߚౝኈߦߟߡ߽߶ߣࠎߤⷡ߃ߡߥߩߢߔ߇ޔᣣ⧷ߩᢥൻᏅߦߟߡߩ⸒߇ߞߚ߆
ߣᕁ߹ߔ߽ߦ߆߇⑳ޕᣣᧄੱ⊛ߥᔕࠍߒߡߚ߆ߤ߁߆ߪߣ߽߆ߊߣߒߡ⥄⑳ޔりߣߒߡߪޔ
ᧄᒰߦ╵߃߇ߥߊߡ㧔ࠫࡦࡑ߽ᛴ߃ߡ㧕࿎ߞߡࠆߦኻߒߡߩߘߡߞ߿߁ߤޔࠍ⍮ࠄ
ߕ⥄ߟ߆ޔりࠍഥߌࠃ߁ߣߒߡߊࠇߡࠆੱߦߔ߆㧔߹ߚ߁ߤࠍߩੱߩߘޔലᨐ⊛ߦᒁ߈ߔ
߆㧕ߣߥߚߞ߆ࠃ߫ࠇ߇⺰⼏ߩߡߟߦޔ㧔ߎࠇ߽ᓟ߆ࠄߢߔ߇㧕ᕁ߹ߒߚޕ
㧟㧚ޣታ⠌ࠍ㛎ߒߡࠆᤨࠍߣߎߥ߁ࠃߩߤޔᗵߓ߹ߒߚ߆㧫㧔ߩਛߢㅀߴߡߊߛߐߞߡ߽߆߹
߹ߖࠎ㧕ޤ
㧞㧚ߣಽߌࠆߎߣ߇ߢ߈߹ߖࠎߢߒߚޕ
㧠㧚ࠄ߆ޣ⠨߃ࠆߣ⥄ߚߥޔりߎ߁ߔࠇ߫ࠃ߆ߞߚߣ߁ߎߣ߇ࠅ߹ߔ߆㧫߽ߒࠆߣߔࠇ
߫ߘࠇߪߤ߁߁ߎߣߢ߆߁ࠂߒߢߩߚߞ߆ࠃ߫ࠇߔߦ߁ࠃߩߤޔ㧫ޤ
ߎࠇ߽ޔ㧞㧚ߢ╵߃ߡߒ߹ߞߚࠃ߁ߥ᳇߇ߒ߹ߔ߇ޔㅊ⸥ߒ߹ߔߣޔᣣᧄ⺆ߢ߽߁߹ߊߢ߈
ߚ߆ߤ߁߆ಽ߆ࠄߥߎߣߦኻߒߡߢ⺆⧷ޔ⠨߃ࠃ߁ߣߔࠆߣߔ߹ߔ߹ޔᷙੂߒߚߩߪߑࠆࠍ
ᓧ߹ߖࠎޔߡߞߣ߆ޕㅢ⸶߇ࠆߣ⦟߆ߞߚ߆ߣ߁ߣ⥄ޔߊߥ߽ߢߌࠊ߁߁ߘޔಽߩ⸒ߚ
߆ߞߚߎߣߩᩭᔃߩㇱಽ߇વࠊࠄߥࠃ߁ߦᗵߓߚ߆߽ߒࠇ߹ߖࠎޔߪࠅߚߩߎޕᣣᧄ⺆ߣ⧷⺆
ߩᕁ⠨᭽ᑼߩ㆑ߥߩ߆߽ߒࠇ߹ߖࠎ߇ߊࠃޔಽ߆ࠅ߹ߖࠎޕ
㧡㧚ߩߎޣታ⠌㛎߆ࠄឭߐࠇࠆ㗴ὐ߿⇼ὐߪߥࠎߢߔ߆㧫ޤ
ߎࠇ߽ߔߢߦ╵߃ߡߒ߹ߞߡ߹ߔ߇ࠅ➅ޔߒߦߥࠆߎߣࠍ⸵ߐࠇࠆߩߢࠇ߫⺣⋧ޔ⠪ߩࡕ
࠴ࡌ࡚ࠪࡦࠍ⋥ធ⊛ߦ߁ߎߣߩࡔ࠶࠻ߣ࠺ࡔ࠶࠻ߦߟߡޔ⠨߃ߐߖࠄࠇ߹ߒߚ⥄⑳ޕり
ߪߊߤ߭ޔᗵᖱ⊛ߦߥߞߡߒ߹߹ߒߚߒ㧔߹ࠅߦߪߡߎߥ߆ߞߚߣᕁ߹ߔ߇㧕߁߿ޔ
ߊᕁ⠨ᱛߦߥࠅ߆ߌࠆߣߎࠈߢߒߚ߇ࠇߎޕᢥൻߩ㗴߆ߤ߁߆ߪಽ߆ࠅ߹ߖࠎߩߢߩઁޔᣇߩ
ߏ⠨ኤࠍ߅ુߢ߈ࠇ߫߁ࠇߒߊᕁ߹ߔޕ
㧢㧚ߩߎޣታ⠌ߩ㛎߆ࠄߥߚ߇ቇࠎߛࡐࠗࡦ࠻ߪߥࠎߢߔ߆㧫ޤ
ߎࠇ߽㧞㧚ߦᦠߡߒ߹ߞߚߎߣߢߔ߇ࠃࠅࠃޟޔᄌൻࠍ߈ࠇࠆߚߦ⑳ߣߚߥޔޔ
ߪߎ߁ߒߡࠍߒߡࠆ߁ߣޠታᗵࠍᡰេ⠪ⵍޔᡰេ⠪㑆ߢᓧࠆߚߦߥ߁ࠃߩߤޔCEVKQPࠍ
ߎߖ߫ࠃ߆ߩߘޔ㗴ᗧ⼂߇ᓧࠄࠇߚߣᕁ߹ߔޕ
㧣㧚ߦ߆߶ޣઃߌട߃ࠆࠦࡔࡦ࠻߿⾰߇ࠇ߫ߥࠎߢ߽ߤ߁ߙޤ
࠺ࡕࡦࠬ࠻࡚ࠪࡦߦ߅ઃ߈วߚߛߚ⊝᭽ߦޔᷓߊᗵ⻢↳ߒߍ߹ߔ࠻ࠬࡦࡕ࠺ߩߎޕ
࡚ࠪࡦߩ㑆ᤨߪ⑳ޔ㑆߇ᱛ߹ߞߚᗵⷡ߇ߞߚߩߢߔ߇ޔታ㓙ߦޔળ႐ߩᤨ⸘߽ᱛ߹ߞߡߚ
ߘ߁ߢߔࠖ࠹ࠪ࠾ࡠࠢࡦࠪߩߘޕ㧔ߣ߱ߴ߈ߢߒࠂ߁߆㧫㧕߇⑳ߣߒߡߪߣߡ߽ශ⽎ᷓ߆ߞߚߢ
ߔޕ
┻ڎౝ৻⌀㧔੩ㇺᄢቇ㧕
㧝◲ޣනߥ⥄Ꮖ⚫ࠍߒߡߚߛߌࠆߣ߁ࠇߒߢߔޤ
੩ㇺᄢቇᄢቇ㒮ᢎ⢒ቇ⎇ⓥ⑼ߦᚲዻߒߡ߅ࠅ߹ߔୃޔ჻⺖⒟ੑᐕߩ┻ౝ৻⌀ߣ↳ߒ߹ߔኾ㐷ߪᢎ
⢒ᔃℂቇ⚻ߦ․ޔ㛎ߩવᛚࠍ࠹ࡑߦવ⛔⧓⢻߿᳃ଶ⧓⢻ߩᏧඅߩᜰዉࠍ࠽࠹ࠖࡧࠕࡊࡠ࠴
ߩⷞὐ߆ࠄಽᨆࠍ߅ߎߥߞߡ߹ߔޕ
㧞ޣᣣߩታ⠌ߢߤߩࠃ߁ߥߎߣ߇ߎࠅߥ߁ࠃߩߤߪߚߥޔ㛎ࠍߒ߹ߒߚ߆ޕ
HKTUVRGTUQPPCTTCVKXGߩᒻᑼࠍ↪ߡᤨ߫ࠇ߈ߢޔ㑆ࠍㅊߞߡ⸥ㅀߒߡߊߛߐޤ
ᦨೋߦ⺑ߩ࠽ࠖ࠺ࡦ࠼ࡦࡠޔࠍ&T0GKN,CEMUQPࠃࠅߚߛ߈߹ߒߚޕᣢߦߎࠇ߹ࡔ
ࡦࠣࠬ࠻ߥߤߢᖱႎࠍߚߛߡ߅ࠅ߹ߒߚࠃ߁ߦޔ.QPFQP&GCPGT[ߣ߁႐߇කᏧ߿ࠞ࠙ࡦ
ߥߤߦኻߔࠆතᓟ⎇ୃࠍⴕߞߡࠆ႐ߛߣ߁⼂ߪߞߚߩߢߔ߇ޔ0GKNవ↢ߩߏ⺑ߦ
ࠃࠅතᓟ⎇ୃߛߌߢߥߊ⺞ޔᩏ߿(&ߥߤ߽ⴕ߁ㇱ㐷ߢ߽ࠅ⥃ߦ࡞࠲࠻ޔᐥක㧔ኅ㧕ߩᚑ㐳ࠍଦ
ߔ႐ߢࠆߣ߁ߎߣ߇⏕ߢ߈߹ߒߚޕ
⛯ߡ࠽ࡠޔవ↢ࠃࠅࠢ࠴ࡖ߇ࠅ߹ߒߚ࠽ࡠޕవ↢ߩࠢ࠴ࡖߢߪ․ߦޟᄌൻ
ࠍଦߔߪࡧࠖ࠹࠽ߦߚޠ㊀ⷐߢࠆߣ߁ߎߣ߇㕖Ᏹߦශ⽎ߦᱷࠅ߹ߒߚߥ߁ࠃߩߘޕᄌൻࠍ
ଦߔߚߦߤࠇߛߌࠢࠗࠕࡦ࠻ߩ‛⺆ߦ㑐ᔃࠍะߌޔᴚߒ⥃ࠍߣߎ߁ߣ߆ࠆߡߒ㉼⸃ޔᐥ
ኅߩ࠽࠹ࠖࡧࠦࡦࡇ࠹ࡦࠬߣ߮ࠍࠬࡦ࠹ࡇࡦࠦࡧࠖ࠹࠽ߩߎޔ㜞ࠆߎߣߦࠬࡄࡧ
࡚ࠖࠫࡦߩਛᔃ߇ࠆߣ߁ߩ߇ࡠ࠽వ↢ߩਥᒛߢߞߚߣ⸥ᙘߒߡ߅ࠅ߹ߔޕ
ߎߩࠢ࠴ࡖߩᓟߢੑੱ৻⚵ߣߥߞߡࡠ࠽వ↢ߩ⻠⟵ࠍᝄࠅࠅࠆߔ⺰⼏ޔ႐߇ਈ߃ࠄࠇ
ߚߩߢߔ߇ߢߎߎޔᄢ߈ߊ㗴ߣߥߞߚߩ߇ࡧࠖ࠹࠽ޟ㧔ࠆߪ࠽࠹ࠖࡧࠦࡦࡇ࠹ࡦࠬ㧕
ߣ߁ⷞὐࠍࠇࠆߎߣߢߎࠇ߹ߢߩ⥃ᐥߩᛛᴺߣታ〣㕙ߢߤߩࠃ߁ߦᄌࠊࠆߩ߆߁ߣޠὐߢߒ
ߚߩߎޕὐߦߟߡᢪ⮮వ↢߿ઁߩࡈࡠࠕߩᣇ߆ࠄ⦡ߥޘᗧ߇߇ࠅ߹ߒߚ߇⾰ޟߦ․ޔߔࠆޠ
ߣ߁ὐࠍ㊀ⷞߔࠆߩ߇ࠍࡧࠖ࠹࠽ޔขࠅࠇࠆ㓙ߩታ〣㕙ߢߩᄢ߈ߥᄌൻߢޔᣣᧄߣ⧷࿖ߢߪ
⁁ᴫ߇㆑߁ߚߦ৻ޔߦޟᓥ᧪ߣߤ߁㆑߁߆╵߅߁ߣ߆ߥߪߢߩߥࠇࠄ߃╵ߪߩ߁ߣޠ
߃ࠍߚߛ߈߹ߒߚޕ
࿁ߩታ⠌ߡߒߘޔᓟᣣⴕࠊࠇߚ&T*CNRGTPߦࠃࠆ⊒ࠍㅢߓߡᗵߓߚߎߣߢߪࠆߩߢߔ߇ޔ
⾰ޟߔࠆࠍࠅ⺆ߦ߆ޟߪࠆޠᒁ߈ߔ߆ߦߣߎ߁ߣޠᒝᗧ⼂ࠍ߽ߞߡ⥃ᐥኅߩᜰዉߦ
ᒰߚߞߡࠆߣ߁ߎߣ߇∩ᗵߐߖࠄࠇ߹ߒߚޕ㧔ᣣߩ&T*CNRGTPߪࠢࠗࠕࡦ࠻ߦኻߒߡߤ
ߩࠃ߁ߥ⾰ࠍߔࠆߩ߆ߣ߁ߎߣߦߟߡὶὐࠍᒰߡߡ⊒ߐࠇߡࠄߞߒ߾߹ߒߚ㧕
ᤤ㘩ࠍߪߐࠎߢ߇ߩߚࠇࠊⴕޔศ᳗వ↢ߣ&T*CNRGTPߦࠃࠆ⥃ᐥ⊛㕙ធߢߒߚߪߡߟߦ⚦ޕ
ศ᳗వ↢ߦవߦㅍߞߡߚߛ߈߹ߒߚࡔ࡞ߦᦠ߆ࠇߡ߅ࠅ߹ߔ߇ߥ߁ࠃߩߤޔౝኈ߇ߒวࠊࠇ
ߚߩ߆ߣ߁ߎߣߦ㑐ߒߡߪࡊࠗࡃࠪ⼔ߩ㑐ㅪ߆ࠄᏅߒប߃ߐߖߡߚߛ߈ߚߣᕁ߹ߔޕ
ᒻᑼߣߒߡߪศ᳗వ↢߇ࠢࠗࠕࡦ࠻&ޔT*CNRGTP߇⥃ᐥኅ࠽ࡠޔవ↢߇ࠬࡄࡃࠗࠩޔ
ߘߒߡߘࠇࠍߡࠆᚒޘෳട⠪ߣ߁ᒻߢ⥃ᐥ㕙ធ߇ㅴⴕߒߡ߈߹ߔޔߡߒߘޕศ᳗వ↢ߩᖠ
ߺ㧔㗴㧕ߦኻߒߡ&ޔT*CNRGTP߇⡞߈⾰ޔࠍߔࠆ&ߡߒߘޕT*CNRGTP߇࿎㔍ߥ⁁ᴫߦ㒱ߞߚߣ
߈߿㗴ࠍᗵߓߡࠆߣ߈ߦࡠ࠽వ↢ߦ⾰ࠍߒ࠽ࡠޔవ↢ߪ&T*CNRGTPߩ㗴ߦኻߒߡ
ࠕ࠼ࡃࠗࠬࠍㅍࠅߩߘޔߡߒߘޔ㗴߇ෳട⠪ߣߒߥߊߡߪߌߥࠃ߁ߥ߽ߩߢࠇ߫ޔෳ
ട⠪ߦ⥄ࠄߩᗧࠍવ߃ߚ߁߃ߢޔวᗧࠍขࠈ߁ߣߔࠆߣ߁ෳട⠪ߣ⥃ᐥኅߩ㑆ߦࠆሽߣߒ
ߡᯏ⢻ߒߡ߅ࠅ߹ߒߚޕ
ߒวߩᦨਛߦᗵߓߚߎߣߪޔศ᳗వ↢߇ᣣᧄ⺆ࠍߒࠍࠇߘޔౝ⮮వ↢߇⠡⸶ߒ&ޔT*CNRGTP
߇ߘࠇࠍ⡞ߊ&ޔߦࠄߐޕT*CNRGTP߇ߒߚౝኈࠍౝ⮮వ↢߇⠡⸶ߒޔศ᳗వ↢߇⡞ߊߣ߁ᒻߢ
ߞߚߚᤨޔ㑆߇߆߆ࠆഀࠅߦ㗴߇ㄝࠍߐ߹ࠃߞߡࠆࠃ߁ߥᗵߓࠍฃߌ߹ߒߚߩߎޕ㕙ធ
ߦ⚳ࠊࠅߪߊࠆߩߛࠈ߁߆ߣ߁ߎߣ߿ᤨޔ㑆ߩഀࠅߦㅴࠎߢߥࠃ߁ߦᗵߓࠆ㕙ធߦኻߒߡਇ
ߩࠃ߁ߥ߽ߩࠍᗵߓࠆߎߣߦߥࠅ&ޔT*CNRGTPߩߖࠅߩࠃ߁ߥ߽ߩࠍᗵߓߚߎߣࠍⷡ߃ߡ߹
ߔޕ
ߚߛߒߥ߁ࠃߩߘޔวߩਛߢ߽&T*CNRGTP߇ᔀᐩߒߡߦߎߛࠊࠅޔ᭽ⷺߥޘᐲ߆ࠄ⾰
ࠍⴕ࠽ࡠߦᤨޔవ↢ߦᡰេࠍ᳞ޔߣ߆ߒߡศ᳗వ↢ߩ㗴ߩࠦࠕߦㄼࠈ߁ߣߔࠆᆫ߇
ߪߞ߈ࠅߣࠇߡ߹ߒߚޕ㕙ធ߇ṛߞߡࠆࠃ߁ߥශ⽎ࠍ⏕߆ߦฃߌ߹ߒߚ߇ߩߘޔᔀᐩߒߡ⾰
ߔࠆߎߣߦߎߛࠊࠅޔ߆ࠍߒઃߌߚࠅޔᒝᒁߦ㕙ធࠍ⚳߃ࠃ߁ߣߪߒߥᆫߦࡠ࠽వ
↢߇ᦨೋߦ߅ߞߒ߾ߞߡߚߚࠍߩ߽߁ߣޠࠬࡦ࠹ࡇࡦࠦࡧࠖ࠹࠽ޟޔ᳇߇ߒ߹ߒߚޕ
ᦨ⚳⊛ߦߪ&T*CNRGTP߇ࡠ࠽వ↢ߣߒวࠍ߽ߜ࠽ࡠߡߒߘޔవ↢߇ෳട⠪ߦኻߒߡ
ߎࠇߢ⚳ࠊࠅߦߒࠃ߁ߣ߁วᗧࠍขߞߚߢ&ޔT*CNRGTP߆ࠄੑߟߩ⾰߇ศ᳗వ↢ߦኻߒߡ
߆ߌࠄࠇߩߘޔߦศ᳗వ↢߇╵߃ࠆߎߣߢ㕙ធߪ⚳ࠊࠅ߹ߒߚޕ
⚂㧠㧜ಽ߶ߤⴕࠊࠇߚ㕙ធߩᓟޔਃੱߏߣߩࠣ࡞ࡊߦಽ߆ࠇߡޔ㕙ធࠍ⹏ଔߒ⾰ߥ߁ࠃߩߤޔ
߇ශ⽎ߦᱷߞߚ߆ߣ߁ߎߣߦߟߡߒ߁ᤨ㑆߇ਈ߃ࠄࠇ߹ߒߚޕਃੱߩࠣ࡞ࡊߩਛߦᔅ
ߕ৻ੱߪකᏧ߇ࠆࠃ߁ߦߣ߁ࡠ࠽వ↢ߩᜰ␜ߩరߪ⑳ޔਛᎹవ↢᧻ޔ᎑వ↢ߣ߁ਃੱߩ
ࠣ࡞ࡊߩਛߢ⼏⺰ࠍⴕ߹ߒߚޕ
ߘߩਛߢޔᣣᧄ⺆ߣ⧷⺆ߣ߁⸒⪲߇㆑߁ਛߢⴕࠊࠇߚ㕙ធߩਛߢޔㅢ⸶ߣ߁ሽࠍߔࠆߎ
ߣߢଦߐࠇߚ᳇ߠ߈߇ߞߚߣ߁ᗧ߿࠽࠹ࠖࡧࠍࡌࠬߦߔࠆ߆ࠄߎߘߩ⪲⸒ޔሽ߇ߒ
ࠈ㗴ߣߥߞߡߒ߹ߞߚߩߢߪߥ߆ߣ߁᭽ߥޘᗧ߇ߡ߈߹ߒߚߦ․ޕਛᎹవ↢߇ઔߞߡ߅
ࠄࠇߚޟޔౝ⮮వ↢ߣ߁ㅢ⸶ߩሽ߇߅ࠄࠇߚߎߣߢޔศ᳗వ↢ߩਛߢ࠲ࡦ߇ߎߞߚ߹ߟޔ
ࠅޔ᳇ߠ߈߇ଦߐࠇߚߩߢߪߥ߆ⷞ߁ߣޠὐߪ⑳⥄りߦߪోߊߥߊޔࠈߒޔṛᗵߛߌ߇ศ
᳗వ↢ߩᱷߞߡߚߩߢߪߥ߆ߣᗵߓߡߚ⑳ߦߣߞߡߣߡ߽ᢾᣂߥⷞὐߦᗵߓ߹ߒߚ⚿ޕᨐߣ
ߒߡᓟߦศ᳗వ↢ߩᗵᗐߣߒߡ᭽ߥޘ᳇ઃ߈߇ߞߚߎߣࠍෳട⠪ߩ೨ߢ߅ߞߒ߾ߡ߅ࠅޔਛᎹవ
↢ߩⷞὐߩ㍈ߐߦᗵགྷߒߚߎߣࠍⷡ߃ߡ߹ߔޕ
ੱ⊛ߦߪ࿁ߩ㕙ធ߇ߩ⪲⸒ߦ߈ߣߚࠇࠊⴕߢޠ࠼ࠬࡌࠬࡦ࠺ࡆࠛޟ㗴ߪᨐߚߒߡ㗴
ߣߥߞߚߩߛࠈ߁߆ߣ߁ߩߪߣߡ߽᳇ߦߥߞߚὐߢࠅ߹ߔޠ࠼ࠬࡌࠬࡦ࠺ࡆࠛޟޔߒ߽ޕ
ߢࠇ߫ޔ㕙ធߪᭂ┵ߥ႐วޔᢙሼߣ⸥ภߩࠃ߁ߥ߽ߩߩ߆ߟߊߡߒߘޔන⺆ߛߌߢࠃߊ⪲⸒ޔ
ߩ⠡⸶ߪ߶ߣࠎߤ㗴ߦߥࠄߥ߆ߣ߅߽߹ߔ৻ޕᣇޔ߫ࠇߢޠ࠼ࠬࡌࡧࠖ࠹࠽ޟޔ
ߦߎߛࠊࠆߣ߁ᆫࠍᜬߜ⛯ߌࠆߚޔᒰ⠪ߩ⸒⪲ࠍߞߡ⾰ࠍߒߚࠅߥࠄ߆ࠊߊࠃޔ
⸒⪲ߦߟߡࠃࠅᷓߡߊߚߦࠍ⊒ߔࠆߣ߁ߎߣ߇ࠆߩߢߒࠂ߁⸒ߩߘޔߚߩߘޕ
⪲߇ㅢ⸶ߩ㗴ߥߩ߆ޔ߽ߣࠇߘޔศ᳗వ↢⥄りߩ㗴ߥߩ߆߆ߟߊ߁ߣߤߥޔㅢᏱߩ㕙ធ
ߣߪ㆑߁ࠗࠡࡘߥ㗴߇ߡ߈ߚߚ&ޔT*CNRGTPߦߣߞߡߪ࿎㔍ߐࠍᗵߓߚߩߢߪߥ߆
ߣᕁߞߡ߅ࠅ߹ߔޕ࿁ߩ㕙ធߩࠃ߁ߦౝ⮮వ↢ߣㅢ⸶ࠍߒߚ㕙ធߛ߆ࠄߎߘࡧࠖ࠹࠽ޟޔ
ࡌࠬ࠼⥝ߩޠᷓ㕙߇ࠇߚࠃ߁ߥᗵߓ߇ߒ߹ߒߚޕ
ࠣ࡞ࡊߏߣߦߢߚᗧࠍ⊝ߢߔࠆߚߦߒޔวࠊࠇߚౝኈࠍ⊒ߒ&ޔߡߒߘޔT*CNRGTP
ศ᳗వ↢ߣ߁ᒰ⠪ߩᣇߩࠄ⥄߽ࠄ߆ޘᗵᗐࠍߔߣ߁႐߇⸳ߌࠄࠇ߹ߒߚޕవߦ߽⸥ߐߖߡ
ߚߛ߈߹ߒߚ߇ޔศ᳗వ↢ߩᗵᗐߣߒߡޟ㕙ធࠍฃߌߡࠆᦨਛߦᤨ㑆߇ṛߞߡࠆࠃ߁ߥශ⽎
ߪోߊή߆ߞߚ⥄ߪߦ⊛⚳ᦨޕಽߩਛߢ᳇ઃ߈߇ࠅߩߎޔ㕙ធࠍฃߌߚߎߣࠍᗵ⻢ߒߡࠆߣޠ
߁⸒⪲㧔ᱜ⏕ߢߪߥߩߢ㑆㆑ߞߡߚࠄ↳ߒ⸶ࠅ߹ߖࠎ㧕ߦߪᱜ⋥ޔ㛳߈ࠍᗵߓ߹ߒߚߎޕ
ߩศ᳗వ↢ߩ⊒⸒ࠍㅢߒߡ⥃߽ߒߕࠄߥ߆ޔᐥኅ㧔&T*CNRGTP㧕ߦߣߞߡᚑഞߒߚߣᕁ߃ࠆࠃ߁ߥ
㕙ធߢߥߊߡ߽ߢߎߘޔࠍ⊒ߖࠄࠇߚࠢࠗࠕࡦ࠻ߦߣߞߡߪߥࠎ߆ࠄߩ᳇ઃ߈ࠍ߽ߚࠄߔน
⢻ᕈࠍߔࠆߩߛߥߣᗵߓߚߎߣࠍⷡ߃ߡ߅ࠅ߹ߔޕ
ᦨᓟߦࡠ࠽వ↢߆ࠄߩ߅⸒⪲ࠍߚߛߚߢᧄޔᣣߩታ⠌ߪ⚳ੌߚߒ߹ߒߚޕ࿁ߩታ
⠌ోࠍㅢߓߡߣࡦࠪࠖ࠺ࡔ࠼ࠬࡌࡧࠖ࠹࠽ߚߞ߆ߥߩߣߎߛࠎ⺒߆ߒߢᧄߢ߹ࠇߎޔ
߁ߩ߇ߤߩࠃ߁ߦታ㓙ߦⴕࠊࠇߡࠆߩ߆ߩߘޔߡߒߘޔ⠨ኤߩᷓߐߦୟߐࠇߚ৻ᣣߢߒߚޕ
ᤓᐕޔ੩ㇺᄢቇߢᢪ⮮వ↢߇࡞ࡂࡦࠣޟᢎߩ‛⺆ක≮⻠ᐳࠍޠขࠅߍߡߊߛߐߞߚߩߢ
ߔ߇߁ߣࠬࡦ࠹ࡇࡦࠦࡧࠖ࠹࠽ߪ߈ߣߩߘޔᔨ߿ޟ⡞ߊߩߣߎޠ㊀ⷐᕈ㧔ࠫࡖࠬ࠻ࠬ
࠾ࡦࠣ㧕ߥߤߦߟߡṼὼߣࠊ߆ߞߚࠃ߁ߥߥ߁ࠃߥࠄ߆ࠊޔ⢷ߩਛߦ߃ࠆࠃ߁ߥ߽ߩ߇ߞ
ߚߎߣࠍߢ߽ⷡ߃ߡ߅ࠅ߹ߔޕ
ߒ߆ߒޔ࿁৻ޔㅪߩታ⠌ࠍฃߌߡߊਛߢ߆ߦᖚ⠪ߩ‛⺆ߦ⡊ࠍߌߡࠆߩ߆ޔߡߒߘޔ
ᖚ⠪ߩ‛⺆ࠍᒁ߈ߔߚߦߤߩࠃ߁ߥᎿᄦࠍߒߡࠆߩ߆ߣ߁ߎߣࠍᒝߊᗵߓࠆߎߣ߇ߢ߈߹
ߒߚޟߪࠣࡦ࠾ࠬ࠻ࠬࡖࠫߣࠆߔ߽߿߿ޕ⡞ߊߎߣߛߌߒ߆ߒߥ⪲⸒ߥࡧࠖ࠹ࠟࡀ߁ߣޠ
ߦ߽ฃߌขࠇ߹ߔ߇࠽ࡠޔవ↢߿&T*CNRGTP߇ታṶߒߡߊߛߐߞߚߎߣߪޔߒߡߚߛṼὼߣ
ᖚ⠪ߩ⺆ࠅߦ⡊ࠍߌࠆߛߌߢߥߊޔࠈߒޔᖚ⠪ߩ⺆ࠅߦࠅㄟߺߦࠄߐޔ㗴ߩࠦࠕߣߥࠆㇱ
ಽ߳ߣࠆߚߦ⾰ࠍߒ⾰ߩߘޔߦኻߔࠆࠢࠗࠕࡦ࠻ߩ╵߃ߦߐࠄߦ⾰ࠍ㊀ߨࠆߣ߁ޔ
ࠗࡦ࠲࡚ࠢࠪࡦࠍ೨ឭߣߔࠆࠃ߁ߥޟ⡞ߊⴕ߁ߣޠὑߢࠆߎߣࠍᗵߓࠅ߹ߒߚޕ
หᤨߦޟߩߎޔ⡞ߊⴕ߁ߣޠὑ߇ߒߡ৻㐳৻⍴ߢりߦߟߊࠃ߁ߥᛛⴚߢߪߥߊޔᖚ⠪ߩ⢛᥊
ߦ߇ࠆߩ߆ޕ߇ࠢࠗࠕࡦ࠻ߦߣߞߡ㗴ߢࠆߩ߆⸃߫ࠇߔ߁ߤޔߢ߈ࠆߩ߆ߥߤߣ
߁ⶄᢙߩ㗴ߦ⋡ࠍ㈩ࠅߥ߇ࠄ߽ޔᓢߦޘ㗴ߩࠦࠕ߳ߣㄼߞߡߊ㜞ᐲߥⴕὑߢࠆߎ߁ߣޔ
ߣ߽หᤨߦᗵߓߚᰴ╙ߢߔޕ
㧠㧚ࠄ߆ޣ⠨߃ࠆߣ⥄ߚߥޔりߎ߁ߔࠇ߫ࠃ߆ߞߚߣ߁ߎߣ߇ࠅ߹ߔ߆㧫߽ߒࠆߣߔࠇ
߫ߘࠇߪߤ߁߁ߎߣߢ߆߁ࠂߒߢߩߚߞ߆ࠃ߫ࠇߔߦ߁ࠃߩߤޔ㧫ޤ
ᄙߊߩ႐ߦ߅ߡ⥄ಽ⥄りߩ⧷⺆⢻ജߩૐߐ߇㗴ߣߒߡ∩ᗵߔࠆ߽ߩ߇ࠅ߹ߒߚޔ߫߃ޕ
࿁&ޔT*CNRGTPߦࠃࠆࠞ࠙ࡦࡦࠣ߇ⴕࠊࠇ߹ߒߚ߇ੱࠆߖ߇⺆⧷ߌߛࠆ߈ߢޟ߽ᤨߩޔ
߇ᦸ߹ߒ߁ߣޠᜰ␜߇ᦨೋߦࡠ࠽వ↢ࠃࠅࠅ߹ߒߚ⚿ޕᨐޔศ᳗వ↢৻ੱߛߌ߇ࠞ࠙ࡦ
ࡦࠣࠍ⇼ૃ㛎ߔࠆߣ߁ᒻߦߥࠅ߹ߒߚ߇ૃ⇼ߩࠣࡦࡦ࠙ࠞߥ߁ࠃߩߎޔ㛎ߪᧄ᧪
㧟㧠ੱ⒟ᐲߢ߿ߞߡࠆࠃ߁ߢ┙߁ߣ߆ߥߪੱࠆ߿߆⺕߽ߦઁޔ⠪ࠍߞߡ߅ࠅ߹ߒ
ߚ⥄ޕಽ⥄りߥ߁ࠃߩߎޔᯏળࠍ↪ߒߡࠍࠣࡦࡦ࠙ࠞ߇ࠄ⥄ޔฃߌࠬߦ߁ࠃߩߤ߇ࠇߘޔ
ࡄࡃࠗࠩߣߩ㑆ߢ߿ࠅขࠅߐࠇࠆߩ߆ߣ߁ߎߣߪߗ߭⍮ࠅߚߣᕁ߹ߒߚ߇ߩ⺆⧷ޔ⢻ജ
⊛ߥ㗴߆ࠄㄉㅌߖߑࠆࠍ߃ߥߥߣޔᕁ߹ߒߚޕ
㧣㧚ߦ߆߶ޣઃߌട߃ࠆࠦࡔࡦ࠻߿⾰߇ࠇ߫ߥࠎߢ߽ߤ߁ߙޤ
࿁ߩታ⠌ߪᧄᒰߦᥦ߆᱑ㄫߩⓨ᳇ߩర⚳ޔᆎ৻⽾ߒߡㅴࠄࠇ߹ߒߚޕḰߦߪ⋧ᒰߩᤨ㑆
ߣߘߒߡ᳇㆜ࠍߚߛߚߎߣߪ㑆㆑ࠅ߹ߖࠎᧃޕየߦߥࠅ߹ߔ߇࠽ࡠޔవ↢ࠍߪߓ
ߣߔࠆࡠࡦ࠼ࡦ࠺ࠖ࠽ߩ⊝᭽ߦߪෘߊᗵ⻢ߩᗧࠍㅀߴߐߖߡߚߛ߈ߚߣᕁ߹ߔᧄޕ
ᒰߦࠅ߇ߣ߁ߏߑ߹ߒߚޕ
┻ڎኅ৻⟤㧔੩ㇺᄢቇ㧕
㧝◲ޣනߥ⥄Ꮖ⚫ࠍߒߡߚߛߌࠆߣ߁ࠇߒߢߔޤ
੩ㇺᄢቇᄢቇ㒮ᢎ⢒ቇ⎇ⓥ⑼ඳ჻ᓟᦼ⺖⒟ ᐕߩ┻ኅ৻⟤ߣ↳ߒ߹ߔޕኾ㐷ߪ↢ᶦ⊒㆐ᔃℂቇߢޔ
߿߹ߛࠃ߁ߎవ↢ߩߏᜰዉࠍ⾦ߞߡ ᐕ⋡ߦߥࠅ߹ߔޕᣣ߹ߢޔਇᅧᴦ≮ࠍฃߌߡ߽ሶߤ߽ࠍᜬ
ߡߥ߆ߞߚᅚᕈߚߜ߇⚻ߩߘޔ㛎ࠍߤߩࠃ߁ߦᗧߠߌޔᕁឬߡߚੱ↢‛⺆ࠍ༚ᄬߒߚᓟޔ
ߤߩࠃ߁ߦᣂߒ‛⺆ࠍ⚜߉ߒߡߊߩ߆ߦߣߎ߁ߣޔ㑐ᔃࠍᜬߞߡ࠽࠹ࠖࡧ⎇ⓥࠍ⛯ߌߡ
ෳࠅ߹ߒߚޕ࿁ߪޔකᏧߢ߽⥃ᐥኅߢ߽ߥߎߩ⑳߇ޔ0CTTCVKXG5MKNNUHQT%NKPKECN6GCEJGTU
ߣ㗴ߔࠆ 95 ߦߟߡߌࠆߩߛࠈ߁߆ߣ߁৻ߩਇߣࠍࠇߎޔ㛎ߔࠆߎߣߢ⑳⥄りߦߤߩࠃ
߁ߥᄌൻ߇ߎࠆߩߛࠈ߁߆ߣ߁ࡢࠢࡢࠢߔࠆࠃ߁ߥᦼᓙࠍᛴ߈ߟߟޔ95 ߦෳടߐߖߡߚߛ߈
߹ߒߚޕ
㧞 ޣᣣߩታ⠌ߢߤߩࠃ߁ߥߎߣ߇ߎࠅߥ߁ࠃߩߤߪߚߥޔ㛎ࠍߒ߹ߒߚ߆ޕ
HKTUVRGTUQPPCTTCVKXGߩᒻᑼࠍ↪ߡᤨ߫ࠇ߈ߢޔ㑆ࠍㅊߞߡ⸥ㅀߒߡߊߛߐޤ
ඦ೨ਛߪ &T.CWPGT ߦࠃࠆࠢ࠴ࡖ߇ࡔࠗࡦߢߒߚ⧷ޔߕ߹ޕ࿖ߩක≮ࠪࠬ࠹ࡓ߿කቇᢎ⢒╬
ߦߟߡ◲ẖߥߏ⺑߇ࠅ ߡ⛯ޔ0CTTCVKXG/GFKEKPG ߳ߣዉ߆ࠇ߹ߔᦨޕೋߦ⑳߇ᔃᗖ߆ࠇߚ
ߩߪޔ%QPXGTUCVKQPUKPXKVKPIEJCPIG ߣ߁ࡈ࠭ߢߔޟޕᄌൻࠍࠗࡦࡃࠗ࠻ߔࠆળߞߡ㧫ޠ
ߣ⥝ᵤߚߒߢޘ㧔ߎߩ 95 ߢߪෳട⠪ߩᔃࠍ㣐ឞߺߦߔࠆࠃ߁ߥޔ߿⪲⸒ߥ࠴࠶ࡖࠠࠆࠁࠊޔ
⛗߿౮⌀ޔᤋ߇ߜߎߜߦដߌࠄࠇޔ㧝ᣣࠍㅢߒߡ㕖ᏱߦᏁߺߥṶ߇ᣉߐࠇߡࠆߣᗵߓ߹
ߒߚ㧕ޕ
&T.CWPGT ߩਥᒛߪᐞߟ߆ࠅ߹ߒߚ߇ࠍ࠻ࠢࡄࡦ߽ࠗᦨߦ⑳ޔਈ߃ߚߩߪޔ#UVQT[VJCVJCU
EQJGTGPEGCPFWUGHWNPGUUHQTVJCVRCVKGPVCVVJCVOQOGPV ߣ߁߽ߩߢߒߚޟߦ․ޕᖚ⠪ߦߣ
ߞߡߩ⽾৻ޠᕈߣലᕈߣ߁ὐ߇⥝ᷓߊࠍࡧࠖ࠹࠽ߪࠇߎޔࠅᚲߣߒߡߘߩੱߩ⚻㛎ߩᗧ
ߠߌࠍℂ⸃ߒࠃ߁ߣߔࠆ㓙ߩࠅ⺆ޟޔᚻߦߣߞߡߩߣߒ╬ߦޠᗵߓ߹ߒߚޕቴⷰ⊛ߦߪޔ⍦⋫
ߛࠄߌߢᷙᴋߣߒߡ⣂⛊ߩߥ⺆ࠅߢ߽ࠅ⺆ޔᚻߩᢥ⣂ߦ߅ߡߪ৻⽾ᕈ߇ࠅ߇╭ޔㅢߞߡࠆ
ࠤࠬߪዋߥߊߥߣᕁࠊࠇ߹ߔޕ⡬߈ᚻߦߣߞߡ㕖৻⽾⊛ߢ‛⺆߇⎕✋ߒߡࠆߣߒ߆ᕁ߃ߥ
႐ว߇ߣߎ߁ߣޔ߆ߩߥ߃ࠅ⺆߆ߒߦ߁ࠃߩߘߗߥޔ߇ߣߎߩߘࠈߒޔ㊀ⷐߢߐ߃ࠆߣ߽
⠨߃ࠄࠇ߹ߔߩࡘࡆ࠲ࡦࠗޔߪ⑳ߡߞࠃޕ႐ߢ߽࠹ࠢࠬ࠻ಽᨆߩ႐ߢ߽ࠆ߈ߢޔ㒢ࠅ⺆ࠅᚻߩり
ߦߥߞߡࠍ⺆‛ߩੱߩߘޔℂ⸃ߒࠃ߁ߣദߡ߈߹ߒߚઁޕᣇޔක≮ߩ႐ࠍ⠨߃ߡߺ߹ߔߣޔකᏧ
ߦޟᖚ⠪ߦߣߞߡߩ⌒߁ߣޠᏅߒߢ߽ߞߡ⺆ࠅࠍ⡬ߡ߽ࠄ߃ࠆߎߣߪޔᖚ⠪߿ᖚ⠪ߩኅᣖߦߣ
ߞߡߪޔᄢᄌ㔍ᐘߖߥߎߣߢߔ㧔߽ߣࠃࠅ⑳ߪකᏧߩ⚻㛎ߪࠅ߹ߖࠎ߇ޔᖚ⠪߿ߘߩኅᣖߣ
ߒߡߩ⚻㛎ߪࠅ߹ߔ㧕߇⑳ޔߌࠊࠅߣޕ㛎ߒߚਇᅧᴦ≮ߩ႐ߢߪޔㅢᏱߩ∛ޟ᳇ߥ߁ࠃߩޠり
⊛⧰∩ࠍ߁∝⁁߇㗼ൻߒߡߥߚ㧔ᴦ≮ࠍᣉߐࠇߚᓟߢߪ㗫❥ߦ㗼ߒ߹ߔ߇㧕ߩߘޔ
⌒Ꮕߒߪ㕖Ᏹߦ㊀ⷐߢࠆߣᕁࠊࠇ߹ߔ߇ޔታߦߘߩ⌒Ꮕߒߦળ߁ߎߣߪ⒘ߢࠅޔߦකᏧ
߇ᜬߜ߃ߡߚߣߒߡ߽ޔකᏧߩ೨ߢᖚ⠪߇⌀ޟᗧߒࠍޠ㔍⁁ᴫ߇ࠅ߹ߒߚ㧔ᖚ⠪⥄り߇ߘ
ࠇࠍᄬߞߡߒ߹߁߇⺆‛ޔකᏧਥዉߢዷ㐿ߔࠆߥߤ㧕ޕ
95 ߩਛߢߚ⸒⪲ߢߪޔ㕖Ᏹߦታ〣⊛ߥⷰὐ߆ࠄ SWGUVKQPKPI ߣ߁⸒⪲߇ශ⽎ߦᱷࠅ߹ߒߚޕ
⑳߇ⴕߞߡࠆࠗࡈࠬ࠻ࠗࡦ࠲ࡆࡘߢߪࠅ⺆ࠍ⺆‛ޔᚻߦᆔߨ⺆ߥ↱⥄ߌߛࠆ߈ߢޔ
ࠅࠍ᳞߹ߔޕή⺰߇⺆‛ޔṛࠆࠃ߁ߥ႐วߦߪౕޔ⊛ߥ⾰ࠍߒߡ⺆ࠅࠍᒁ߈ߔᎿᄦߪߒ߹
ߔ߇ޔᚢ⇛⊛ߦ⾰ࠍ㊀ߨߡߊߎߣߪࠅ߹ߖࠎޕೋ߆ࠄዉ߈ߒߚኻ⽎߇ࠆ႐วߪޔ
㧔ඨ㧕
᭴ㅧ⊛ߥ㕙ធߦߒ߹ߔ৻ޕᣇ 0CTTCVKXGOGFKEKPG ߦ߅ߡߪޔ㗴ߦኻߔࠆᣂߒℂ⸃ࠍតߔߚ
ߦ⾰ࠍߒߡߊߣ߹ߔޕᚢ⇛⊛߆ߤ߁߆ߪಽ߆ࠅ߹ߖࠎ߇ ߩߢߎߎޔSWGUVKQPKPI ߪޔ⠨߃
ࠆߚߩ⾰ޔ⡬ߊߚߩ⾰ߣߐࠇ⚿ޔᨐ⊛ߦ⸃㉼ XU⡬ߣ߁ੑ㗄ኻ┙ࠍਸ਼ࠅ߃ࠆᚻᴺߦ
ߥࠅᓧࠆߩߛߘ߁ߢߔޕਔ⠪ߩᏅ⇣ߪޔ߇ੱߩߘࠆ⺆ߢޠߎߎ́߹ޟޔ㗴ࠍᛴ߃ߡࠆ߆ุ߆
ߩ㆑ߦࠃࠆ߽ߩߣᕁࠊࠇ߹ߔ⎇ࡧࠖ࠹࠽ߩ⑳ޕⓥߦ߅ߌࠆ⺆ࠅᚻߩᄙߊߪޔ㗴ࠍਸ਼ࠅ߃ߚ
ᓟߢ⚻ߩߘޔ㛎ࠍ߰ࠅࠆੱࠅ⺆ߪ⑳ޕߔߢޘᚻߦነࠅᷝ߁ߛߌߢޔ㗴ߩ⊒߿⸃ࠍេഥߔࠆ
ࠊߌߢߪࠅ߹ߖࠎ ߒ߆ߒޕ0CTTCVKXGOGFKEKPG ߩ⺆ࠅᚻߪޔ࠻ࡦࠛࠗࠢޔࠫࠗࡃࡄࠬޔ
ᖚ⠪ࠃߖߦࠇߕޔࠄ߆ߩ㗴ࠍᛴ߃ߚੱࠅ⺆ޔࠅߢޘᚻ⥄り߇ࠍߣߎࠆ⺆ޔㅢߒߡޔ㗴ࠍ
⸃ߒߚߣᦸࠎߢࠆੱߣࠆߢޘ⠨߃ࠄࠇ߹ߔߩߘޕᗧߢ 0CTTCVKXGOGFKEKPG ߦ߅ߌࠆ⡬߈
ᚻߦߪ PCTTCVKXGEQORGVGPEG ߇ਇนᰳߢࠅࠍࠇߘޔ㜞ࠆߚߦ߽&ޔT.CWPGT ߇ߐࠇߡࠆ 6KGT
VTCKPKPI ߪ㕖Ᏹߦ↪ߣᕁ߹ߒߚޕ
ࠢ࠴ࡖߢߪޔ%QPXGTUCVKQPUKPXKVKPIEJCPIG ߳ߩࠠࡢ࠼ߣߒߡޔUGXGP%̉U ߇ឭଏߐ
ࠇ߹ߒߚޕవߦ⑳ߩ⎇ⓥߣ 0CTTCVKXGOGFKEKPG ߦ߅ߌࠆ⡬߈ᣇߩ㆑ࠍㅀߴ߹ߒߚ߇ޔታߪ ߟߩ
% ߦߪ߇࠻ࡦࡅߥ⋉߽ߡߞߣߦ⑳ޔḷࠇߡ߹ߒߚޔ߫߃ޕᅢᄸᔃߩᄢಾߐⶄߪ⺆‛ޔ㔀ߢਇ⏕
ታߛ߆ࠄߎߘน⢻ᕈ߇ᐢ߇ࠆޔਇ⏕ታᕈ߆ࠄഃㅧᕈ߇↢߹ࠇߩࠄ⥄ޔᨒ⚵ߺࠍᄖߔ߇㐿ߌࠆߎߣ
ߥߤ߽ߢ߆ߥޕ㕙⊕߆ߞߚߩߪ ߁ߣޠߥߒߊߴࠆߥߪࠬࠗࠔࡧ࠼ࠕޟޔECWVKQPߎޔࠄߥߗߥޔ
ߎߢߪ㗴ࠍ⸃ߔࠆߚߩ႐ߣߒߡ UWRGTXKUKQP ߇⟎ߠߌࠄࠇߡࠆߣᕁߞߡ߅ࠅ߹ߒߚߩߢޕ
&T.CWPGT ߪ⸃߽ߦࠅ߹ޟޔ╷ࠍਈ߃ߡߒ߹߁ߣޔォ឵ߒ㔍ߊߥࠆߣޠㅀߴࠄࠇ߹ߒߚ߇ߎߎޔ
ߦ߈ߡޟ⠨߃ࠆߚߩ⾰ߡߚࠄޔߣ߆ߩߚߞߛߣߎ߁߁ߘߪߣޠ⣤ߦ⪭ߜߚᰴ╙ߢߔޕ
ඦᓟ߆ࠄߪ UWRGTXKUKQP ߩ࠺ࡕࡦࠬ࠻࡚ࠪࡦ߇ⴕࠊࠇ߹ߒߚ߇ࠍࠇߎޔߒߚߎߣߪ⑳ޔ
ߦߣߞߡᓧ㔍ߊߚ߹ޔೝỗ⊛ߥ⚻㛎ߣߥࠅ߹ߒߚ㧔ౝኈߪᣢߦઁߩవ↢ᣇ߆ࠄߏႎ๔߇ࠅ߹ߔߩ
ߢ⋭⇛⥌ߒ߹ߔ㧕ߩઁޕෳട⠪ߦߣߞߡߪᘠࠇߚశ᥊ߢߞߚ߆߽ߒࠇ߹ߖࠎ߇ޔߪߡߞߣߦ⑳ޔ
ߚߣ߃࠺ࡕࡦࠬ࠻࡚ࠪࡦߢ߽ޔUWRGTXKUKQP ߩታ㓙ࠍࠆߩߪೋߡߛߞߚ߆ࠄߢߔޕ
UWRGTXKUKQP ߪઁߩవ↢ᣇߩࡐ࠻ߦ߽ࠆㅢࠅޔߦᤨޔߣࠅߊߞࠁޔṛ᳇ߦㅴࠎߢߞߚࠃ
߁ߢߔᤨߩߘޔߪߦ⑳ߒ߆ߒޕ㑆ߩᵹࠇ߇․⇣ߥ߽ߩ߆ߤ߁߆ߪಽ߆ࠅ߹ߖࠎߢߒߚޕᲣ࿖⺆ࠍ⇣
ߦߔࠆ⠪ห჻ߩ UWRGTXKUKQP ߢࠆߎߣ߿ޔᢥൻߩ⋧㆑߆ࠄ UWRGTXKUGG ߩᛴ߃ࠆ㗴ߩᢥ⣂ࠍ
UWRGTXKUQT ߇ᛠីߒ㔍ߎߣߥߤ߇ߩߘޔㅴⴕߦᓇ㗀ߒߚߎߣߪ⏕߆ߢߒࠂ߁ߎ́߹ޟ߇ߔߢޕ
ߎ⓭ޔߦޠὼឭߐࠇߚߦߟߡ UWRGTXKUQT ߇හᐳߦℂ⸃ߒޔUWRGTXKUGG ߦߣߞߡ↪ߥᄌൻ
ࠍ߽ߚࠄߔߎߣߪ߁ߘޔኈᤃߥߎߣߣߪᕁ߃߹ߖࠎޕUWRGTXKUGG ߩ⠪ߦਈ߃ࠄࠇߚ᧦ઙߩ ߟ
ߪ⸃ᧂޟߩ㗴ࠍޠᛴ߃ߡࠆߎߣߢࠅߩߘޔߪࠇߘޔ㗴߇⸃ߒ㔍㔍ߢࠆߎߣࠍⵣ
ઃߌ߹ߔߚߒߣࠅߊߞࠁߩߎޔࠈߒޔߡߞ߇ߚߒޕዷ㐿ߪޔታ㓙ߩ UWRGTXKUKQP ߦㄭߩߢߪߥ
߆ߣ⑳ߦߪᕁࠊࠇ߹ߒߚޕUWRGTXKUQT ߪ UWRGTXKUGG ߩ⺆ࠅ߆ࠄৼካߦ⸒⪲ࠍ⡬߈ขࠅߦߐ߹ޔ
SWGUVKQPKPI ࠍߐࠇߡ߹ߒߚߒޔUWRGTXKUGG ߽ߘࠇߦኻߒߡ⌀ߦᔕߓߡ߅ࠄࠇ߹ߒߚߒ߁ߘޕ
ߚᓔㆶߩࡊࡠࠬ߇ߣߡ߽ࠕ࡞ߦᗵߓࠄࠇ߹ߒߚߩߢᤨޔ㑆߇⚻ߟߦߟࠇ࠻ࠬࡦࡕ࠺ޟߩߎޔ
࡚ࠪࡦߪ⊛⋡ߩޠߛߞߚࠎߛࠈ߁㧫ߣ߁⇼߇ᶋ߆ࠎߢ߈߹ߒߚߥ߁ࠃߩߤޔ߇⺕ޕࠍޔ
ߤߩࠃ߁ߦ⺆ࠆߩ߆੍ߊߚߞ߹ޔ᷹ߢ߈ߥਛߢߩ UWRGTXKUKQP ࠍෳട⠪ߦߖࠆߎߣ߇ޔᒰ 95
ߦ߅ߡߤߩࠃ߁ߥᗧ⟵ࠍ߽ߟߩ߆߇⥃ޔᐥኅߣߒߡߩ⍮⼂߽⚻㛎߽ߥ⑳ߦߪ⋡⊝ޔᒰ߇ߟ߆
ߥߊߥߞߡߚߩߢߔޕ
ߘߩࠃ߁ߥ⁁ᴫߩਛ& ߚࠇߐ␜ߦ⊛⚳ᦨޔT.CWPGT́UWRGTXKUQT 㑆ߩ ߩߎޟUWRGTXKUKQP ߪᄬᢌ
ߦ⚳ࠅߘ߁ߛ߁ߣޠળ& ߡߒߘޔT.CWPGT ߆ࠄߩߩߟ ߽ߩࠆߔߦࠅ⚳ߡߞ߹߿ޟ߆⏕ޔᚻ
Ბߏߥ߁ࠃ߁ߣޠឭ᩺ߪߦ⑳ޔ㛳߈ߣⴣ᠄ࠍ߽ߚࠄߒ߹ߒߚޕ5WRGTXKUQT ߩ┙႐ߩᣇߦߘߩࠃ߁
ߥㆬᛯ⢇߇ࠆߣߪ੍ޔᗐ߽ߒߥ߆ߞߚ߆ࠄߢߔ㧔ߊ߹ߢߎࠇߪ࠺ࡕࡦࠬ࠻࡚ࠪࡦߢࠅޔ
ߘ߁ߒߚዷ㐿ࠍߖࠆߎߣߦ߽ޔ߆ߨࠄ߇ߞߚߩߢߒࠂ߁ߌߤ㧕ޕ࿁ߪޔ㒢ࠄࠇߚᤨ㑆ౝ
ߢߩ࠺ࡕࡦࠬ࠻࡚ࠪࡦߢࠅ߁ߣߥࠄߥ߫ࠇߌߥߖߐ⚿⚳ߕ߃ࠅߣޔ⚂߽ߞߚߎߣ
ߣផኤߐࠇ߹ߔ߇ޔߒ߆ߒޔታߦ߽ߎ߁ߒߚࠤࠬߪࠅ߃ࠆߩߢߪߥߢߒࠂ߁߆㧫UWRGTXKUQT
ߣߡ UWRGTOCP ߢߪࠅ߹ߖࠎߒ UWRGTXKUKQP ࠍฃߌߚ߆ࠄߣߞߡޔᔅߕߒ߽ UWRGTXKUGG ߩḩ⿷
ߔࠆ⚿ᨐ߇ᓧࠄࠇࠆࠊߌߢߪߥߣᕁࠊࠇ߹ߔߛߚޕ࿁ߩ UWRGTXKUKQP ߇ޟᄬᢌࠊߚߞࠊ⚳ߦޠ
ߌߢߪߥߎߣߪޔUWRGTXKUGG ࠍᜂࠊࠇߚవ↢ߩᝄࠅࠅ߆ࠄࠄ߆ߢߔޔߪߦߎߘޕUWRGTXKUQT
ߩ SWGUVKQPKPI ࠍฃߌߡߩ UWRGTXKUGG ߩᐞߟ߆ߩ᳇ߠ߈ߣޔᣂߚߥࡄࠬࡍࠢ࠹ࠖࡧߩ⧘↢߃߇⸥
ㅀߐࠇߡ߹ߒߚ߆ࠄޕ
࠺ࡕࡦࠬ࠻࡚ࠪࡦᓟߢࡦ࡚ࠪ࠶ࠞࠬࠖ࠺ߩࡊ࡞ࠣੱ ޔᝄࠅࠅࠍⴕ߹ߒߚޕකᏧࠆ
ߪ⥃ᐥᔃℂ჻ߩవ↢ᣇߣߒว߁ਛߢߣ⑳ޔߪ⑳ޔవ↢ᣇߣߩᣇޔℂ⸃ߩߒᣇߩ㆑ࠍ∩ὓߦ
ᗵߓ߹ߒߚ ߫߃ޕUWRGTXKUQT ߩ⾰ߩߒᣇ ߟߦߒߡ߽߇⑳ޔ㆑ᗵࠍⷡ߃ߚὐߦߟߡޔవ↢
ᣇߪ⊛⏕ߦߘߩᗧ࿑ࠍᛠីߒޔᵹࠇࠍℂ⸃ߐࠇߡ߅ࠄࠇ߹ߔߩ⑳ޕ㆑ᗵߪ⊛ᄖࠇߛߞߚߩ߆̖ߣ
᳇⪭ߜߔࠆ㕙ޔኾ㐷ߩᢎ⢒ࠍฃߌ⥃ޔᐥߩ⚻㛎ࠍⓍߺޔ႐ࠍᜬߟవ↢ᣇߣߩᓐᚒߩᏅߪߞߡ
ᒰ೨ߥࡧࠗ࠽ߒࠄ⑳ߪ⑳ޔᗵⷡߦޔ࿁ߩቇ߮ࠍടߒߡ߶ߊߡߒ߆↢ߦ࠼࡞ࠖࡈߩ⑳ޔ
߆ߥߥ̖ߣᕁ⋥ߒߡ߽߹ߒߚޕ
㧟㧚ޣታ⠌ࠍ㛎ߒߡࠆᤨࠍߣߎߥ߁ࠃߩߤޔᗵߓ߹ߒߚ߆㧫㧔 ߩਛߢㅀߴߡߊߛߐߞߡ߽߆
߹߹ߖࠎ㧕ޤ
ߣಾࠅ㔌ߖߕޔᣢㅀߚߒ߹ߒߚޕ
㧠㧚ࠄ߆ޣ⠨߃ࠆߣ⥄ߚߥޔりߎ߁ߔࠇ߫ࠃ߆ߞߚߣ߁ߎߣ߇ࠅ߹ߔ߆㧫߽ߒࠆߣߔࠇ
߫ߘࠇߪߤ߁߁ߎߣߢ߆߁ࠂߒߢߩߚߞ߆ࠃ߫ࠇߔߦ߁ࠃߩߤޔ㧫ޤ
ታ⠌ౝߢᗵߓߚ㆑߿ߥࠄ߆ࠊޔᗵⷡࠍࠎߖ߹ࠇߒ߽߆ߩߚߞ߆ࠃ߫ߖߦ⋥₸ޔߤߟߩߘޔ
߇ߩߘޔᗵⷡ߇ᰴߣޘḷࠇㆊ߉ߡޔᱜ⋥ޔᚻߊ⸒⪲ߦߩߖࠄࠇߥߣ߁ᗵߓ߇ࠅ߹ߒߚޕ
ߒ߆ߒߎߩᗵⷡߪ߽ߘ߽ߘޔᒰ 95 ߇ක≮߿ᔃℂ⥃ᐥߩኾ㐷ኅࠍኻ⽎ߣߒߚ߽ߩߢࠆએ߿ޔ
ࠍ߃ߥ߽ߩߣ⠨߃ࠄࠇ߹ߔޕታ⠌ਛߩߘߪࠆޔᓟޔኾ㐷ߩవ↢ᣇߦߏᢎ␜ߚߛߚࠅޔᢥ
₂ߢ⏕ߒߚࠅߒߡ⸃ޔᶖߒߚㇱಽ߽ࠅ߹ߔ߇ߣࠆߔ߆ߒ߽ޔ㆑ᗵߪ㆑ᗵߩ߹߹ߦࠇߕޔ
߆ߩᒻߢ⥄ಽ⥄りߩ⎇ⓥߦ↢߈ߡߊࠆ᳇߇ߒߡ߹ߔ߹߹ߩߘޔࠄ߆ߔߢޕᄢಾߦᱷߒߡ߅ߊߩ
߽ࠃ߆ߥ̖ߣᕁߞߡ߹ߔޕ
㧡㧚ߩߎޣታ⠌㛎߆ࠄឭߐࠇࠆ㗴ὐ߿⇼ὐߪߥࠎߢߔ߆㧫ޤ
࠽࠹ࠖࡧߩน⢻ᕈߣ㒢⇇ߩࡖ࠴ࠢޕਛߢߞߚߪߦࡧࠖ࠹࠽ޔ⒳ޘ᭽ޔ߿ࠅ߇ߥߟߥޘ
ᄙ᭽ߥࠬ࠻߇⛊ߺว߁ⶄ㔀ᕈߣ߁․ᓽ߇ࠅޔߦ߃ࠁࠇߘޔਇ⏕߆ߥߎߣ߽ᄙ߇ޔน⢻
ᕈ߇ᐢ߇ࠅᄌൻ߇߈ᤃߣ߁ਥᒛߦ⇣⺰ߪࠅ߹ߖࠎߢࡦ࡚ࠪ࠻ࠬࡦࡕ࠺ޔߒ߆ߒޕታ㓙
ߦߎߞߚޟSWGUVKQPKPI ߩⴕ߈߹ࠅ߆߁ࠂߒߢߩߚߓ↢ࠄ߆ߎߤߪޠ㧫ⴕ߈ߞߚߩߪ
UWRGTXKUQT ߩ PCTTCVKXGEQORGVGPEG ߇ૐߚߢߒࠂ߁߆㧫߅ߘࠄߊߩޔ႐ߦߚੱߢࠃߩߘޔ
߁ߦᗵߓߚᣇߪዋߥߣᕁࠊࠇ߹ߔⶄߩࡧࠖ࠹࠽ޕ㔀ᕈߣਇ⏕ታᕈ߇ޔᢥ⣂ଐሽᕈߣ߁࠽࠹
ࠖࡧߩ߽߁ ߟߩ․ᓽߣ↪ߒ߁ߣߪࡧࠖ࠹࠽ޔᷙੂࠍ߽ߚࠄߒޔṛ߿ᴉ㤩ࠍ߽ߚࠄߔ႐ว
߽ࠅ߃߹ߔޕ࿁ߩࠃ߁ߦ⸒⺆ᢥൻࠍ⇣ߦߔࠆੱ㑆ห჻ߩ UWRGTXKUKQP ߢߪޔᢥ⣂ଐሽ⊛ߥ࠽
࠹ࠖࡧߪޔน⢻ᕈࠍᐢߍࠆ㕙ޔᷙੂࠍ߈ᤃ߆ߞߚߩߢߪߥߢߒࠂ߁߆ޕὶὐࠍ⛉ࠅㄟߚ
ߩ SWGUVKQPKPI ߩᓳ߇ޔㅒߦὶὐࠍ߷߆ߒߪߣߚߒࠄߚ߽ࠍࠅ߹߈ⴕޔ⠨߃ࠄࠇߥߢߒࠂ
߁߆㧫
㧢㧚ߩߎޣታ⠌ߩ㛎߆ࠄߥߚ߇ቇࠎߛࡐࠗࡦ࠻ߪߥࠎߢߔ߆㧫ޤ
0CTTCVKXGOGFKEKPG ߦ߅ߌࠆ࠽࠹ࠖࡧߣ⥄⑳ޔりߩ⎇ⓥߦ߅ߌࠆ࠽࠹ࠖࡧߩ⇣หޕᚻߊ
ߢ߈ߥߩߢߔ߇ޔ㧔⥄ߢߪࠅ߹ߔ߇㧕࠽࠹ࠖࡧߦ߽ࠈࠈߞߡ⎇߇⑳ޔⓥߢะ߈ว
ߞߡ߈ߚ࠽࠹ࠖࡧߣޔ࿁ߩ 95 ߢᛒߞߚ࠽࠹ࠖࡧߪߜࠂߞߣ㆑߁ߣ߁᳇߇ߒߡ߹ߔ⥄⑳ޕ
りߪ⚻ޔߒߥߺߣ⺆‛ࠍ↢ੱޔ㛎߇ᣂߚߥᗧߠߌߦࠃߞߡ⺆ࠅ⋥ߐࠇޔᣂߚߥ⥄Ꮖ߇↢ᚑߐࠇߡ
ߊࡊࡠࠬࠍ⊒㆐ߣᝒ߃ࠆ┙႐ߦଐߒޔᒰ⠪⥄りߩ࠽࠹ࠖࡧߒ⋡⌕ߦޠߒ⋥ࠅ⺆ޟߦ․ޔ
ߡ⎇ⓥࠍⴕߞߡ߹ߔޕ࿁ߪ߁߽ޔዋߒታ〣⊛ߥ࠽࠹ࠖࡧޔ឵⸒ߔࠇ߫࠽ߩߡߒߣ࡞࠷ޔ
࠹ࠖࡧࠍቇࠎߛࠃ߁ߦᕁ߹ߒߚޕ
㧣㧚ߦ߆߶ޣઃߌട߃ࠆࠦࡔࡦ࠻߿⾰߇ࠇ߫ߥࠎߢ߽ߤ߁ߙޤ
&T.CWPGT ࠍߪߓ࿁ߩ 95 ߦ㑐ࠊࠄࠇߚవ↢ᣇޔࠬ࠲࠶ࡈߩ⊝᭽ᣇߦᔃ߆ࠄᗵ⻢↳ߒߍ
߹ߔᦨޕᓟߦޔ㐷ᄖṽߢࠆ߇ࠁ߃ߩ㆑ᗵ߿ࠊ߆ࠄߥߐߪࠅ߹ߒߚ߇ᧂޔ⍮ࠍ⍮ࠆ༑߮߿ⷞ㊁
߇ᐢ߇ࠆሜߒߐ߇ࠍࠄࠇߘޔಒ㚧ߒߡߚߎߣࠍ⸥ߒߡ⚳ࠊࠅ߹ߔޕ
ڎᢪ⮮ᷡੑ㧔ንጊᄢቇ㧕
ᦨೋߦዋߒᱧผ⊛ߥ⚻✲ߦ⸅ࠇߡ߅߈ߚ& ߇⑳ޕT,QJP.CWPGT ߩฬ೨ߦೋߡ⸅ࠇߚߩߪޔ
ᐕߦ $/, ߦឝタߐࠇߚ 0CTTCVKXG$CUGF/GFKEKPG ߦ㑐ߔࠆㅪタߩ╙㧟࿁⋡㧔0CTTCVKXGDCUGF
OGFKEKPGCPCTTCVKXGCRRTQCEJVQOGPVCNJGCNVJKPIGPGTCNRTCEVKEG㧕ࠍ⺒ࠎߛᤨߢࠆߎޕ
ߩ⺰ᢥߪࠊߕ߆ 㗁ߩ⺰ᢥߛߞߚ߇ޔㅪタߐࠇߚ㧡✬ߩ⺰ᢥߩਛߢ߽ߔ߿ߺ⺒߽ᦨߡߞߣߦ⑳ޔ
ߩߢߞߚ ޔ߇ࠇߎޕᐕߦ⧷࿖ߢ ߐࠇߚޡޔ0CTTCVKXG$CUGF/GFKEKPG&KCNQIWGCPF
FKUEQWTUGKPENKPKECNRTCEVKEGޡ┨ ╙ߩޢ0CTTCVKXGCPFOGPVCNJGCNVJKPRTKOCT[ECTGޢ
ࠍ࠳ࠗࠫࠚࠬ࠻ߒߚ߽ߩߢࠆߎߣࠍߔߋᓟߢ⍮ߞߚޕ
ߎߩᦠ☋㧔એਅޡޔ0$/ ේ⪺ߔ⇛ߣޢ㧕ߪ ޔᐕߦ⑳ߚߜߩࠣ࡞ࡊߦࠃߞߡࡉࠖ࠹࠽ޡޔ
ࡌࠗࠬ࠻ࡔ࠺ࠖࠬࡦ㧙ක≮ߦ߅ߌࠆ‛⺆ࠅߣኻߡߒߣޢ㊄ ߆ࠄ⊒ⴕߐࠇࠆߎߣߦߥࠆߩ
ߛ߇ޔᱜ⋥ߦ⸒߁ߣޡߩߎޔ0$/ ේ⪺⥄ޢߪޔߒߡಽ߆ࠅ߿ߔᧄߢߪߥߩߜ߁ߩߘޕ┨߆
ߪ⑳ޔ㆐㧔⠡⸶⠪ߩᄙߊߪකᏧߢߞߚ㧕ߦߣߞߡోߊߥߓߺߩߥಽ㊁ߦዻߔࠆ߽ߩߢߞߚߒޔ
ߢ߽ޔ㨬ߎߩᧄߪోߣߒߡࠍ⸒ߚߩ߆ߐߞ߬ࠅಽ߆ࠄߥ㨭ߣ߁ᗵᗐࠍੱ⊛ߦߪࠃߊ
⡊ߦߔࠆ߽ࠇߘޕήℂߩߥߢࠆ␠߿⺰⺆‛ޕળ᭴ᚑਥ⟵߿'ޔ$/ ߣ 0$/ ߩ⛔วߣߞߚ㗴ߦ
ߟߡߩℂ⺰⊛ߥ┨߇ࠆ߆ߣᕁ߁ߣޔኾ㐷ኅߢߪߥၫ╩⠪ߦࠃࠆ㨬KNNPGUUPCTTCVKXG∛ߩ‛
⺆㨭ߘߩ߽ߩߩ┨߇ࠆޕᭂߟߌߪᦨ⚳┨ߢߪࠇߎޔㅜਛ߹ߢ⺒ߺㅴߡೋߡࠊ߆ࠆߩߢࠆ߇ޔ
කቇඳ‛㙚ࠍ⥰บߦߒߚ㨬ᐝ㔤⼄㨭ࠅ⺆ޔᚻߪᱫ⠪ߥߩߢࠆޕ
ߎߩᦠ☋ߩਛߢ&ޔT.CWPGT ߇ᦠߚ╙ ┨ߪߥ߁ࠃߩ⑳ޔකቇߣ⥃ᐥᔃℂቇߩႺ⇇㗔ၞߦ߅
ߡޔታ〣ߣℂ⺰ࠍߤ߁ߟߥߢߊ߆ࠍᮨ⚝ߒߡࠆ߽ߩߦߣߞߡ߽ᦨޔᗵߢ߈ࠆߣߣ߽ߦޔ㕖
Ᏹߦ␜ໂߦን⺰ᢥߢߞߚߎߣߪ㑆㆑߇ߥߺ⺒ޕߒߡߺߡ߽ߎߩ╙ ┨ߪޔ㨬ታ〣⍮ߣ
ߒߡߩ 0CTTCVKXG$CUGF/GFKEKPG ߣߪߤࠎߥ߽ߩߢࠆߩ߆㧫㨭ߣ߁ᅢᄸᔃࠍᛴߡޡ0$/ ේ⪺ޢ
ࠍ⺒ߺᆎࠆ⺒⠪ߦߣߞߡߪ⇼ߩߘޔ߽ࠅࠃ┨ߩߤߩᧄߩߎޔߦ⋥ធ╵߃ߡߊࠇࠆ߽ߩߢߞߚޕ
ߎߩ┨ߢ &T.CWPGT ߇ᒝ⺞ߒߡࠆߎߣߪޔᄢ߈ߊ߹ߣࠆߣੑߟߢࠆߣᕁࠊࠇࠆ৻╙ߩߘޕ
ߪߩ≮⸻⥸৻ޔ႐ߢߩታ〣ߦ߅ߡ⋧ޔኈࠇߥⶄᢙߩ‛⺆ࠍߤ߁ᛒ߁߆ߣ߁㗴ߢࠆߎޕ
ࠇߦߟߡߪߩ ޔᖚ⠪ߩ‛⺆߇␜ߐࠇߡ߅ࠅߦࠄߐޔฦߩޘᴦ≮ㆊ⒟ߦ߅ߌࠆ⪺⠪ߩᔃߩേ߈
ࠍౣ᭴ᚑߒߚ⺆ࠅߦࠃࠆ⸃⺑߇タߖࠄࠇߡࠆޕฦߩౝኈ߽␜ໂߦን߽ߩߢࠆ߇⺰ߩߎޔ
ᢥߩ⺆ࠅߩᒻᑼߘࠇ⥄߇ᭂߡᢎ⢒⊛ߢࠆ⚿ޕዪߩߣߎࠈޔᴦ≮⠪ߩၮᧄ⊛ߥࠬ࠲ࡦࠬߪⶄޔ
ᢙߩ‛⺆ߩ߁ߜߩߤࠇ߆৻ߟߛߌࠍᱜߒߣߔࠆߩߢߪߥߊ⋧ޔ⍦⋫ߔࠆ‛⺆߇૬ሽߒߚࠅ㍲ߒ
ߚࠅߔࠆ✕ᒛߦ⠴߃ࠆߣ߁ߎߣߢࠆ⺑ࠍࠬࡦ࠲ࠬߥ߁ࠃߩߘޕߔࠆ߭ߣߟߩ‛⺆ߣߒߡ⪺ޔ
⠪ߪ␠ળ᭴ᚑਥ⟵ߣ߁ℂ⺰ࠍឭ᩺ߔࠆ⚿ߩߘޕᨐޔ㨬⸻≮ߣߪߜࠊߥߔޔ⺆‛ࠆߥ⇣ޔᖚ⠪߇ᜬߜ
ㄟ⥄વ⊛ߥ‛⺆ߣޔකᏧ߇ᜬߜㄟኾ㐷ኅߣߒߡߩ‛⺆ߣߩ㑆ߢኻ߇ⴕࠊࠇࠆ⛘ᅢߩ࠴ࡖࡦࠬ
ߣ߁ߎߣߦߥࠆ㨭㧔R㧕ߥ߁ࠃߩߎޔߚ߹ޕታ〣ߦߟߡ⺆ࠆߚߦߪߥ߁ࠃߩߎޔᒻᑼߦࠃࠆ
⺆ࠅ߇߰ߐࠊߒߣ߁ߎߣࠍߪ┨ ╙ޔ⍎ߦ㧔ߒ߆ߒࡔ࠲ࡌ࡞ߢᥧ␜⊛ߦ㧕ឭ␜ߒߡࠆޕ
ߒ߆ߒߎߩ┨ߦ߅ߡ⪺ߟ৻߁߽ޔ⠪߇ᒝ⺞ߒߡࠆߎߣߪࠕࡉࠖ࠹࠽ࠆߌ߅ߦ≮⸻⥸৻ޔ
ࡊࡠ࠴ߦ߅ߌࠆ㨬⾰㨭ߩ㊀ⷐᕈߢࠆ⪺ޕ⠪ߪߩࡉࠖ࠹࠽ࠆߌ߅ߦ≮⸻⥸৻ޔਃߟߩ㕙ߦߟ
ߡએਅߩࠃ߁ߦᢛℂߒߡࠆޕᒁ↪ߒࠃ߁ޕ
̌৻⥸⸻≮කߣߒߡߩ⥃ᐥ⚻㛎ࠍㅢߒߡ߇ࡉࠖ࠹࠽ޔᜬߟਃߟߩ㕙ߦ᳇ߠߚޕ㧝㧕વ⛔⊛
ߥ∛ޔᱧࠍߣࠆߣ߁ࠃߊ⍮ࠄࠇߚᓎഀޕ㧞㧕ᖚ⠪⥄りߩߦ߹ߣ߹ࠅࠍᜬߚߖࠆߎߣࠍ⸵ኈߒߡޔ
⡊ࠍߌࠆᔅⷐ߇ࠆ߆ࠍዅ㊀ߔࠆࠃ߁ߥࠞ࠙ࡦࡦࠣ⊛㕙ޕ㧟㧕ߎࠇ߹ߢᖚ⠪߇ᛴߡ
ߚ߽ߩߣߪ㆑ߞߚᣂߒᗧࠍតࠇࠆࠃ߁ߥ⾰ࠍᴦ≮⊛㕙╩ޕ⠪߇ᦨ߽⥝ࠍⷡ߃ޔએਅ
ߦㅀߴࠆᢙ⺑ߢ∝ߩޘߒߚߩߪᦨߩߎޔᓟߩ㕙ߢࠆ̍ޕ㧔R㧕
ߎߩ㧟߇ ߦߐ߹ޔ%QPXGTUCVKQPUKPXKVKPIEJCPIG ߩᛛᴺߢࠆߺ⺒ࠍ┨ ╙ޔ߇ࠈߎߣޕߒ
ߡߺࠆߣಽ߆ࠆߩߢࠆ߇ߥ߁ࠃߩߎޔ㨬⾰ߦࠃࠆᴦ≮ᛛᴺ㨭ߘߩ߽ߩߦߟߡߪ⺒ࠍ┨ ߩߎޔ
ࠎߢ߽ߤߎߦ߽ᦠ߆ࠇߡߪߥޕ
ߎߎߢ &T.CWPGT ߇㧔ඨ߫ᚢ⇛⊛ߦ㧕 ߟߦಽ㘃ߒߡࠆ߁ߜߢޔ㧕ߣ 㧕ߪᚒ߅ޔߡߞߣߦޘ
ߥߓߺߩ߽ߩߢࠆࠍࠇߎޕߩ⸒⪲ߢ߅߈߆߃ࠆߣޔ㧝㧕ߪකቇࡕ࠺࡞ޔ㧞㧕ߪᔃℂ⥃ᐥࡕ࠺࡞
ߦㄭ߫߃ޕጯᧄߪ⥃ޔᐥߦ߅ߌࠆ⡞߈ᣇࠍޔ㧝㧕ᖱႎ⡬ขဳߣޔ㧞㧕ฃኈဳߦಽߌޔฦߟߦޘ
ߡ⚦ߦ⺰ߓߡࠆ㧔ጯᧄޔ㧕ޕ࿁ߩࡢ࡚ࠢࠪ࠶ࡊߦ߅ߡ߽ෳട⠪߆ࠄޔ0CTTCVKXG$CUGF
5WRGTXKUKQP ߪޔᣣᧄߦ߅ߌࠆ⥃ᐥᔃℂቇ⊛ࠕࡊࡠ࠴ߣߤߎ߇⇣ߥࠆߩ߆㧫ߣ߁⇼߇๒ߐࠇߚ
ߎߣߣ߽㑐ଥ߇ࠆࠃ߁ߦᕁࠊࠆޕ
ᴡว㓳㓶ߪᧄޔ㇌ߦ߅ߡ 0$/ ߦᦨ߽ᣧߊᵈ⋡ߒߚ৻ੱߢࠅޔㅳೀකቇ⇇ᣂ⡞ߢߩ⑳ߣߩኻ⺣
㧔㧕ߦ߅ߡ㨬ᦨㄭ㧘ߎߩޡ0CTTCVKXG$CUGF/GFKEKPGޢ㧔$/, ⊒ⴕ㧘౮⌀㧕ߩሽࠍ⍮ࠅ㧘ߣ
ߡ߽㛳߈߹ߒߚ߇⑳ޕ೨߆ࠄ⠨߃ߡߚࠃ߁ߥߎߣ߇ߔߴߡᦠߡࠅ㧘ሜߒߊߥߞߡ⚫ߒߡ
ࠆߩߢߔ㨭ߣㅀߴߡࠆ≮♖ޔߒ߆ߒޕᴺߣ‛⺆ߩ․㓸ภ㨬♖≮ᴺ XQN0Q㨭ߩᏎ㗡ߦ
߅ߡޔ㨬࠽࠹ࠖࡉࡇߦ߅ߡߪ⾰ޔࠍ㊀ⷐߥᛛᴺߣߒߡ↪ࠆߣ⡞ߡࠆ߇ߪ⑳ޔ
ߘࠇߦߟߡߪߒߊߥߩߢ⪺ߩઁߪߡߟߦ⚦ߩߘޔ⠪ߦ߹߆ߖߚ㨭ߣᦠߡࠆޕ
ߎߩࠃ߁ߥߎߣ߽૬ߖߡ⑳ߩℂ⸃ߣߒߡߪޔක≮ߪࠆޔᔃℂ⥃ᐥߩ㗔ၞߦ߅ߡࠖ࠹࠽ޔ
ࡉߦᵈ⋡ߔࠆߣ߁ᆫߪޔᔅߕߒ߽⾰ᛛᴺࠍ↪ࠆߎߣߣห⟵ߢߪߥ߇&ޔT.CWPGT ߇ឭ໒
ߔࠆޔ0CTTCVKXG$CUGF5WRGTXKUKQP ߦ߅ߡ⾰ޔᛛᴺࠍߤߩࠃ߁ߦ↪ࠄࠇࠆ߆ߣ߁ߎߣߪޔ
߹ߐߦߎߩࠃ߁ߥኻߦ߅ߌࠆਛᩭߦዻߔࠆߎߣߢࠆߣ߁ߎߣߛޕ
&T.CWPGT ߪߔߢߦޔ0CTTCVKXGDCUGF2TKOCT[%CTGCRTCEVKECNIWKFG ߣ߁⪺ᦠ㧔ጊᧄ
⋙⸶㧦࠽࠹ࠖࡉࡌࠗࠬ࠻ࡊࠗࡑࠤࠕ㧙ታ〣ࠟࠗ࠼㧕ߦ߅ߡࠍࡉࠖ࠹࠽ߩߎޔត⚝
ߒޔഃㅧߔࠆߚߩߊߟ߆ߩ࠹ࠢ࠾࠶ࠢߦߟߡ৻┨ࠍഀߡㅀߒߡࠆߩߢࠅߘ߫߃ޔ
ߩ┨ߩਛߢߪޔᓴⅣ⊛ߥ⾰ߩࠬ࠻ߣߒߡޔ4CPMKPISWGUVKQPU 5RGEWNCVKXG SWGUVKQPU
4GNCVKQPCN SWGUVKQPU %QPVGZVWCNKUKPI SWGUVKQPU +PVTQFWEKPI FKHHGTGPEGSWGUVKQPU
9QTUVECUGSWGUVKQPU ߥߤ߇ߍࠄࠇߡࠆߩߛ߇ޔᱜ⋥⸒ߞߡߎࠇࠍ⺒ࠎߛߛߌߢߪߤ߁߽ࡇࡦ
ߣߎߥߩߢࠆࠍ߆ߩߥ߁ߘߡߒ߁ߤޕ⠨߃ߡߺࠆߣޔᒰὼߩߎߣߥ߇ࠄޔ㨬࠽࠹ࠖࡉࠕࡊࡠ
࠴ߣߪනߥࠆᛛᴺߢߪߥࡇޔߪࠇߘޕ㧔ࠆߪ⸻ኤ㧕ߣ߁↢߈ߚࠦࡦ࠹ࠢࠬ࠻ߩਛ
ߢṶߓࠄࠇࠆߎߣߦࠃߞߡޔ
ᗧઃߌࠄࠇޔലᨐࠍ⊒ើߔࠆ߽ߩߢࠆߦ㆑ߥ㨭ߣ߁╵߃߇ߔߋߦߞߡߊࠆߎߣ߇੍ᗐ
ߢ߈ࠆޕ
ታߪ⑳߇ࡢ࡚ࠢࠢࠪ࠶ࡊߦෳടߒߚߩߪޔታߪߎࠇ߇ ࿁⋡ߢࠆޕ
ᦨೋߪ ޔᐕߦ %CODTKFIG
ߢⴕࠊࠇߚޔ0CTTCVKXG$CUGF/GFKEKPGEQPHGTGPEG ߩࡒ࠾ࡢ࡚ࠢࠪ࠶ࡊߢࠅ ޔ࿁⋡ߪ ᐕߩ ߦ੩ㇺߢⴕࠊࠇߚޔඨᣣߩࡢ࡚ࠢࠪ࠶ࡊߢߞߚ& ߽ࡖ࠴ࠢߩࠇߕޕT.CWPGT
ߩޔ⍴ࠢ࠴ࡖߣࡠ࡞ࡊࠗߡߞࠃߦࡦ࡚ࠪ࠻ࠬࡦࡕ࠺ߪࠆޔ᭴ᚑߐࠇߡ߅ࠅߘޔ
ߩᔨࠍℂ⸃ߔࠆߎߣߪ㔍ߒߊߥߩߛ߇ᤨޔࠅߪ߿ޔ㑆ߩ⚂ߩߚߩߘޔታ〣⊛ߥ㕙ࠍචಽ
ߦℂ⸃ߔࠆߦߪ⥋ࠄߥ߆ߞߚޕ
ߘ߁߁ࠊߌߢޔ࿁ߩࡢ࡚ࠢࠪ࠶ࡊߢߪޔታ〣࠺ࡕࡦࠬ࠻࡚ࠪࡦߦᄢ߈ߥᦼᓙࠍᛴߡ
⑳ߪෳടߒߚޕ
࠺ࡕࡦࠬ࠻࡚ࠪࡦߩࡠ࡞ࡊࠗߦ߅ߡߪޔෳടࡔࡦࡃߩ৻ੱߢࠆศ᳗ߐࠎ߇ࠬࡄ
ࡃࠗࠫߣߥࠅ&ޔT*GNGP*CNRGTP ߇ࠍࠩࠗࡃࡄࠬޔോ&ޔT.CWPGT ߪߐࠄߦࠬࡄ
ࡃࠗࠩߩࠬࡄࡃࠗࠩߩᓎഀࠍߣࠅࠅ߿ߩߡోߩࡦ࡚ࠪ࠶ߦࠄߐޔขࠅߪޔㅢ⸶ߩౝ⮮
వ↢ࠍㅢߓߡ⠡⸶ߐࠇోࡊ࡞ࠣޔຬߦ㐿ߐࠇࠆߣ߁ޔ㕖Ᏹߦ⥝ᷓ᭴ㅧߩਛߢⴕࠊࠇߚޕ
ࠬࡄࡆ࡚ࠫࡦߩࠦࡦ࠹ࡦ࠻ࠍߏߊ◲නߦⷐ⚂ߔࠆߣޔศ᳗ߐࠎ߇ዞ⡯ᡰេࠍᜂᒰߒߡࠆ⊒
㆐㓚ኂࠍᜬߟᄢቇතᬺ↢ߦߟߡߩ㗴ߢߩߎޔቇ↢ߪᡰេ࠴ࡓߦࠃࠆᡰេࠍฃߌߡࠆߎߣߦ
ߥߞߡࠆߩߛ߇ޔᡰេߩㅢߒߪߚߞߡ߅ࠄߕޔศ᳗ߐࠎߪߎߩߚߦ㕖Ᏹߦᒝࠬ࠻ࠬࠍᗵ
ߓߡࠆߣ߁ࠃ߁ߦ߹ߣࠄࠇࠆޕታߪߎߩࠤࠬߪ㑆ធ⊛ߦ࠴ࡓߩࡏࠬߣߒߡߩ⑳ߦ߽㑐ଥ
ߒߡߊࠆ߽ߩߥߩߢޔᱜ⋥⸒ߞߡ⥄ޔಽ⥄り߽ᗵᖱࠍំߐ߱ࠄࠇࠆ߽ߩߛߞߚ&ޕT*CNRGTP ߩ⾰
ߪᦨޔೋޔศ᳗ߐࠎߣࠢࠗࠛࡦ࠻ࠍߋࠆࠦࡦ࠹ࠢࠬ࠻ࠍৼካߦࠄ߆ߦߒࠃ߁ߣߔࠆ߽ߩߢ
ࠆߣᗵߓࠄࠇߚ߇ޔળߪᰴ╙ߦࠞࠝࠬߩ⁁ᴫ߳ߣ⪭ߜㄟࠎߢߊࠃ߁ߦᕁࠊࠇޔ⡬ߡࠆ⑳ߚ
ߜࠣ࡞ࡊ߽ߘߩࠞࠝࠬߩਛ߳ߣᒁ߈ㄟ߹ࠇߡߊࠃ߁ߥ㊀⧰ߒߐߦᡰ㈩ߐࠇߚࠃ߁ߦᗵߓࠄࠇߚޕ
ߘߩࠞࠝࠬߩਛ߆ࠄࠆ⒟ᐲߩ৻⽾ᕈߩࠆࠬ࠻߇ᶋ߆߮߇ߞߡߊࠆน⢻ᕈߪ߶ߣࠎߤߥ
ߩߢߪߥ߆ߣߐ߃ᗵߓࠄࠇߚޕศ᳗ߐࠎ߇⺆ࠈ߁ߣߔࠆߎߣߪ &T*CNRGTP ߣߪߟߥ߇ࠄߕޔ
ࠣ࡞ࡊࡔࡦࡃ߽ߎߩ߿ࠅߣࠅߣߟߥ߇ࠆߎߣߦ࿎㔍ࠍᗵߓߡߚߪࠇߎޕศ᳗ߐࠎߩ↪ࠆ⸒
⪲ߣศ᳗ߐࠎ⥄り߇ߟߥ߇ࠆߎߣߩ࿎㔍ߐߪߦࠄߐޔศ᳗ߐࠎߣࠢࠗࠛࡦ࠻߇ߟߥ߇ࠆߎߣߩ࿎
㔍ߐߣࡦࠢߒߡࠆࠃ߁ߦᗵߓࠄࠇߚߥ߁ࠃߩߎޕ㐽Ⴇ⊛⁁ᴫߩਛߢ߇ࠢࡉߩࡦ࡚ࠪ࠶ޔ
ឭ᩺ߐࠇ&ޔT.CWPGT ߇ෳടߒߡ߇ࡦ࡚ࠪࠢࡈޔ㐿ߐࠇߚߩߘޕਛߢޔ㨬ߎߩ࠶࡚ࠪࡦࠍᤨ
㑆ౝߦ⚳ࠊࠄߖࠆߎߣߪήℂߛߣߒߡޔ㒠ෳߒߡߒ߹߁ߎߣ߽৻ߟߩㆬᛯ⢇㨭ߣ߁ࠃ߁ߥޔᭂߡ
₸⋥ߥ߿ࠅߣࠅ߇ශ⽎⊛ߛߞߚ࠲ࡔߩࠄࠇߎޔߒ߆ߒޕળࠍᡰ߃ࠆ㔓࿐᳇ߪ⚳ᆎ৻⽾ߒߡޔ᷷߆
ߊ⪭ߜ⌕ߚ߽ߩߢߞߚ߽ߡߣߪࡦ࡚ࠪࠢࡈߥ߁ࠃߩߎޕᣂߒ㛎ߢ࡞ࠣߣࡦ࡚ࠪ࠶ޔ
ࡊోߦౣ߮⪭ߜ⌕߈ߣޔ߆߇↢߹ࠇࠆᦼᓙࠍขࠅᚯߐߖࠆ߽ߩߛߞߚߩߘޕ೨ᓟߩ߿߿ⶄ㔀
ߥ᭴ㅧߩ࠶࡚ࠪࡦߢ↪ࠄࠇߚߊߟ߆ߩ⾰ߩ߁ߜޔශ⽎ߦᱷߞߚ߽ߩࠍ߿߿৻⥸ൻߒߡขࠅ
ߔߣ㧔⸥ᙘߪᱜ⏕ߢߥ߆߽⍮ࠇߥ߇㧕એਅߩࠃ߁ߦߥࠆޕ
ߩߘޟቇ↢߳ߩᡰេ߇߽ߒᦨᖡߩ⚿ᨐߦߥߞߚߣߒߚࠄߪߦߚߥޔ߇ߎࠆߩߢߔ߆㧫ޠ
ߩߘޟቇ↢߳ߩᡰេ߇ࠆ⒟ᐲḩ⿷ߩߊ߽ߩߦߥߞߚߣߒߚࠄࠍࠇߘߡߞ߿߁ߤߪߚߥޔ⍮
ࠆߎߣ߇ߢ߈߹ߔ߆㧫ޠ
ߩߘޟቇ↢߇⥄⊒⊛ߦ⥄ಽߩࠍㆬᛯߢ߈ࠆߎߣࠍេഥߔࠆߚߦ⾰ߥࠎߤߪߚߥޔࠍߘߩ
ቇ↢ߦߒߚߣᕁ߹ߔ߆㧫ޠ
ᦨೋߩ⾰ߪ 9QTUVECUGSWGUVKQPU ߣ߫ࠇࠆ߽ߩߩ৻ߟߛࠈ߁ࠍ࠻ࠬࠢ࠹ࡦࠦࠆޕᗐቯߐߖ
ࠆߎߣߦࠃߞߡ⾰ߩࡊࠗ࠲߁ߣࠆߖߐ↢ࠍ࠻ࠬࠆߌ߅ߦ࠻ࠬࠢ࠹ࡦࠦߩߘޔߢࠇߎޔ
ࠄߩ⾰ߩ⋡⊛߇ޟޔᣂߒࠬ࠻߇ᶋ߆߮߇ߞߡߊࠆㆬᛯ⢇ࠍჇ߿ߔߪߣߎࠆߦߣߎޠ
੍ᗐߢ߈ࠆ⾰ߩ⋡⇟ ޕߪߩࡦ࡚ࠪ࠻ࠬࡦࡕ࠺ߩߢ߹ࠇߎޔਛߢ㗫࿁ߦ↪ࠄࠇߡ߈ߚ߽ߩߢ
ࠆ߇ߡߞߣߦߚߥޟޔḩ⿷ߩߊᡰេߣߪ߆㧫ࠍޠ߁ߩߢߪߥߊߡ⥄ޡߪߚߥޟޔಽ⥄
り߇ḩ⿷ߒߚߡߞ߿߁ߤࠍߣߎ߁ߣޢ⍮ࠆߩ߆㧫ࠍޠ߁ߡࠆ⾰ߩߎޕ߇ߥߍ߆ߌࠆ߽ߩߪ
ⶄ㔀ߢ⹏ޔଔߩࡊࡠࠬ߿⹏ଔߩၮḰࠍ⋭⊛ߦ߁ߡࠆߣ⠨߃ࠄࠇࠆޡޟޕḩ⿷ߔࠆ߁ߣޢ
⍮ࡊࡠࠬߩᚑ┙ၮ⋚ߪࠆޔၮḰߡߟߦޠ߁⾰ߢࠆޕㅢᏱ⥄ޔಽ⥄りߩ⹏ଔ⊛⍮
ߩࡊࡠࠬߪ⥄ޔಽ⥄りߦߣߞߡߪࡉ࠶ࠢࡏ࠶ࠢࠬߦߥߞߡࠆߩߢߦߎߎޔὶὐࠍᒰߡࠆ⾰
ߪ⥄ޔಽ߇┙ߞߡࠆၮ⋚ࠍ߈ㄟࠃ߁ߥᬺࠍⷐ⺧ߔࠆ⾰ߥ߁ࠃߩߎޕߪ TGHNGZKXG㧔⋭ࠍ
ଦߔ㧕ߥ⾰ߩ৻⒳ߣ߽⠨߃ࠄࠇࠆ߇⾰ߥ߁ࠃߩߎޔࠍ⾰⊛⺰⼂ޟ㧦GRKUVGOQNQIKECNSWGUVKQPޠ
ߣࠞ࠹ࠧࠗ࠭ߒߡߪߤ߁߆ߣ⠨߃ߡߺߚࠅ߽ߔࠆޕਃ⇟⋡ߩ⾰ߪߜࠂߞߣᗧࠍ⓭߆ࠇߚߎޕ
ࠇߪޟޔലߥ⾰ߦߟߡߩ⾰⾰ޔࠅߢޠߦߟߡߩ⥄Ꮖ⸒⊛ߥ⾰ߢࠆߩࠄࠇߎޕ
⾰ߩ߁ߜ ⇟⋡⾰ߩ⋡⇟ ޔߪޔ᭴ㅧ߇㓏ጀ⊛ߢࠆߊ߆ߦߣޕන⚐ߥ⾰ߢߪߥ⦟߽ߒ߽ޕ
ᅢߥ㑐ଥᕈߩਛߢࠊࠇߚߥࠄߣޠࠎ߁ޟޔ⠨߃ㄟࠎߢߒ߹߁ࠃ߁ߥ⾰ߢࠆߒߦࠇߘޔኻߒ
ߡ╵߃ࠆߚߦߪⷞޔὐߩࡌ࡞ࠍᄌ឵ߐߖߥߌࠇ߫ߥࠄߥ⾰ߩߎޕߦኻߔࠆ╵߃߇ᶋ߆߮
߇ߞߡߊࠆߣߔࠇ߫ߪੱߩߘߪߦᤨߩߘޔᄌኈߒߡࠆޕᄌኈߔࠆߣ߁ࡊࡠࠬߥߒߦߪ╵߃ࠄ
ࠇߥ⾰ߢࠆ߫ࠇߌߥߺߡߞ߿ߪ߆߁ߤ߆ߊߊ߹߁ޕಽ߆ࠄߥߒ߇߃╵ߥࠎߤޔᶋ߆߮
߇ߞߡߊࠆ߆੍ᗐߢ߈ߥ⾰ߛߒ߽ޔߒߛߚޕචಽߥ㑐ଥᕈ߇᳇ઃ߆ࠇߡߥߥ߆ߢߩߎޔ⒳
ߩ⾰߇ᛩߍ߆ߌࠄࠇߚࠄߩߎޔ⒳ߩ⾰ߪࠢࠗࠛࡦ࠻㧔ࠆߪࠬࡄࡃࠗࠫ㧕ࠍ⪺ߒߊ
ំߐ߱ࠆ⾰ߢࠆ߆ࠄޔᷙੂߐߖߚࠅޔ႐วߦࠃߞߡߪᔶࠅࠍߊࠃ߁ߥ⾰ߦ߽ߥࠅ߆ߨߥޕ
↰ᯅᵹߦ⸒߃߫ࠆ߱ߐំޟޔ೨ߦචಽߦᛴ߃ߥߌࠇ߫ߥࠄߥ߇ߣߎ߁ߣޠ⢄ⷐߦߥࠆߣᕁࠊ
ࠇࠆޕ
ߐߡ ޔᣣߩ࠺ࡕࡦࠬ࠻࡚ࠪࡦ߇ޔᒰ⠪ߦߣߞߡߤߩࠃ߁ߥലᨐࠍߍߚ߆ߦߟߡ
ߪߥޘ⦡ޔᣇ߇ࠅ߁ࠆߛࠈ߁ߩߘޕᓟߩ⑳ߩ⥝ߪޟߡ߃ޔᄌኈࠍ⺃⊒ߔࠆ⾰ߩᛛᴺࠍޠ
߽ߞߣౕ⊛ߦ㧔ᢥሼㅢࠅޟりࠍ߽ߞߡޠ㧕ℂ⸃ߒߚߣ߁ߎߣࠈߦ⛉ࠄࠇࠆߎߣߦߥߞߚޕᣣ
ᧄ߳Ꮻߞߡ߆ࠄߩ⥄ಽߩታ〣߿ᢎ⢒ߩ႐ߦ߅ߡ⧷ޔ࿖ߢߩ㛎ߪࠍઃߌട߃ߚߛࠈ߁߆㧫ߘ
ߒߡ⥄⑳ߩߢ߹ߪࠇߘޔりߩታ〣ߦ߆ࠍઃߌട߃ᓧࠆߛࠈ߁߆㧫ߘࠇߪ߁߹ߊ⑳ߩਛߦ߅ߐ߹
ࠆߛࠈ߁߆㧫 ߘ߁ߔࠆߎߣߦࠄ߆ߩ㓚ო߇ࠆߛࠈ߁߆㧫ߘߩࠃ߁ߥ⾰ࠍ⥄ಽߦߥߍ߆
ߌߥ߇ࠄߘߩᓟࠍㆊߏߔߎߣߦߥߞߚޕ
ࠆᣣߩ㕙ធߩ৻ㇱࠍᛮ☴ߒߡ␜ߔޕ㧔ౝኈߩ⚦ߪᄌᦝߒߡࠆ㧕
ᄢቇ↢ # ำߪޔᄢቇߦ߅ߌࠆታ⠌ߥߤߩ㓸࿅ⴕേߦ࿎㔍ࠍᛴ߃ߡࠆߎߣࠍ⥄ⷡߒߡࠆߒޕ
߆ߒޔታ⊛ߪࠍޠߐߒ⧰ޟᛴ߃ߥ߇ࠄ߽߆ߣࠎߥޔᣣᏱߩታ⠌ߪߘࠇߥࠅߦߎߥߖߡࠆߒޕ
߆ߒޔ# ำߪߘߩߦޠߐߒ⧰ޟතᬺ߹ߢ⠴߃ߡߌߘ߁߽ߥߣᗵߓߡࠆߩߘޕᣣߩ㕙ធߢޔ
╩⠪ߪޔ# ำ߇ޔታ⠌ߩࠣ࡞ࡊߩਛߢᗵߓߡࠆޟਇోᗵߦޠὶὐࠍᒰߡߥ߇ࠄࠍޔ⡬ߡ
ߚ⸃ޔ߇ߚࠇߐ߇ߣߎߥޘ⦡ࠅߥ߆ޕ╷ߪᶋ߆ࠎߢߎߥ߆ߞߚ╩ޕ⠪ߪએਅߩࠃ߁ߥ⾰
ࠍߒߡߺߚޕ
㧨߽ߒߎߩᰴߩታ⠌ߢޟޔᣣߪ৻ᔕ߁߹ߊߞߚߥߣޠᗵߓࠆߎߣ߇ߢ߈ࠆߣߒߚࠄߚߥޔ
ߪ߇ߣߎߩߘߡߞ߿߁ߤޔಽ߆ࠆߩߢߒࠂ߁߆㧫㧪
# ำߪᴉ㤩ߦ㒱ߞߚޕᓐߪࠄ߆ߦ⌀ߦ⾰ߩߘޔߦኻߔࠆ╵߃ࠍ⠨߃ߡߚᤨߩࠅߥ߆ޕ㑆
߇ߚߞߡޔᓐߪફߖߡߚ⋡ࠍߍޕߚߞ⸒߁ߎޔࠄ߇ߥߟࠍ⑳ߦߋߔߞ߹ޔ
ޔߪࠇߘޟන⚐ߥߎߣߢߔޕ߇㗡ߩਛߢ⦡ޘ⠨߃ߡࠆߎߣࠍޔታ㓙ߦߘߩ႐ߢ⹜ߒߡߺࠆߎ
ߣ߇ߢ߈ࠇ߫ߪᤨߩߘޔḩ⿷ߢ߈ࠆߩߢߔޠ
ߎߩ╵ߪߩ⑳ޔᗧࠍߟߚߥ߁ࠃߩߘޕ⏕ߥ╵߃߇ߞߡߊࠆߛࠈ߁ߣߪ⑳ߪ੍᷹ߒߡ
ߥ߆ߞߚߒߒ߽ޔ⏕ߥ╵߃߇ߞߡ᧪ߚߣߒߚࠄ߇߃╵ߥ߁ࠃߩߤޔߞߡߊࠆߎߣߦߥࠆߩ
߆ߪߦ⑳ޔᒰ߽ߟ߆ߥ߆ߞߚޟߦߐ߹ޔߪࠇߘޕή⍮ߩ⾰ ߡߒߣޠ# ำߦᛩߍ߆ߌࠄࠇޔ#
ำߪߘࠇ߹ߢోߊ⏕ߥ⸒⪲ߣߒߡߪ߹ߢ⺆ߞߚߎߣߩߥᣂߒࠬ࠻ࠍᶋߐߖߚޕ
㧨ታ㓙ߦߘߩ႐ߢ⹜ߒߡߺࠆߣ߁ߎߣࠍ߁߽ޔዋߒౕ⊛ߦᢎ߃ߡߊࠇ߹ߖࠎ߆㧫㧪
ޔ߫߃ߣߚޟታ㛎ࠍߔࠆߣ߈ߦߪࠣ࡞ࡊߢหᬺࠍߔࠆߩߢߔ߇ࠇ߿߁ߎߪ࠻ࠗࡔࡓ࠴ޔ
߫߁߹ߊߊߛࠈ߁ߣ⠨߃ߡࠆߩߦޔߦߪߘ߁ߪᕁ߃ߥᤨ߇ࠅ߹ߔߣߞ߽ޔ߫߃ޕ㆑
߁ᣇᴺߢ߿ߞߚᣇ߇⦟ߩߢߪߥ߆ߣޠ
㧨ߥࠆ߶ߤߐߛߊߡߌ⛯ޔ㧪
⥄ޔᤨߩߘޟಽߩ⠨߃ࠍญߦߔߣ⋧ޔᚻ߇⚊ᓧߒߡߊࠇߥ႐ว⺑ޔߒߥߌࠇ߫ߥࠄߥߩ
ߢߔ߇߇ߣߎ߁߹ߒߡߞߥߦ߾ߜߏ߾ߜߏߢߎߘޔᄙߩߢޔ㤩ߞߡࠆߎߣ߇ᄙߩߢߔޕ
ࠆߪ⺑ࠍߖߕߦ⥄ߣߐߞߐޔಽߩ߿ࠅᣇߢ߿ߞߡߒ߹⥄ޔ߫ߌߊ߹߁߇ࠇߘޔಽߩ⠨߃
߇ᱜߒ߆ߞߚߎߣ߇⸽ߢ߈߹ߔޔߒ߆ߒޕታߦߪߤߩߤߜࠄ߽ߢ߈ߥߎߣ߇ᄙߩߢߔޠ
㧨ߘ߁ߔࠆߣޔำߩ⸒߁ޔ⠨߃ࠍታ㓙ߦ⹜ߒߡߺࠆߣ߁ߎߣߪޔዋߥߊߡ߽ੑߟߩน⢻ᕈࠍ
ࠎߢߡߪߟߣ߭ޔ⠨߃ࠍญߦߒߡ⚊߇ੱߩઁࠍࠇߘޔᓧߒߡߊࠇࠆ߆ߤ߁߆⹜ߒߡߺࠆߣ
߁ߎߣߢޔߪߟߣ߭߁߽ޔታ㓙ߦታⴕߒߡߺߡ߁ߣࠆߺߡߒ⹜ࠍ߆߁ߤ߆ߊߊ߹߁߇ࠇߘޔ
ߎߣߢߔ߆㧫㧪
ߣߛࠅ߅ߣߩߘޟᕁ߹ߔޠ
㧨ߘߩߤߜࠄ߆ࠍታⴕߢ߈ࠇ߫ߩߘޟޔታ⠌ߪ߁߹ߊߞߚߣޠำߪᗵߓࠆߎߣ߇ߢ߈ࠆߣ߁
ߎߣߢߔߨ㧪
ޠߔߢࠅ߅ߣߩߘޟ㧔એਅ⇛㧕
ߎߩ⚻㛎߆ࠄ╩ޔ⠪ߪ⦡ࠍߣߎߥޘ⠨߃ߐߖࠄࠇߚޕ㧨߽ߒߎߩᰴߩታ⠌ߢޟޔᣣߪ৻ᔕ߁߹
ߊߞߚߥߣޠᗵߓࠆߎߣ߇ߢ߈ߚߣߒߚࠄ߇ߣߎߩߘߡߞ߿߁ߤޔߪߚߥޔಽ߆ࠆߩߢߒࠂ߁
߆㧫㧪ߣ߁⾰ߪ߆ߥࠅⶄ㔀ߥ᭴ㅧࠍ߽ߟ⾰ߢ⧷ޔ࿖ߢߩ㛎ߢࠆ⒟ᐲቇࠎߢ߈ߚߎߣࠍޔ
ᣣᧄ⺆ߦ⠡⸶ߒߩߘ߽߆ߒޔ႐ߩࠦࡦ࠹ࠢࠬ࠻ߦㆡวߔࠆࠃ߁ߦࠍޠ߫ߣߎޟޔᎿᄦߒߚ߽ߩߢ
ࠆࠆޕᗧߢߪ߆ߥࠅ߉ߎߜߥ⾰ߢࠆߣ⸒߃ࠆߦࠇߘޕኻߒߡޔ# ำߪߒ߫ࠄߊߩ㑆⠨߃ߚ
ᓟߦߪࠇߘޟන⚐ߥߎߣߢߔޕࠆߢߩߚ߃╵ߣޠ
ߘߒߡޔߪ╵ߩߘޔዋߥߊߣ߽⾰ߒߚᤨὐߢߪ⑳ߩਛߦߪߥ╵߃ߛߞߚޔߒ߆ߒޕ# ำ߇⏕
ߦ⺆ߞߚᓟߦߪߪࠇߘޔᭂߡ⚊ᓧߩߊ⺆ࠅߦߥߞߚޕ# ำߪᧄ⾰⊛ߦޟតⓥ⠪ߒޕߛߩߚߞߛޠ
߆ߒ # ำ߇⥄ࠄߘࠇࠍ⺆ࠆ߹ߢߪޟޔតⓥ⠪ߣߒߡߩ # ำޕߚߞ߆ߥ߽ߦߎߤߪޠ# ำߪޟតⓥ⠪
ߣߒߡߩ⥄ಽߡߞࠃߦߣߎࠆ⺆ࠄ⥄ࠍޠഃㅧߒߚߊߒߤߚߤߚޔ߇⑳ߪࠇߘޕ߆ߌߚ⾰߇⺃
⊒ߒߡ߽ߩߢࠆ߆߽ߒࠇߥ߇⾰ߩߘޔ߇ߥߐࠇࠆ೨߆ࠄߔߢߦޟតⓥ⠪ߣߒߡߩ # ำߕߪޠ
ߞߣߘߎߦߚߩߢࠆޕ
ڎጊ↰ජⓍ㧔੩ㇺᄢቇ㧕
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߇ᦨޔㄭ♧ޔዩ∛ࠞࡦࡃ࡚ࠪࡦࡑ࠶ࡊߣ߁ޔኻဳߩᣂߒᢎ⢒࠷࡞ࠍߞߡޔᖚ⠪ߐ
ࠎߩ࠽࠹ࠖࡧߦ⸅ࠇࠆᯏળ߇ዋߒߕߟߢ߈ߡ߈߹ߒߚޕ࿁ߎߩࠃ߁ߥࡊࡠࠫࠚࠢ࠻ߦෳടߐߖ
ߡߚߛߚߎߣߪߡߞߣߦߒߚࠊޔ㕖Ᏹߦᗧ⟵ߢߒߚޕߚߒ߹ߑߏ߁ߣ߇ࠅ߽߁ߤޕ
㧞 ޣᣣߩታ⠌ߢߤߩࠃ߁ߥߎߣ߇ߎࠅߥ߁ࠃߩߤߪߚߥޔ㛎ࠍߒ߹ߒߚ
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߹ߕ)ޔߪߢࠬࠡࠗޔ2 ߦߎߩࠃ߁ߥ 95 ࠍⴕߞߡࠆߎߣߦޔ㕖Ᏹߦ㛳߈߹ߒߚߓߪޔߚ߹ޕ
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ᜬߜ߹ߒߚޕ
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╵߃ࠍߟߌߚ߇ࠆะ߇ࠆ߆ߣ߁ߎߣࠍ㕖Ᏹߦታᗵߒ߹ߒߚ ߇ࠇߎޕGXKFGPEG ߛ߆ࠄߣ߁
⚊ᓧߩߒ߆ߚߪޔකᏧߦߣߞߡߪ㕖Ᏹߦᭉߢߔߩߢޔߚ߹ޕጯᧄవ↢߽ߍߡ߅ࠄࠇߚࠃ߁ߦޔ㧢
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ߣ߽ߡߣࠅߪ߿ޔᔃߒ߹ߔޕ
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ⶄ㔀♽ߩਛߢߪዊߐߥᄌൻ߽ᄢ߈ߥᄌൻߣߥࠆޔ95 ߦෳടߒߚߎߣߢࠃࠅ EQPHWUKPI ߦߥࠆߎߣ߽
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ߎߣ߇ࠆߩߢ߽ߒਈ߃ࠆߣߒߡ߽ᦨᓟߦޔEQPHTQPV ߖߕ EJCNNGPIG ߔࠆ߇ࠬࡦࡃޔᄢޕ
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ࠆᔅⷐ߇ࠆޕ
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ߴߐߖߡߚߛ߈߹ߔ㧕ޕ
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߹߹ߖࠎ㧕ޤ
.CWPGT వ↢ߣ *CNRGTP వ↢ߩ߿ࠅߣࠅࠍ⡞߈ߥ߇ࠄޔ࿁ߩࠃ߁ߥㅴⴕߩߒ߆ߚ߇ࡃߩ⺆⸒ޔ
ࠕߦࠃࠆ߽ߩߥߩ߆ޔౝኈ⊛ߦ㔍ߒࠤࠬߥߩ߆ߩߘޔਔᣇ߇㑐ਈߒߡࠆߎߣߦߪ᳇ߠ߈ߥ߇
ࠄߩࠄߜߤ߇ߢ߹ߎߤޔ㗴ߥߩ߆ࠊ߆ࠄߥߢ߹ߒߚ㧔⑳ߪ 5WRGTXKUKQP ߣ߁߽ߩࠍ㛎ߒ
ߚߎߣ߇ࠅ߹ߖࠎߩߢ㧕ᦨޕᓟߩ ߩߎޟޔ5WRGTXKUKQP ߇ᄬᢌߦ⚳ࠊࠅߘ߁ߛޔߪߣߎ߁ߣޠ
ߐߔ߇ߦౖဳ⊛ߥ⚳ࠊࠅᣇߢߪߥߩߛࠈ߁ߣᕁ߹ߒߚ߇ࠅࠊ⚳ߥ߁ࠃߩߘޔᣇߢ߆ࠊߦࠄߐޔ
ࠄߥߊߥࠅ߹ߒߚޕ߆╵߃߇ᓧࠄࠇࠆ㧔╵߃ࠍਈ߃ࠄࠇࠆ㧕ߎߣࠍᒰߚࠅ೨ߩࠃ߁ߦᕁߞߡߚޔ
߹ߚ߆╵߃ࠍߟߌࠃ߁ߣߒߡߚ⥄ಽ߇߹ߒߚ߇⺰⚿ޟޕߡߥࠍࡑࡦࠫޔᛴ߃ߚ
㗴ޔߢߩࠆߡߒࠍߡߟߦޠ߆ᱜ⸃ࠍᦼᓙߔࠆߎߣ⥄࠽ࡦࡦࠬߢࠆߩߦߦ߁ࠃߩߤޕ
ᄌࠊࠆࠃ߁߽ߞߡߊ߆ߡߟߦࠬࡠࡊߩࠅߣࠅ߿ޔ⠨߃ࠄࠇࠆࠃ߁ߥ┙ߜ⟎ߦޔᱷᔨߥ߇ࠄޔ
ߘߩᤨߦ⥄ಽߪߥ߆ߞߚࠃ߁ߦᕁ߹ߔޕ
㧠㧚ࠄ߆ޣ⠨߃ࠆߣ⥄ߚߥޔりߎ߁ߔࠇ߫ࠃ߆ߞߚߣ߁ߎߣ߇ࠅ߹ߔ߆㧫߽ߒࠆߣߔࠇ
߫ߘࠇߪߤ߁߁ߎߣߢ߆߁ࠂߒߢߩߚߞ߆ࠃ߫ࠇߔߦ߁ࠃߩߤޔ㧫ޤ
࠽࠹ࠖࡧߦ⥝߇ࠆߣ⸒ߥ߇ࠄ⥄ޔಽ߇ਥ⊛ߦ⺆ࠆߎߣ߳ߩ⥄ାߩߥߐࠍ⸒⸶ߦߒߡޔ
ฃߌりߦߥߞߡߚߎߣߪ⥄ޔಽߩਛߢߩ⋭ὐߣߒߡߍࠄࠇ߹ߔޕ㧔࿁ߩታ⠌ߦ㒢ࠄߕᏱߦ
⥄ಽ⥄りߩ⺖㗴ߢߔ߇ޕޕޕ㧕ឭଏࠍߒߡߊߛߐߞߚޔศ᳗వ↢ߩാ᳇ࠍ⠌ߚߣᕁߞߡ
߅ࠅ߹ߔޕ
㧡㧚ߩߎޣታ⠌㛎߆ࠄឭߐࠇࠆ㗴ὐ߿⇼ὐߪߥࠎߢߔ߆㧫ޤ
ࠗࠡࠬߩᢥൻߢߪ⺆⸒ߡߴߔޔൻߔࠆߣ߁ߎߣ߇ޔ㕖Ᏹߦ㊀ⷐⷞߐࠇߡ߹ߔ߇ޔᣣᧄੱߦ
ߪዋߒߥߓߺߦߊߣߎࠈ߇ࠆߩߢߪߥ߆ߣᕁ߹ߔޕᣣᧄੱߦวߞߚ 95 ߩᣇᴺࠍ⠨߃ߡߊ
ᔅⷐ߇ࠆߩߢߪߥ߆ߣᕁ߹ߒߚޕ
㧢㧚ߩߎޣታ⠌ߩ㛎߆ࠄߥߚ߇ቇࠎߛࡐࠗࡦ࠻ߪߥࠎߢߔ߆㧫ޤ
߽ߣ߽ߣࠍߔࠆߣ߁ߎߣߦ⥄ା߇ߥߩߢ ߢࠇߘޔPCTTCVKXG ࠍቇ߮ߚߣᕁߞߚߩߢߔ߇ޔ
ቇߴ߫ቇ߱߶ߤ߹ߔ߹ߔ EQPHWUKPI ߦߥߞߡࠆߩ߇ߩ⁁ᘒ߆ߣᕁ߹ߔޔߐߥࠄ߆ࠊޔߒ߆ߒޕ
ਇ⏕߆ߐ߆ࠄߎߘቇ߱ߎߣ߇ᄙߊࠆߣ᳇ߠߌߚߩߪ⚻ࠃޔ㛎ߢߒߚޕ
㧣㧚ߦ߆߶ޣઃߌട߃ࠆࠦࡔࡦ࠻߿⾰߇ࠇ߫ߥࠎߢ߽ߤ߁ߙޤ
ߺߥߐ߹ߩ┙ᵷߥߏႎ๔ࠍߒߡޔౣᐲቇ߫ߖߡߚߛ߈߹ߒߚ߹ߑߏ߁ߣ߇ࠅ߽߁ߤޕ
ߒߚޕ
ߎ߁ࠃߛ߹߿ڎ㧔੩ㇺᄢቇ㧕
╙ ㇱ ߩࡁ࠻ࠃࠅ ߿߹ߛࡔࡕ㧞
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ࠄ㛎ߔࠆ߇ޔ࿁ߪઍ⠪ ੱ߇ⴕߞߡޕߚߞߥߦࠬࡦࠛࠖ࠺ࠝߪߣޔ
Ԙࠢ࡞࠻ߣࠗࡦ࠻ࡠ࠳࡚ࠢࠪࡦ
࠽࠹ࠖࡧࠕࡊࡠ࠴ࠍ࠻࠾ࡦࠣߔࠆߣ߈ߦᔅⷐߥ߈߆ߌޕ
⸃ޟ
UQNWVKQPߐࠇߡߥ
ޔᖚ⠪ߦ߹ߟࠊࠆߥ࡞࠽࡚ࠪ࠶ࠚࡈࡠࡊޔࠆࠊߟ߹ߦࡓ࠴ޔ
ࠫࡦࡑߩࠆ㗴ࠍ߽ߞߡࠆੱޕࠆߩߟࠍޠ
⊝ߩ೨ߢߒߡ߽ࠍࠬࠤޔߖࠆੱޕ⠨߃ߡࠆߎߣࠍญߦߔߎߣߩߥࠎߺޕ೨ߢߒ
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Ꮐ߆ࠄࡠ࠽ޔࡦࡋޔศ᳗ߣࡦࡋޔߪ࠽ࡠޕዋߒ㔌ࠇߡ߿߿ᓟࠈޕ
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5QNWVKQP ࠍਈ߃ࠆߩߢߪߥߊޔURCEGQHVJKPMKPI ࠍਈ߃ࠆ
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ߦ ߡߒࠍߣ࠽ࡠޔVJKPMKPIURCEG ߣߒߡ߁ޕ
ࡋࡦߣศ᳗ߐࠎߩ࠳ࠗࠕࡠࠣߩⴕࠊࠇᣇ⾰ߩࡦࡋޔߩߥ߆ߢࠃ߇ࡦ࡚࠴ࠬࠛࠢߩߎޔ
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ࡓࠣࡠࡊع2㧦Symposium on Narrative Research in Health and Illness
Day 2: Wednesday 1st July 9.30-17.00
Title: Symposium on Narrative Research in Health and Illness
Venue:
a.m.: Council Room, University College London, Gower Street, London WC1N 6BT
p.m.: Lecture Theatre 1.03, Malet Place Engineering Building, London WC1E 7JE
Convenors: Prof. Trisha Greenhalgh (University College London), Prof. Brian Hurwitz (Kings
College London)
Proposed programme:
9. 30: Welcome by Prof. Trisha Greenhalgh (University College London)
9.45: Narrative medicine: an introduction. Prof. Trisha Greenhalgh (University College
London)
10.30: Visual narratives of life cycle and death in Japanese, British and French adults. Prof.
Yoko Yamada PhD (Kyoto University)
11.00: Discussion
11.15: Coffee
11.30: Narrative-based evidence-using Medicine: a story of reconciliation between EBM and
NBM in Japan. Prof. Seiji Saito MD, PhD (University of Toyama)
12.00: What sort of narrative is a clinical case? Prof. Brian Hurwitz (Kings College London)
12.45: Discussion
13.00: Buffet lunch
14.00: Narrative based knowledge management. Dr. Takashi Yoshinaga, PhD (University of
Toyama)
14.30: Choice and loss in infertility experience: the narratives of Japanese women who
accepted their lives as childless women. Ms. Kazumi Takeya (Kyoto University)
14.45: How midlife women image 'mother-self-daughter' relationships: the drawings of 'care'
story. Ms. Naoko Nishiyama (Kyoto University)
15.00: Discussion
15.15: Tea
15.30: A conversation-based tool for diabetes self-management education. Dr. Chizumi
Yamada MD, PhD (Kyoto University)
15.45: How to narrate the transmission of traditional Japanese dance. Mr. Kazuma Takeuchi
(Kyoto University)
16.00: Presentation by Dr. Neil Vickers (Kings College London)
16.45: Discussion
17.00: End
18.00. Meal in restaurant
Additional participants for Day 2: Dr. Helen Halpern, Dr. Victoria Holt (pm only) and Dr.
Serena North (London Deanery), Ms. Junko Wakitani (Tavistock Clinic)
Storylines of self-management: Qualitative study of diabetes
narratives in a multi-ethnic inner-city population
Trisha Greenhalgh
(Professor of Primary Health Care, University College London)
Background
Much can be learnt from patients’ illness narratives. We aimed to use diabetes narratives to
inform the design of self-management education.
Study design
Quasi-naturalistic story-gathering i.e. making real-time field notes of stories shared
spontaneously in diabetes self-management education groups.
Setting and sampling frame
Socio-economically deprived London borough. Intervention arm of a randomised trial of
story-sharing.
Methods
82 adults aged 25-86 from six minority ethnic groups participated. Stories were translated in
real time by the facilitator or group members. Ethnographic field notes were transcribed and
analysed thematically (coding sections of text) and narratively (for literary features such as
characterisation and emplotment). Analysis was informed by biomedical and sociological
theories.
Main findings
Thematic analysis revealed seven practical issues facing the person with diabetes: knowledge,
diet, exercise, medication, foot care, self monitoring and attending check-ups. Narrative
analysis revealed eight illness storylines within which these practical issues acquired social
meaning and moral worth: entering the kingdom of the sick, rebuilding spoiled identity,
becoming a practitioner of self-management, living a disciplined and balanced life, mobilising
a care network, navigating and negotiating in the healthcare system, managing the micromorality of selfmanagement ‘choices’, and taking collective action.
Conclusion
Living with diabetes involves both medically recommended behaviours and complex
biographical work to make sense of and cope with illness. Self-management education
programmes should (a) take closer account of the over-arching storylines that pattern the
experience of chronic illness and (b) recognise that some core elements of self-management
knowledge cannot be pre-specified in detail in a structured curriculum.
The illness narrative
Professor Trisha Greenhalgh
University College London
In every human society, people tell stories
We heard our first story at our mother’s knee, and we will
probably tell our last when we lie down to die
In between, whenever a group of people – or even two people –
gather together, they tell stories.
The Bible says “In the beginning was the Word”. A more accurate
translation is “In the beginning was the story told and heard”
Stories tell about adventure and risk, good and evil,
trust and fear, joy and sorrow …
1
JEROME BRUNER
The narrative structure of experience
…and about human virtues such as courage, loyalty, humility, and
honesty which mark out the heroes in all stories.
Narrative as making meaning in the
Knowledge is
socially shared
before it is
‘in our heads’
Learning occurs
by
sharing and
enacting stories
Stories reveal the unwritten rules that make up ‘culture’
Doctors and nurses learn what is wrong with patients, and
why it matters, by hearing their stories
They acquire their professional knowledge by
sharing stories about sick patients
2
The story is the unit of learning, the way we gather experience,
and above all, the way we find out what to do.
Literary devices such as metaphor, irony, suspense and surprise
appeal to the emotions and change people’s desires and motives
LAURENCE
KIRMAYER
Broken narratives
“People do not tell their
stories in a vacuum. They
must fight (be good
rhetoricians or debaters) to
tell their story and to have it
more or less accepted,
authorized, or taken up by
others. They try to control
the circumstances of its
hearing and, to some
degree, of its interpretation.”
Obama is a good leader because he tells good stories, and
because every U.S. citizen wants to be part of his story
ARISTOTLE
Stories have:
Chronology
(unfolding
over time)
Characters
Setting
Trouble
Plot
In the illness narrative, trouble is disease, disability, disfigurement,
and death – and all the difficulties that come with these
3
50 years ago, most illness was acute and short-term.
The doctor visited. Illness was a passive experience.
Today, most illness is chronic. Once diagnosed, it will be with
you for life. Living with chronic illness is hard work.
Illness narrative
as identitybuilding.
The sick person
is a hero who
struggles to be a
good parent, a
good citizen, a
good employee
despite the
trouble that the
Steve Redgrave has redefined what it means to be
a person with diabetes
MIKHAIL BAKHTIN
The listener is an ‘other’ to whom the story is directed.
Kylie has redefined what it means to be
a person with breast cancer
The audience will laugh when they see absurdities in our story;
they will be outraged when they see injustice
4
MIKHAIL BAKHTIN
“Human thought becomes genuine thought, that is, an idea, only
under conditions of living contact with another and alien thought,
a thought embodied in someone else’s voice”
ARTHUR FRANK
The listener is a
witness to suffering
Some research with Bangladeshi patients with diabetes
Most Bangladeshi
patients with
diabetes were
poorly controlled
and did not appear
to understand their
illness
“I heard about a man who
smoked and had his leg cut
off, so I gave up smoking”
“I heard about a woman who kept
finishing off the food the children left,
and she got very fat, so I started to
measure the portions of my food”
The doctor’s advice did not change their behaviour. What changed
their behaviour was a story told by another Bangladeshi.
“I heard about a woman who came to
that clinic, and they gave her insulin
and her baby died, so I won’t go the
clinic and I won’t take the insulin”
5
We did 7 years of action research with the Bangladeshi
community, developing story-sharing groups
We trained facilitators who ran groups in Gujarati, Punjabi, Urdu,
Somali, Farsi, Chinese, English (for African Caribbeans) and Tamil
THE SHARING STORIES MODEL
Spontaneous, informal and unstructured story-sharing:
People tell whatever stories they want about their
diabetes, in whatever order, with no rules about what is
‘important’ or ‘legitimate’
Non-directive facilitation by a non-clinical professional or
volunteer trained in the sharing stories model
Input of clinical professionals (doctors, nurses, dieticians)
must be as a response to the stories shared by group
participants, not a ‘standard speech’
“WRONG STORIES”
Always challenged by counter-narratives from others in the group
Expose confusion and ambiguity that demand an explanation
STORY 1
In a randomised controlled trial, we compared story-sharing
groups with standard nurse-led diabetes education
Everyone brought their tablets. The women sat in a circle, each with her
tablets in a large carrier bag (which demonstrated how much they were all
taking). They took it in turns to hold up a particular ‘problem medicine’
and describe the difficulties they had with it. Such stories drew further
stories from the others in the group (for example, about diarrhoea with
metformin). There was much laughter, and practical advice.
6
STORY 1
STORY 2
An African Caribbean group included
a widowed man, who did not know
how to apply advice from white
British dieticians to his own shopping
and cooking. The women decided to
“sort out this gentleman’s meals”, and
asked him every week for stories of
what he had made to eat.
In the group, the women felt confident to say they did not take the
medication. The GP who had been invited to the session explained
possible strategies for organising their medication and dealing with side
effects. But the best strategies came from the women themselves.
Many women said nothing, but listened to stories told by others.
STORY 3
A Gujarati woman told her
group she had been given a
plug-in footbath.
She was aware of the dangers of
applying external heat to
neuropathic feet
But she needed advice: is it
reasonable to reject an expensive
birthday present from a relative?
His stories of failure at ‘women’s
work’ led to much laughter, but in a
very supportive atmosphere. The man
listened to the women exchanging
stories of cooking. He was soon
confidently preparing healthy meals.
CHERYL MATTINGLY
“A central difficulty with
clinical renderings of patient
sufferings is that in their
abstractness, the world of
the patient is left out. This
world is above all a practical
and moral one in which
patients have life projects
and everyday concerns,
things ‘at stake’.”
THE MICRO-MORALITY OF LIFESTYLE CHOICES
•
Personal stories often contain examples of small-scale
ethical choices
•
Should I do X (which will have these consequences), or
should I do Y (which will have those consequences)?
•
In poor people, micro-morality is often about how best to
spend limited family income or other resources such as
time
STORY 4
A podiatrist arrived with a Powerpoint presentation. The facilitator
politely asked the podiatrist not to show her slides but to listen to the
stories, which she translated. All the women had heard the ‘foot care talk’
before, but they were still confused.
One woman pointed to her shoes and those of her neighbour and said, “I
was told to buy these special shoes for £80, but she was told to go to the
shop and get those shoes for £20. Why was I given different advice?”
7
STORY 5
In one group, women campaigned for women-only swimming sessions at
the local pool. When the pool offered these sessions, they realised they did
not have any swim-suits to wear. They got together and made themselves
special swimming dresses to protect their modesty.
EVALUATION
[1] What would you tell a friend about the group?
[2] What has changed in your life?
[3] How would you change the group?
“I am no longer afraid
of insulin injections”
“We learn the facts from
you [doctors] but we
learn the meaning from
one another”
“I would tell my
friend, ‘come to the
group to find out what
questions to ask’”
“We come to the
group to hear the
experiences of
others’”
“I have put away my
big plates and
bought smaller
ones”
“I have lots of
new recipes”
1. Making sense of
experience (Bruner)
STORY-SHARING GROUPS WERE
•
Significantly better attended than standard education
groups (p < 0.001)
•
Equivalent to standard education in terms of biomedical
outcomes and ‘well-being score’
•
Significantly better than standard education in terms of
patient enablement (p < 0.001)
•
Cheaper than standard education groups
•
Linked to action
8. Negotiating
micro-morality of
lifestyle choices
(Ricoeur)
2. Personalising
knowledge (Polanyi)
7. Raising critical
consciousness
(Freire)
6. Equalising
power imbalance
(Habermas)
3. Building
identity (Strauss)
5. Developing a
community of
practice (Lave)
4. Constructing
shared knowledge
(Vygotsky)
8
THANK YOU FOR LISTENING
Professor Trisha Greenhalgh
University College London
The illness narrative has untapped potential as a tool in clinical care
9
Visual Narratives of Life Cycle
and Death in Japanese,
British and French Adults
Yoko Yamada
(Kyoto University)
1 /7/2009, London
As this introductory story suggests, we
may view our lives as one single life time
from birth to death, or we may image the
long linkages among invisible lives of
peoples and generations .
These questions engage people from
diverse cultures, with different historical
and traditional backgrounds.
The second study is “The Image of
This World and the Next World after
death”.
Japanese, British, French and
Vietnamese University Students were
asked to draw the images of the
relationship between this world and
the next world, and the images of the
transition of their souls.
We have collected over 3000
freehand drawings of these visual life
stories.
• “When we think of the life of a person, it
may be necessary to draw a map of his or
her life in such a way that it starts not
from birth, but from going back to the
past, and concludes not with death but
extends toward the future.
What a person is born into in this world
does not mean only his or her birth. We
should see that he or she is born under
the large shadow of the cycle of people
which includes everyone, and even after
death, there is something in succession.”
(Kenzaburo Oe)
In the context of psychological research
on life-span development, I present two
studies that aim to increase our
understanding of contemporary people’s
imaginary lives and deaths, across several
cultures.
The first study is on the “Image Map of
Life”; participants were Japanese, British
and Austrian University students.
Using my original method of visual
narrative (Image Drawing Method: IDM), I
asked the participants to draw pictures
representing their lives (past, present and
future).
Study1 Image Map of Life
Purpose
• This study examined how people from
different cultural backgrounds represent
images of the course of their lives and
their perspective of time by depicting
their own life stories visually.
• It also critiqued models of life-span
developmental psychology and
constructed new models based on the
different types of naïve images of lives.
Study1 Image Map of Life
Method
Study1 Image Maps of Life
Results
The participants were 874 Japanese
university students, and 151 British
university students.( Now analysing
the data of Austrian university
students)
They were directed to draw an
imaginary map of their life (past,
present, and future) and to explain
their image.
The fundamental visual stories were
extremely common among different
cultures.
They were qualitatively analysed by the
pattern of lives, meanings and values.
The following 8 stories were especially
remarked.
Fundamental 8 stories
1) Climb up Story (rise, up and down)
2)Expand Story (big, large, growth)
3) Road Story (course, way, goal)
4) Event Story (life events, periods)
5) Choice Story (select, turning point)
6) Flow Story (chance, river, wind)
7) Cycle Story (return, repetition)
8) Being Story (stand, watch)
1) Climb Up Story
British; Japanese
1) Climb Up Story : British
Past was difficult.
Present is more difficult with more opportunities.
Future is expected to be rough and opportunities seem
to be more “opportunistic”.
The general feeling of anxiety around the age of
40 seems to come from the realisation that some
day short-term goals and long-term goals merge.
I guess for me long-term goals have something to
do with dream, hope etc, and short-term goals
with responsibility, duty, deadline etc.
Somewhere along the age line the main feature of
goals shift from PREPARATION to
CONTRIBUTION. A part of the anxiety comes
from the recognition that I have not sensed the
shift in my life.
If I wait too long, long-term goals and short-term
goals may collide to fall rather than merge for a
soft landing.
Call it, if you please, “Middle-Age Crisis”.
• 2) Expand Story
• British: roots American
• This MAP represents my feeling that life is a circle of
experience and growth, ever-expanding. My FUTURE
experiences will be wider than my PRESENT experiences
and my PRESENT experiences are more encompassing
than my PAST. I feel that I am/will be forever growing as
a person/individual. Life is by definition growth,
otherwise we are dying. These circles also represent
different cosmologies, worldviews, mindsets within me
that I feel will expand and change as does the universe.
Circles represent harmony to me, as I always hope and
strive for a harmonious life!
• Japanese
• Long and Winding
Road (British)
• Winding road represents the past
time when I did not know what to
do.
• My image of the past is that I did
not proceed straightforwardly.
• “Dead end” represents the
accasions when I thought “this is
not my way”.
• At the bottom, road is very broad,
which means I had a lot of
possibilities and did not feel much
tension in everyday life.
• At the top, the road is getting
wider because I still think I have a
lot of possibilities in the future.
• The road is sometimes black. This
represents sometimes it is dark
and difficult to walk.
• 3) Road Story: British (roots American);
• Japanese
• Although my childhood was not always pleasant, my experiences
provided me with a solid foundation for academic pursuits, intimacy and
success. I only have positive thoughts about my future. I don’t anticipate
any failures, only twists and turns toward success!
• 5) Choice Story
•
• British; My life is like
walking down a road. During
childhood I got to make very
few choices in life (single
road) but as I got older
(around high school) I was
able to make more of my own
decisions. My opportunities
in life increased, as indicated
by the number of roads. In
future (old age) I believe my
opportunities (e.g. career
options) will decrease (fewer
number of roads). The star is
where I am at present. The
increase in people indicates
my increased exposure to a
variety of people.
• 4) Event Story
• British; Japanese
6) Flow Story
British (roots
Mexican) :
River
Japanese:
River, Wind
• Japanese; Life is infinite
selections at the turning
points. There are many
invisible gates.
7) Cycle Story:
British (roots Indian)
Japanese
1)A tree, and nothing else, is presented (that is, in the beginning, an ecological context
preexists. 2) The tree begins to bear fruit. The first fruit (former generations) is very
beautiful. The fruit (myself) has not appeared yet. 3) The fruit that is me appears in this
phase. 4) The fruit that is me is not picked and remains on the tree. 5) The fruit that is
me has fallen to the earth (death). 6) After my death, the fruit that is me nourishes the
earth, and this will continue in subsequent generations in an ecological context.
Study1 Image Map of Life
Discussion
The first 5 stories are considered to be the dominant
stories in the theories of life-span developmental
psychology.
Progress Story
1) Climb Up, 2) Expand Story (up and down, life stage,
grow, success, acquisition, achievement,
competence)
• 8) Being Story
Life course Story
• (British ; roots Greek)
• This is a picture of me sitting on
sand by the seaside and watching
the sea. I like this image of my
life in past, present and future
too. I very much like watching
the sea and the horizon beyond it.
I like viewing a perspective in my
life, the “depth” of the sea, what
comes beyond it. It is endless, I
think, and challenging; attractive
but dangerous too.
3) Road 4) Event 5) Choice 6)Flow Story (life events,
turning point, select, chance)
• Japanese
1 An example of linear Progressivism and
Individualism of life image:
▫
“My life as Climbing up” : the six
phases of self’s life.
▫ 1) I climb at a steady pace.
▫ 2) A pitfall.
▫ 3) A large obstacle.
▫ 4) I overcome the obstacle with much
effort and climb higher.
▫ 5) <Present> More obstacles await me.
▫ 6) The future cannot be seen as it is
hidden in the clouds.
Other 2 stories seem to be important for having
relative viewpoints of the implicit values of
developmental theories and for constructing new
models of life-span development.
1 An example of Generative Life Cycle
“My Life as an Apple Tree”
▫
1) A tree, and nothing else, is presented (that is,
in the beginning, an ecological context preexists.
▫ 2) The tree begins to bear fruit. The first fruit
(former generations) is very beautiful.
▫ The fruit (myself) has not appeared yet.
▫
▫ 3) The fruit that is me appears in this phase.
▫ 4) The fruit that is me is not picked and remains
on the tree.
▫ 5) The fruit that is me has fallen to the earth
(death).
▫ 6) After my death, the fruit that is me nourishes
the earth, and this will continue in subsequent
generations in an ecological context.
Study２ The Image of This
World and The Next World
• The Image Drawing Method (IDM)
• 1) If the next world after death exists,
What do you imagine? Please draw a
picture representing your image of the
relationships between the people in this
world and those in the next world. Please
explain your drawing.
• 2)Drawings of the passage of the soul.
• 3)Quesionnaire: Beliefs of After life (21
items).
Study 2 Typical Results
• 1)The relationships between the people in
this world and those in the next world
• Watching and Caring from the people in next
world in the upper place
• 2)The transition of the soul after death
• The Spiritual Cycle of going up and rebirth
Ｃｙｃｌｅ Ｍｏｄｅｌ
ＪＡＰＡＮ）
Conclusion
• While there was a lot of variation, there
was a fundamental commonality to the
typical visual images of lives and spiritual
life cycles that went across cultural and
traditional borders.
Narrative theory presently constitutes a
major topic of international academic
research.
The so-called "narrative turn" is at the
center of an interdisciplinary field of
study in which knowledge and concepts
are shared among branches of learning
as diverse as philosophy, literature,
psychology, sociology, historical sciences,
economics, medicine and computer
science.
（１７Ｃ．
• Humans are capable of creating complex
images relating to both the visible and
invisible world; thus, they can think
about and narrate ideas using both
speech and visual image.
• These visual images and visual narratives
seem to help people connect their lives to
past and future generations, and to look
at their lives using a long-term
perspective, as well as to imagine their
deaths in the context of long-held
spiritual traditions.
However, there is a language centrism
inherent to narrative research, as revealed
in the well-known discourse over the phrase
"In the beginning was the Word", which
conveys a Western European outlook on the
world.
I would like to propose the concept of the
"visual turn" to offer new representations of
the world.
We could think about the theoretical and
methodological meanings of visual image,
visual narrative and visual media.
Think not forever of yourselves
nor of your own generations.
Think of continuing generations of
our families,
think of our grandchildren
and those yet unborn whose faces
are coming from beneath the ground.
(Native American Elder)
• Yamada, Y. (2004) The generative life cycle
model: Integration of Japanese folk images and
generativity. The generative society (pp.97-112).
American Psychological Association.
• Yamada, Y., & Kato, Y. (2004). Japanese students’
depictions of the soul after death: Towards a
psychological model of culutural representations.
In S. Formanek, & W. Lafleur (Eds.), Practicing
the afterlife: Perspectives from Japan. (pp.417438). Vienna: Verlag der Osterreichischen
Akademie der Wissenschaften.
• Yamada, Y. & Kato, Y. (2006a) Images of circular
time and spiral repetition: The generative life
cycle model. Culture & Psychology, 12, 2, 143-160.
• Yamada, Y. & Kato, Y. (2006b) Directionality of
development and Ryoko Model. Culture &
Psychology, 12, 2, 260-272.
日本
33%
ベトナム
33%
フランス
イギリス
0%
63%
28%
43%
一方向
双方向
その他
39%
38%
45%
10% 20%
4%
25%
19%
30%
30% 40% 50% 60% 70% 80%
図6-4-1 たましいの往来パターン
90% 100%
The concept of the soul(OED )
• Ⅰ1 The principle of life in man or animals; animate
existence． 2 The principle of thought and action in
man, commonly regarded as an entity distinct from
the body; the spiritual part of man in contrast to the
purely physical. 3 The seat of the emotios, feelings, or
sentiments; the emotional part of man's nature.
• Ⅱ 1 The spiritual part of man considered in its moral
aspect or inrelation to God and precepts. 2 The
spiritual part of man regarded as surviving after death
and as susceptible of happiness or mistery in a future
state.
• Ⅲ 1 The disembodied spirit of a (deceased) person,
regarded as a separate entity, and as invested with
some amount of form and personality:
F igu re 1 Th e p o sitio n o f th e n ex t w o rld in co n trast to
th is w o rld in th e d raw in gs o f Jap an ese, B ritish , F ren ch
an d V ietn am ese u n iversity stu d en ts
70%
60%
50%
Ja p an
U.K .
F ra nc e
Vie tnam
40%
30%
20%
10%
0%
vertical
h o rizo n tal
d iago n al
o th erw ise
• The recursive loop in which various elements of my life are enclosed signifies the
circularity of existence which I consider especially true of my life. I was born in
India and I’ve lived in 4 countries since – India (9.5 years), NZ (1 year), Kuwait
(8.5 years) and the UK (3 years). But in the future I intend to come full circle and
return to the country of my birth and settle down there.
• The onion symbolises the different layers of my personality and life. Although I’m
extroverted and outgoing, I’m a private person in a lot of ways. I think the onion
brings together sad and happy aspects of life nicely. Despite the fact that one cries
when chopping onions, it’s worth it for all the flavour it adds to food. My life has
been such a beautiful mixture of opposites. The cornucopia represents the fact
that I consider myself blesses with plenty. And according to legend, since the
cornucopia was placed among the stars, I’ve drawn in a starfish too. This serves
two purposes – one is to show my belief in the interconnectedness of things (from
cornucopia to star to starfish to virtually anything) and also because I love the
symbol of the starfish because of its property of regeneration. The arms of my
starfish point to the 5 elements of which all matter is composed of according to
Ancient Indian philosophy (the Atom, Wind, Fire, Water & Earth). All these
elements hold special meaning to me, with the Atom signifying possibility, wind –
my love of sports & freedom, fire – the need I believe there is for pro-active,
positive social change and passion for people and life, water – the music of the
ocean, music in general (and art as a whole) & the reaffirmation of life (as an
essential life-giving fluid) and Earth – my roots, my family and the people I love.
•
Visual Narratives of Life Cycle and Death in Japanese,
British and French Adults
Yoko Yamada
(Graduate School of Education, Kyoto University)
1 /7/2009, London
In the context of psychological research on life-span development, I present two studies that
aim to increase our understanding of contemporary people’s imaginary lives and deaths, across
several cultures.
The first study is on the “Image Map of Life”; participants were Japanese, British and
Austrian University students. Using my original method of visual narrative (Image Drawing
Method: IDM), I asked the participants to draw pictures representing their lives (past, present
and future).
The second study is “The Image of This World and the Next World after death”. Japanese,
British, French and Vietnamese University Students were asked to draw the images of the
relationship between this world and the next world, and the images of the transition of their
souls. We have collected over 3000 freehand drawings of these visual life stories.
While there was a lot of variation, there was a fundamental commonality to the typical visual
images of lives and spiritual life cycles that went across cultural and traditional borders.
Humans are capable of creating complex images relating to both the visible and invisible
world; thus, they can think about and narrate ideas using both speech and visual image. These
visual images and visual narratives seem to help people connect their lives to past and future
generations, and to look at their lives using a long-term perspective, as well as to imagine their
deaths in the context of long-held spiritual traditions.
Narrative theory presently constitutes a major topic of international academic research. The
so-called "narrative turn" is at the center of an interdisciplinary field of study in which
knowledge and concepts are shared among branches of learning as diverse as philosophy,
literature, psychology, sociology, historical sciences, economics, medicine and computer
science.
However, there is a language centrism inherent to narrative research, as revealed in the wellknown discourse over the phrase "In the beginning was the Word", which conveys a Western
European outlook on the world.
I would like to propose the concept of the "visual turn" to offer new representations of the
world. We could think about the theoretical and methodological meanings of visual image,
visual narrative and visual media.
Narrative-Based Evidence Utilizing Medicine
-A story of reconciliation between EBM and NBM in JapanSeiji Saito MD, PhD
(Centre for Healthcare and Human Sciences, University of Toyama, Japan)
1. Introduction
Narrative-based (NBM) and evidence-based (EBM) medicine are not opposing
methodologies, but ‘complementary, like wheels of a vehicle driving for medical practice
centering on patients to achieve the maximum benefit for the patient positioned in the front seat’.
However, there have been few reports on the integrative practice of NBM and EBM in actual
clinical context. In this paper, the integrative practice of NBM and EBM is discussed along with
the course of a case I encountered. From the NBM viewpoint, this subject is defined as how to
effectively utilize epidemiological evidence in the practical process of NBM.
2. Epistemological problems concerning clinical application of evidence
One thing that must be clarified from the beginning is the presence of epistemological
problems, which are unavoidable when applying clinicoepidemiological evidence in medical
practice. For example, they become apparent as follows:
For a patient with advanced pancreatic cancer, a physician searched for
clinicoepidemiological evidence to assess the patient’s prognosis, and found that the 1-year
survival rate is about 20% (the quality, reliability, and differences associated with subgroups,
such as pancreatic cancer stages, are not questioned in this fictitious scenario). The physician
then informed the patient of this, which resulting in the following conversation:
Physician: Mr. A, there is a 20% chance of your surviving beyond one year.
Patient A: Is that so? My illness must be very serious. So, how long do you think I have?
This example appears nonsense, but it is indeed an essential problem. Study results
obtained from past patient populations (called evidence when the information is reliable) only
provide probabilities. However, questions requiring answers in clinical practice always pertain
to ‘the future of the patient (or the future of ‘me’ on the patient’s side) and what to do’, and it is
impossible to precisely answer these questions. Then, is evidence useless? From the EBM
viewpoint, we can only objectively rely on such ‘general information’. As we try to trust EBM,
it is a contradiction that evidence is not directly useful for actual clinical practice. This is not
due to the insufficiency of studies or incapability of physicians, but this fact is often overlooked.
This is due to so-called ‘category error’ in logic. Evidence is always non-temporal
information on ‘past patient populations’ without time flow, but we require information useful
for making a decision for individual patients, which cannot be utilized without positioning them
within the time course of clinical processes.
In other words, general information on populations cannot be directly fitted to
individual patients, and so this information requires a certain amount of conversion. However,
we cannot sacrifice the accuracy of evidence. It should rather be realized by employing flexible
‘methods of evidence utilization’. I want to emphasize that information can be converted by
‘describing evidence in a narrative form’. Since narrative includes the time course in its
character, it can be easily adopted to fit experiences in clinical practice. Herein, I report a case
along with the course.
3. A case report
1) Beginning of the story
It began with a phone call from a physician I know. Mr. N, 66 years of age, was an
acquaintance of the physician. He had been suffering from mouth-related pain for a long time,
and consequently visited several departments including hospitals well known for practicing
psychosomatic medicine in the dentistry field. However, Mr. N was not satisfied with the
treatment, and desired a new treatment. To be honest, I was reluctant because I knew that
symptoms of patients complaining of discomfort in the mouth are generally difficult to resolve,
and improvement within a short period of time cannot be expected for a patient who failed to
recover following visiting various facilities (specialized facilities capable of psychological
treatment). Moreover, I was not able to perform long-term treatment because I was about to be
transferred. I recommended treatment at a regular medical institution, but the physician who
introduced the patient strongly desired me to examine him, and so I booked Mr. N in for a
consultation.
2) Initial interview
On the first meeting, Mr. N was a mild-mannered elderly gentleman, who was
accompanied by his very anxious wife. After exchanging greetings, I asked Mrs. N to wait
outside the room, and directly interviewed the patient.
I asked, ‘would you tell me about the problem?’, and he recounted the following:
When Mr. N was engaged in teaching at an educational institution about 15 years ago,
he frequently became depressed, and underwent treatment for depression at a psychiatric
department. During the treatment, an episode assumed to be a panic attack occurred, and he was
admitted to a hospital. A severe depressive state was remitted by drug therapy during
hospitalization and after discharge, but he had to leave his job. Since he had an extensive
knowledge of archaeology through teaching, he got a job assisting in the excavation of ruins in
his home town and organizing archaeological documents after his physical condition partially
recovered.
However, pain developed in his mouth about 10 years ago. He was treated for
‘glossalgia’ at several oral surgery, dental, and psychosomatic departments, but the symptom
had not completely resolved. During this period, he received prescriptions of tranquilizers and
sleeping pills from a psychosomatic department. Retrograde amnesia occurred once due to an
excess ingestion of a sleeping pill. He visited a university psychosomatic dentistry department,
where he was instructed in oral care, and also told that he needed to further control his
depressive mood. Since the university was too far to visit frequently, he talked to a physician he
is acquainted with, who referred him to our department.
After obtaining a rough history of the illness, I asked, ‘what is the hardest thing?’, and
Mr. N raised 3 points: 1) constant pain in the tongue and mouth, 2) lethargy, and 3) constipation.
He could not sleep without using drugs, and felt unwell in the morning, indicating a mild
depressive state. I asked, ‘what do you want’, and he said, ‘I feel the condition is getting better
slowly, but I want to recover completely, if possible. I want to undergo treatment at this
hospital.’
3) From the viewpoint of evidence
The illness experienced by Mr. N was recounted above. Although not all areas were
described, I mostly shared his experience. In the next step of NBM, the physician narrates, and
waits for a new story to emerge by exchanging the narratives of the physician and patient.
However, I considered that clinicoepidemiological evidence may be appropriate for the case of
Mr. N in this step.
It is not rare for patients to complain of chronic, strange sensations in the mouth despite
no organic cause being present. Discomfort in the mouth are described with diverse expressions,
such as ‘burning in the mouth’, ‘pain in the tongue and mouth’, and an ‘unpleasant slimy
feeling’ in the mouth. These complaints are generally intractable. Many patients visit dentistry,
oral surgery, and otolaryngology departments, but they most frequently consult general
practioners and regular physicians. These are handled as ‘unidentified complaints’ or in the
‘imagination’ in many cases, and called ‘psychosomatic disorders’ when complaints are
unresolvable or accompanied by a depressive mood, or patients may be handled as a ‘difficult
patient’ or ‘patient with a mental disorder’. However, the following facts are unexpectedly not
recognized:
A chronic discomfort in the mouth complained of by patients as described above is
called burning mouth syndrome. According to epidemiological surveys of general and
comprehensive medical practices, it is a common disease with a very high incidence.
Clinicoepidemiological studies have been performed on it because of its high incidence, and the
resulting evidence is available. The pathology of this disease appears to be very distinct from
that dealt with by scientific treatment, but it is a disease to be indicated for integrated EBM and
NBM treatment.
At this point, recall the 5 steps of EBM. The 1st step is the formularization of problems.
From the NBM viewpoint, there is another step, which could be called step 0.5, before this 1st
step, that involves getting information from a patient by closely listening to him/her, and sharing
information with the patient. The problem cannot be identified without this step. The
formularization of problems with applicable clinicoepidemiological methods (steps 2 and 3)
becomes possible after this step is completed. There may be more than one problem to be
formularized. According to a textbook of standard EBM practices (ref. 1), types of problems to
be formularized include diagnosis, prognosis, treatment (intervention), adverse events, economic
analysis, analysis of clinical judgment, and quality of medical care.
The thing that Mr. N and I wanted to know most in actual clinical practice was
information regarding the most appropriate treatment. However, the diagnosis needs to be
clarified before seeking information. It is not possible to search for evidence concerning
treatment without a definite diagnosis. However, from the NBM viewpoint, a diagnosis is just
an arbitrarily selected story, and what is important at this point is not an answer to ‘what is a
correct diagnosis?’, but an answer to ‘what diagnostic narrative can be shared by the patient (Mr.
N) and physician (myself)?’ My idea is that evidence may be utilized for this task.
Since I thought that diagnostic narratives to be shared with Mr. N were ‘burning mouth
syndrome’ and ‘depression (depressive disorder)’, I referred to an excellent secondary document
on EBM, the Japanese edition of Clinical Evidence (ref. 2). I keep this recently published text on
my desk in the consultation room, and refer to or show it to patients, or use it for discussion with
attending medical students. This text is a promising medium as a secondary document
containing evidence useful at sites of general clinical practice, and it is unique in that evidence
for therapeutic intervention is mainly summarized starting with questions about treatment raised
relatively frequently in primary care. Another characteristic is that the inclusion of
‘recommendations by specialists’ not based on evidence is avoided as much as possible.
Regarding the practical usage of secondary EBM documents, please refer to a simple manual
written by Nago (ref. 3).
4) Back to the interview
Let’s return to the practice. After physical examination, I talked to Mr. N:
‘Mr. N, let me explain my thoughts about your problem.’ ‘Yes, please’. Then, I took out the
Japanese edition of Clinical Evidence, opened it to the page describing ‘burning mouth
syndrome’, and showed it to him. ‘The latest medical evidence (scientific bases) obtained
throughout the world is presented in this book. You have been suffering from pain in the mouth,
and I think it mostly meets the pathology called burning mouth syndrome’.
Mr. N nodded, reading through the page.
‘As you see, this disease is not rare; it says that this disease occurs in 1 to 15% of the total
population, although the incidence varies among reports. Thus, it is a rather common disease’.
Mr. N appeared surprised at the beginning, and then began to look happy, and said, ‘I
see. I was told that I was the only one who ever said such a strange thing, they have never seen
such an odd disease, or there is no treatment because it is a difficult, uncommon disease. I
thought I was the only one who had ever suffered from such an illness, but I am not.’
‘No, you are not. As this book says, the pathology of this disease is being studied all over the
world.’
His face began shining with happiness. So, I put it in the following way:
‘Regarding treatment, unfortunately, there is no evidence that a drug easily cures the
disease. However, as it is described here, there is evidence that cognitive behavioral therapy, a
kind of psychotherapy, is effective. Unfortunately, I am not specialized in cognitive behavioral
therapy, but I know the essence of it.’
‘What kind of treatment is it?’
‘In short, this therapy aims at promoting daily living activities while living with the symptoms,
not at complete healing, for which I will ask how you think or we think together.’
Then, Mr. N said, ‘Ah, the point is to get along and live with the disease.’
‘Yes, yes, that’s right. You understand well.’
‘Because I was told so at many places.’
‘I will work with you as much as I can, if you like. What do you think?’
‘Yes, please.’
Then, I switched the topic to his ‘depressive mood’.
‘Let me talk about the problem that you have no energy or do not want to do anything. This may
be the condition called a ‘depressive mood’ or ‘depressive state’. Please look at this page. There
is much evidence regarding the treatment of depression, as you can see, and there are many
effective drugs.’
Mr. N looked at the page closely.
‘We have to select one from many effective methods. I recommend a recently developed drug
causing less adverse events, SSRI. What do you think?’
‘That’s fine. I leave it to you.’
‘So, I will prescribe the drugs today (SSRI and a Kampo drug for constipation). How about you
visit me every 2 weeks and talk to me?’
‘Yes, I will. Thank you.’
The first consultation ended as described above.
5) The subsequent course
The 2nd consultation took place after 2 weeks. Mr. N came with his wife, and his wife
attended the interview with him.
I asked, ‘How have you been since the last consultation?’, and he replied as follows:
‘Well, there is not much change. I go to work 2-3 days a week, and do what I can. I do not feel
strongly motivated. I cannot be energetic in the morning, but become able to do something when
I go to work. The pain in my mouth is still strong, but it does not bother me at times. I
sometimes forget the pain during skiing and traveling, but it is severe at night. No inconvenience,
such as adverse events, occurred after I started taking the drugs. The constipation improved on
taking the Kampo drug.’
I talked to his wife, and she said, ‘I feel that he gets angry with trivial things more often
than before.’ He said, ‘I do not directly apologize to my wife, but I regret it after I get angry
with her.’
When I asked about the content of his job, he answered that he excavates and organizes
Jomon pottery and stone implements, and writes about them. Since no adverse event was caused
by SSRI, I doubled the dose.
At the 3rd session following another 2 weeks;
‘How have you been recently?’ ‘The condition remains the same. When I feel pressure over
work (excavation), I sometimes become anxious and impatient.’ ‘Would you tell me about it
concretely?’ ‘For example, when I was told that I have to report something by a certain deadline
because it is a significant discovery, I become anxious, wondering whether it is possible because
there are insufficient funds or means of excavation, but I thought it over for 2 days, and realized
that there is no need to think about it so seriously, which made me feel better.’ ‘You realized
something important.’ ‘My mouth pain does not bother me while chewing gum.’ ‘That’s good.’
‘I do not sleep well, and feel unwell in the morning, which is the most difficult now.’ After he
left the room, I asked his wife to come in, and I listened to her. She said that Mr. N was
frequently irritated. He is by nature a perfectionist, but has recently relaxed a little.
At the 4th session 2 weeks later;
‘How have you been since the last session?’ ‘Night sleep is shallow. I wake up at 3 or 4 o’clock
in the morning and cannot sleep thereafter. My mouth is OK in the morning, but bothers me in
the evening.’ After he talked about the symptoms and disease condition, he talked about his
work. ‘The work is hard sometimes, but worth doing. An event sponsored by a local government
will be held soon, and I will prepare adzes by shaving Japanese and evergreen oak woods. I
sometimes think of it, but it does not worsen the condition.’ Since I happened to be interested in
ruins of the Jomon era and whether horse chestnuts eaten in the Jomon era are the same kind as
eaten today, I asked questions to Mr. N, and he happily taught me about it. He was very lively
when he talked about this topic.
On the 5th session, I noticed that his condition had changed from his entering the room,
and he started to talk energetically and happily. ‘I feel very good. My condition started
improving about 2 weeks ago, and the improvement is now clear. When my condition started
getting better, I was sometimes disturbed by what others said or worried about trivial things, but
now I realize that there is no reason to care about such things. My mind is clear. I have not felt
like this for more than 10 years.’ ‘That sounds great. How is the pain in your mouth?’ ‘I went
skiing the other day. I was previously worried about my mouth during skiing, but not at all this
time. I still feel pain sometimes, but I think I can deal with it by applying xylocaine.’ He
continued, ‘Regarding drugs, when I looked at an internet homepage concerning medical
treatment, there were descriptions about drugs, and I found that the drugs prescribed for me are
adequate for my symptoms, which made me happy. I feel that I will be fine as long as I take the
drugs. People around me also say that my complexion looks different, and I enjoy my work.’
When I replied, ‘it’s good to enjoy your work’, he replied, ‘When I initially felt ill,’ and then
told me about a painful episode that he had not talked about in detail before: ‘About 15 years
ago when I was a teacher, I had a ruthless colleague, and he berated and bullied me, saying that I
did not do anything other than excavation, although I was asked to change my workplace to
perform excavation because I had knowledge of archaeology. It was mentally very painful, and I
became anxious and was hospitalized. The pain in my mouth appeared when the depression
remitted. I visited several oral psychosomatic departments, but treatments were ineffective. I
have not felt so good for more than 10 years. Thank you very much’.
Treatment had been scheduled to end at that point because of my other commitments,
and I had promised to introduce him to a local hospital. Mr. N recovered as if he adjusted his life
to this situation. He readily agreed to transfer to another hospital on the condition that he can
continue taking SSRI.
4. Discussion
Although it was a short treatment (only 5 consultations within about 2 months), the
burning mouth sensation and depressive mood that had persisted for 10 years were markedly
improved, and I could pass on treatment to another physician. Now, I will discuss the
relationship between Mr. N and the treatment-related process as an example of integrated EBM
and NBM treatment.
The pathology of Mr. N was diverse and complex, and his pain experienced over the last
decade had a very complex etiology. The 1st step in the narrative approach started with listening
to Mr. N talk, and sharing the experience with him, but this does not mean that the narrative of
the physician is ignored.
In order to construct a medical narrative based on the narrative of Mr. N, the evidence
described in Clinical Evidence was very useful. However, it was not directly helpful. I reinterpreted the evidence and incorporated it into the narrative I constructed, and presented it to
Mr. N.
Firstly, it was significant that Clinical Evidence contains an item, ‘burning mouth
syndrome’, because it revealed to Mr. N that his condition was not an inexplicable, unidentified
disease, but it was ‘recognized worldwide’, ‘not rare’, and ‘being studied’. This evidence
markedly contributed to changing his distressing narrative: ‘others do not understand my pain’,
and ‘I am the only one suffering from such an illness’.
Secondly, I obtained promising information that the efficacy of a psychotherapy,
cognitive behavioral therapy, for this disease has been demonstrated. However, devising a way
to apply this information to treat Mr. N was necessary because, to be precise, the evidence
provided the following information. Let’s refer to Clinical Evidence (ref.2).
Intervention option: Cognitive behavioral therapy
According to a small-scale RCT, cognitive behavioral therapy reduced symptoms of
burning mouth syndrome ... In this RCT (30 cases of persistent burning mouth syndrome),
patients who underwent cognitive behavioral therapy (a once-a-week 1-hour session was
performed 12-15 times) and those who underwent treatment other than cognitive behavioral
therapy with similar consideration as a control group were compared. The cognitive therapy
significantly reduced the severity of symptoms (measured employing a visual analogue scale
within a range of 1=tolerable to 7=intolerable), and the reduction was still significant on followup after 6 months (the mean scores were 5.0 and 4.3 before treatment in the cognitive behavioral
therapy and placebo groups, and 1.4 and 4.7 after treatment, respectively, p<0.001. The numbers
of symptom-free patients 6 months after treatment were 4/15 and 0/15, respectively).
Although the reliability of this information withstands a critical appraisal for evidence,
it was necessary to carefully consider whether this information is directly applicable to Mr. N.
The biggest problem was that this RCT was performed by skilled specialists of cognitive
behavioral therapy. I am not a trained cognitive behavioral therapist. So, can I utilize this
information? It is not possible for me, not specialized in this therapy, to perform the same
treatment as in this RCT. Accordingly, it is not guaranteed to realize an efficacy rate similar to
that achieved in the RCT. So, was it acceptable to tell him to consult a specialist because I could
not treat him? If there is an expert that I can introduce to the patient, this may be one option.
However, unfortunately, this condition may be rare in Japan. Strictly applying evidence under
such a situation is simply preparing an excuse to abandon the therapy, and useless for the patient.
If this is the case, I do not know what EBM is for.
I did not think of it in this way. On the condition that I maintained a therapeutic
relationship with Mr. N, I re-interpreted the evidence to utilize it as follows:
Since cognitive behavioral therapy is a psychotherapy, the forging of a good
relationship with the patient is the first requirement, and putting all your energy into this never
has a negative influence on treatment. On simplifying the essence, cognitive behavioral therapy
is comprised of firstly, assistance to identify and dispel inappropriate automatic thinking
(change in cognition), and, secondly, to increase the quality of life (QOL) even without the
complete remission of symptoms. For example, the continuation of a conversation based on the
above basic attitude may not aggravate Mr. N’s condition, even though the standard techniques
of cognitive behavioral therapy are not directly employed. It is not wrong to expect a favorable
influence, and I may be able to achieve this.
I informed Mr. N of my interpretation as frankly as possible, which resulted in a
conversation: ‘Ah, the point is to get along and live with the disease.’ ‘Yes, yes, that’s right.
You understand well’. I felt a favorable response through this conversation.
As described above, re-interpreting evidence and presenting it in a narrative form as a
topic promotes dialogic interaction with the patient, and the subsequent co-construction of a new
desirable narrative over the treatment course. I want to emphasize that evidence should be
utilized to construct and maintain a favorable relationship.
The latter course of Mr. N may be understood as a process of his narrative being
activated under such a relationship. SSRI may have, of course, contributed to the improvement
of the pathology. Furthermore, the information that Mr. N incidentally found on the Internet
may have strengthened the narrative that SSRI is appropriate for him, contributing to the
favorable change. The story may progress not only at the site of treatment, and the promotion of
daily living activities may be of greater significance.
In the 5th session, the last interview, Mr. N willingly talked about his painful experience
around the time of disease onset. It may not be very important to discuss whether becoming able
to talk about something one could not previously is the cause or result of a favorable change in
the disease condition, but, in one interpretation, many patients complaining of discomfort in
their mouth and pharynx may manifest the symptoms as a symbolically somatized expression of
their mental state: they cannot talk about what they want to.
To the question, ‘what improved the disease condition of Mr. N?’, the answer from the
viewpoint of EBM may be that it is not possible to deduce anything because there was no
epidemiological data, while the answer from the NBM viewpoint may be that this is not
important because both humans and medical practices are essentially complex. Thus, EBM and
NBM are ‘wheels of the same vehicle’ indeed.
References
1) Sackett DL, Richardson WS, Rosenberg W, and Haynes RB: Evidence-based MEDICINE.
Churchill Livingstone. 1997 (translation supervised by Hisashige T: Evidence-based Medicine:
Practice and educational methods of EBM. OCC Japan, 1999)
2) Japan Clinical Evidence Editorial Board: Clinical Evidence, Japanese edition 2002-2003.
Nikkei BP, 2002
3) Nago N.: A sequel to the EBM Practice Workbook: The maximization of medical care now.
Nankodo, 2002
EBM as Black Ships for Japan
Narrative-Based Evidence-Utilizing
Medicine
-A story of reconciliation between EBM and NBM in Japan-
The steam-powered ships
break the halcyon slumber
of the Pacific;
a mere four boats are enough
to make us lose sleep at night.
night
1853 at Uraga
Seiji Saito MD, PhD
University of Toyama
EBM and NBM
‘Wheels of the Same Vehicle?’
A Triad Model of Medical Care
Noda S, 2009
Beginning of the story
Epistemological Problems of Application of
Evidence for Individual Clinical Practice
Mr. N, 66 years of age
V He had been suffering from mouth-related pain
for a long time, and consequently visited
several departments including hospitals well
known for practicing psychosomatic medicine
in the dentistry field.
V He was not satisfied with the treatment, and
desired a new treatment.
V
V
Physician: ‘Mr. A, there is a 20% chance of
your surviving beyond one year.’
V
Patient A: ‘Is that so? My illness must be
very serious. So, how long do you think I
have? ’
Initial interview
V
When Mr. N was engaged in teaching at an
educational institution about 15 years ago, he
frequently became depressed, and he was
admitted to a hospital.
hospital Since he had an
extensive knowledge of archaeology through
teaching, he got a job assisting in the
excavation of ruins in his home town and
organizing archaeological documents after his
physical condition partially recovered.
Initial interview(2)
However, pain developed in his mouth about 10
years ago. He was treated for ‘glossalgia, but the
symptom had not completely resolved.
V He visited a university psychosomatic dentistry
department, where he was instructed in oral care,
and also told that he needed to further control his
depressive mood.
V He said, ‘I want to recover completely, if
possible.’
V
From the Viewpoint of Evidence
A chronic discomfort in the mouth complained
of by patients without organic change is called
burning mouth syndrome.
V The incidence of burning mouth syndrome was
reported as 0.7-15% in general population.
V As the intervention option, Cognitive behavioral therapy may be useful.
V
(Clinical Evidence 2002-2003)
V
Back to the interview
‘Mr. N, let me explain my thoughts about your
problem.’
V ‘Yes, please’.
V ‘The
‘ h latest
l
scientific
i ifi evidence
id
in
i medicine
di i
obtained throughout the world is presented in this
book. You have been suffering from pain in the
mouth, and I think it mostly meets the pathology
called burning mouth syndrome’.
V
Back to the interview(2)
‘As you see, this disease is not rare; it says that
this disease occurs in 1 to 15% of the total
population.’.
V ‘I
I see.
see I was told they have never seen such an
odd disease, or there is no treatment because it is
a difficult, uncommon disease. I thought I was
the only one who had ever suffered from such an
illness, but I am not.’
V ‘No, you are not. ’
V
Back to the interview(3)
‘Regarding treatment, unfortunately, there is
no evidence that a drug easily cures the
disease. However, as it is described here, there
is evidence that cognitive behavioral therapy is
effective. Unfortunately, I am not specialized
in cognitive behavioral therapy, but I know the
essence of it.’
V ‘What kind of treatment is it?’
V
Back to the interview(4)
‘Regarding treatment, unfortunately, there is
no evidence that a drug easily cures the
disease. However, as it is described here, there
is evidence that cognitive behavioral therapy is
effective. Unfortunately, I am not specialized
in cognitive behavioral therapy, but I know the
essence of it.’
V ‘What kind of treatment is it?’
V
Back to the interview(6)
‘Let me talk about the problem that you have no
energy to do anything. This may be the
condition called a ‘depressive mood. Please look
at this page.
page There is much evidence regarding
the treatment of depression.’ ‘We have to select
one from many effective methods. I recommend
a recently developed drug causing less adverse
events, SSRI.’
V ‘That’s fine. I leave it to you.’
V
Hoarse Chestnuts:
Past /Present, The East/The West
Back to the interview(5)
‘In short, this therapy aims at promoting daily
living activities while living with the symptoms,
not at complete healing, for which I will ask how
you think or we think together.
together ’
V ‘Ah, the point is to get along and live with the
disease.’
V ‘Yes, yes, that’s right. You understand well.’
V ‘Because I was told so at many places.
(laughing) ’
V
The subsequent course (the 4th session)
‘The work is hard sometimes, but worth doing.
An event sponsored by a local government will
be held soon, and I will prepare adzes by
shaving Japanese and evergreen oak woods in
the similar way as Jomon period.’
V I happened to ask Mr.N whether horse
chestnuts eaten in the Jomon era are the same
kind as eaten today in Japan and in England.
Mr. N, happily taught me about it.
V
The subsequent course (the 5th session)
‘When I initially felt ill about 15 years ago, I
had a ruthless colleague, and he berated and
bullied me, saying that I did not do anything
other than excavation.
excavation It was mentally very
painful, and I became confused and was
hospitalized. The pain in my mouth appeared
when the depression remitted.
V ‘ I have not felt so good for more than 10
years. Thank you very much’.
V
Can I utilize this information?
Re-interpreting evidence and presenting it in a
narrative form as a topic promotes dialogic
interaction with the patient, and the subsequent
co-construction
co
construction of a new desirable narrative
over the treatment course.
V The information of epidemiological evidence
should be utilized to construct and maintain a
favorable relationship between health
professionals and patients.
V
What improved the illness of Mr. N?
Effect of SSRI?
Effect of an imitation of CBT?
V Reframing of disease concepts?
V Stories bridging time and distance (Jomonperiod and present time, the East and the West)
mediated by ‘Horse Chestnuts’?
V This is not important because both humans
and medical practices are essentially
complex.
V
V
What kind of a narrative is the clinical case report?
Work In Progress Talk at UCL to Japanese Senior Educators,
1st July 2009.
Brian Hurwitz
A few years ago, I explored the literary and stylistic qualities of clinical case reports as
textual tools which enable clinicians to think medically about a sick person’s situation.i I
traced some historical changes:
In Hippocratic reports - 5-4thth C BC - the case report is a highly controlled text with a
dispassionate narrator who observes body surfaces and shows little personal involvement
with the patient.
Case reports from Galen – 2nd C AD - are more conversational in tone, pay greater
attention to anecdote and patient perspective and are more egalitarian.
Seventeenth and eighteenth century UK case reports are also conversational and contain a
great deal of dialogue and the patient’s voice. They are frequently constructed in terms of
a curious discourse not confined to medicine, but found also in the study of geology,
fossils, and meteorology, a discourse that uses novelistic techniques to depict the
marvellous and retain it as an object of investigation by experimental and natural
philosophy. These case descriptions employ dramatic devices to delay the moment of
diagnosis or the outcome of a story, in order to increase narrative tension and degrees of
physician involvement with the suffering subject.
The present-day case report is much more standardized and abstract than its predecessors,
partly due to the influence of the reporting of bedside measurements and partly as a result
of the growing importance of biochemical, pathological, and imaging investigations.ii
These developments have been accompanied by a division of the case report into distinct
sections devoted to the history of complaint, the examination, the investigation, and the
treatment.
In today’s paper I want to ask why we have cases? What sorts of things are cases, what
role do they serve in medicine, and why do they come in the form of a text or discourse?
Now cases are a feature of many disciplines, including ethics, theology, law,
psychotherapy, psychoanalysis, social work and police detection. Cases probably
function differently in these different disciplines.
Taking the clinical case as our focus, the case report narrates what a clinician finds
worthy of
noticing, recording and emphasizing and, most importantly,
the information he or she wishes to convey to a wider audience, an audience that neither
knows – will never know, look at, nor hear from – the person to whom the case pertains.
So: case reports are presentational and communicational discourses that place before an
audience a linguistic portrait of sorts, one that focuses on particular facets of a patient’s
medical or psychological situation, frequently featuring technical descriptions – ‘the
findings’. Not being based on prior questions, experimental control, nor on an
examination of scientific laws or principles, cases are created out of a process of
witnessing - noticing, describing, identifying and classifying – undertaken by an
attendant health care expert.
Such ‘portraits’ offer a strange form of likeness placed before a wider audience in the
form of reports. They are offered to a wider audience in the hope that they will awaken in
its members a flicker of recognition, perhaps concerning similar cases already met with,
perhaps of future patients, yet to be encountered. So, case reports are situated within a
framework of comparison; and, although case reports feature highly abbreviated and
formulaic clinical histories, physical and psychological characteristics, peculiarities of
presentation, investigation, and course or treatment, such features cannot be so
abbreviated as to preclude awakening such recognitions.
Case reports arise from specific situations – but they are not transcriptions of medical
records, clinical notes, the private logs of physicians or psychologists, the letters that pass
between doctors concerning patients – nor are they video or audiotapes of consultations,
or doctors talking about patients - although, of course, aspects of cases are differentially
expressed in each of these sorts of discourses.
Case reports transmit knowledge from the level of the consultation to a wider
professional and science audience, and have rightly been called ‘an epistemic genre’iii, a
form of ‘wordy knowledge’ that makes claims about a particular person. These reports
arise from practices that are ‘immersed in the particular’ – habits of observation,
classification, note-taking and abstraction, which together comprise ‘a way of knowing
that yokes mind and senses together’ thereby providing a grounding for diagnosis,
treatment and medical advance.iv v vi
SLIDE
‘… the term case signals that, from at least one party’s point of view, the form of writing
or discussion …will always remain attached to a specific individual…[will always be]
epistemically nailed down to the level of the individual.’vii (P810)
In other words, what can be learnt from a case necessarily remains linked, however
complicatedly, to a single individual. True, it is not that individual’s story in the sense of
their own composition – and here we recall Kathryn Hunter’s phrase, ‘one patient two
stories’ – and the case report does not confine itself to an individual level of information
– in medicine it is generally couched in a technical language that relates to scientific
knowledge and clinical practice. But the case report arises from and quintessentially is
about, a particular individual.
The root meaning of case in English derives from the Latin casus meaning a fall, as in
befall. Casus originally referred to something notable, an unfortunate exemplum of a
condition or predicament. In Roman law, it referred to a cause for action, a statement of
the facts of the matter grounded in a narrative, the term narrative referring then to that
part of a legal document containing alleged facts supporting a claim.
On one account, the case reports can be viewed as a type of narrative – ‘a usable story’.
But case reports can also be understood to access and represent – perhaps in part to
construct – a virtual model of phenomena under scrutiny, created from different types of
testimonies operating at many levels: that of conversation, observation, clinical
examination, biochemical analysis of body fluids, microscopy of tissues, and imaging of
structures etc. And within this model treatment usually plays a functional role.
If the case report is both a linguistic portrait (of sorts) of limited aspects of a person, and
the specification of a model or virtual object of that person (or part of him/her), this
accounts for why it’s couched in a hybrid language, and why it moves effortlessly across
a personal and experiential lingo towards a technical, impersonal and expert language.
The case report, then, is a remarkable textual technology of representation, which forms
an ‘epistemic bridge’ between the individual who consults and more general
understandings - scientific knowledge, medical technique and psychological theory.
Does the notion of a case precede that of case report? Or, is our apprehension of cases so
bound up with discussing and comparing word pictures of them, that we can legitimately
collapse together case and case report?
SLIDE
‘The case represents a problem-event that has animated some kind of judgment… a
symptom, a crime… a situation, …any irritating obstacle to clarity’viii writes Laurant
Berlant
For Berlant,
‘What matters is the idiom of the judgment [and this]… varies tremendously across
disciplines, [and] professions: law, medicine, chat shows, blogs, each domain [has] its
vernacular and … conventions for folding the singular into the general….’
This is an important feature of a case report. Although the case arises from and returns to
the individual, it has within its sights applicability to a wider domain. This aspiration from the singular to the more general – in part reflects its position along a spectrum of
past and future other cases and in part reflects its conceptual context, but it raises the
difficulty of induction – how much that is true about a single individual is also true of
others?
The case report for Berlant is ‘… a genre …pointing to the form information takes, so
that it can be judged:’ ‘[T]he case reveals itself not fundamentally as a form but as an
event that takes shape …One might say that a case is what an event can become.’
‘Usually, when an event happens there are no outcomes; it fades into the ordinary
pulsations of living on undramatically, perhaps in memory without being memorable’ –
perhaps not even in memory, because the event goes unnoticed, or at least, unnoticed for
any significance it may hold.
[But] ‘When an event occurs out of which a case is constructed, it represents a situation
in which people are compelled to take its history, seek out precedent, write its narratives,
adjudicate claims about it, make a judgment, and file it somewhere: a sick body, a traffic
accident, a phenomenon, instance, or detail that captures the interpretive eye. …’
When an event… perturbs.. disturbs, creates a louder noise ‘it opens up a field of debate
about … description, narration, evaluation, argument and judgment’.
That is what makes an event a case, and cases generate texts, which we call clinical case
reports. [slide of 3 levels: case, case report, illness narrative]
The case report is an official, medical account of a person’s illness or episode. Like a
fixative, it transfixes (freezes) a particular version of a living and dynamic situation. As
well as overtly transmitting information, case reports convey a latent content: values and
presuppositions about what constitutes patienthood, how doctor-patient relationships are
to be understood and represented in different periods. Today, cases generate other sorts of
texts, too, such as illness narratives, memoirs, pathographies and blogs about which I will
say no more for the moment.
I have asked you to read a case report from The Lancet about a 39 yr old, right handed,
community nurse. I want to mention three features of this report:
Firstly
There remain clear traces of the patient’s own words in this case not only in the use of the
term ‘flipped’ which is in inverted commas, but in the description given that is not in
quotes, for example, it is almost certainly her words we hear when we read that she
crawed back to to her bed.
Secondly
This case is written up in reference to other similar but forgotten cases of this particular
condition, so that this report offers a recovery of forgotten knowledge and one end of a
spectrum of similar case descriptions. Multiple cases permit comparison of one case with
the written accounts of other cases from which summary descriptions and measures can
begin to be discerned
Thirdly
This report is framed by a title – The Case of the Forgotten Address – that sets up a
problem or a puzzle together with the expectation that this puzzle will be fathomed, and
fathomed in an exemplary fashion. The title of The Lancet report is resonant of the 18th
C rhetoric of the curious and extraordinary. At this time case reports were often framed
by titles heralding perplexity, mystery and access to the secret and mysterious. How
could this woman have forgotten her address and her vision have flipped, so she saw
everything upside down, yet continue to work?
In the nineteenth century, this fathomability is manifest in other sorts of accounts , such
as the literature of eccentric biography, which typically comprises short stories or
accounts of bodily transgressive individuals – O’Brien, the 8ft 1-inch Irish Giant or
Daniel Lambert the 52 stone caretaker of a Leicestershire Work House – characters who
attain fame in novelistic accounts which accord wonders of humanity the same intense
interest that is accorded to wonders of nature in the reports of naturalists and physicians.
The Case of Dr Jekyll and Mr Hyde by the writer, Robert Louis Stevenson, in the 19thC
and the Casebook of Sherlock Holmes or the in the 20th C, operate on templates not
dissimilar to a mystery of this sort – a mystery set up in order to be unraveled. This hints
at connections and influences operating between the clinical case report and other forms
of writing.
The case, it’s been said, is a traveling genre that spans the sciences and the humanities –
this is one reason why in medicine, the case is the contested and troubled ground where
distinctions between person, patient, experiences, symptoms, subjectivity and objectivity
collide. Such storied construals do not stand alone – they exist within a chain of
intertextuality, conform (more or less) to certain templates and exhibit styles of reporting
that restrict – as much as enlighten - our understanding of ill health and what it means to
be a patient.
i
Hurwitz B. Form and representation in clinical case reports. Literature and Medicine 2006 25:2; 216-40.
. See Risse and Warner, “Reconstructing Clinical Activities.”
iii
Daston L. Knowldege and belief. Max Plank Institute for then History of Science http://www.mpiwgberlin.mpg.de/en/research/projects/knowledgeBelief/index_html
iv
Craeger A NH, Lunbeck E, Wise M N. Introduction. In: Craeger A NH, Lunbeck E, Wise M N (eds)
Science without laws. Duke: Duke University Press, 2007, 4.
v
Daston L. Observation as an epistemic genre. Talk delivered at Cases in Science, Medicine and the Law.
Conference, CRASSH, Cambridge 20/4/07.
vi
Forrester J. “If p, then what? Thinking in cases’” History of the Human Sciences 1996;9:1-25.
vii
Forrester J. On Kuhn’s case: psychoanalysis and the paradigm. Critical Inquiry 2007:1;782-819.
viii
Berlant L. On the case. Critical Inquiry 2007:1;663-672.
ii
What sort of a Narrative is the Clinical
Case Report?
London Visit of Senior Educators and Clinicians
from Japan 1st July 2009
UCL
Brian Hurwitz, King’s College London
The Case of the Forgotten Address
A 39-year-old right-handed community nurse
presented to us on the neurology ward in April,
2005. She had appeared subdued before starting
the afternoon shift and when asked she could not recall
h home
her
h
address.
dd
Th
The nurse's
' symptoms
t
had
h d begun
b
48
hours previously, when she woke with a bitemporal
headache. Her vision then “flipped 180°” so that all
images appeared inverted... She was able to crawl back
to bed….
Samarasekera S, Dorman P. The case of the forgotten address.
Lancet 2006;367:1290
Form and Representation in
Clinical Case Reports
B i Hurwitz
Brian
H
it
Literature and Medicine 25, no. 2
(Fall 2006) 216–240 © 2007 by The
Johns Hopkins University Press
Case as a representational tool
Case Reports – linguistic ‘portraits’
• Hippocratic case reports (4th and 5th C BC)
• Presentational
• Galenic (2nd C AD)
• Communicational
• 17th & 18th C case reports
• 19th and 20th C reports
• Hospital and GP Cases – including self
reports by doctors
• Not medical records, letters, notes…etc
• Conversationally or formally presented
Case Report –
A narrative and a model composed of testimonies
• Conversation
• Observation – external/internal
• Description/analysis – fluids, tissues
‘…the term case signals that, from at
least one party’s point of view, the
form of writing or discussion … will
y remain attached to a specific
p
always
individual…
[will
always
be]
epistemically nailed down to the level
of the individual….’
• Imaging
• Response to treatment
‘…the case represents a problem-event
that has animated some kind of
judgement .. A symptom, a crime…a
y irritating
g obstacle to
situation,, … any
clarity….’
Forrester J. On Kuhn’s case: psychoanalysis and the paradigm Critical
Inqury 2007:1; 783-819
‘…the case reveals itself… as an event
that takes shape…. One might say that
a case is what an event can become.’
Berlant L. On the case. Critical Inqury 2007:1; 663-72.
Berlant L. On the case. Critical Inqury 2007:1; 663-72.
What is a case?
• Events and occurrences pertaining to
individuals
• Case
• Case Report
• Biography, Memoir, Pathography,
Illness Narrative
The Case of the Forgotten Address
Narrative based Knowledge Management: Human and Social
Developmental Change Process through Organizational Knowledge
Creation Activities
Takashi Yoshinaga
㧔Student Support Centre, University of Toyama㧕
I would like to introduce organizational knowledge creation theory which was developed by
Nonaka and his colleagues and discuss relationship between this theory and narrative approach.
My major is organization theory in business field, especially research and development
organization. My recent concern is relationship between narrative approach and organizational
knowledge creation theory.
I bring up definition of knowledge. Knowledge is a dynamic human/social process of
justifying personal belief toward the truth (Nonaka and Takeuchi, 1995: p.58). In addition,
Nonaka and his colleagues discussed that knowledge has four characteristics: subjective,
process-relational, aesthetics and created through practice (Nonaka et al, 2008).
First, the above definition of knowledge rely on Michael Polanyi’s concept (1958), “tacit
knowing.” Nonaka and his colleagues (2008) argued that knowledge created through human
beings’ individual, active and subjective shaping and integration of experience. Thus they focus
on three subjective factors on management: values, contexts and power. Second, they also relied
on Alfred North Whitehead’s concept (1978), “process philosophy.” They argued that
knowledge is treated as social process for pursuit of common good. Third, in accord with
discussions between knowledge and aesthetics (Tayler and Hansen, 2005; John, 2001), they
argued that knowledge emerges in a series of value judgments which depends on how we
perceive truth, goodness and beauty (Nonaka et al, 2008). Finally, in accord with discussions
between unpredictable situation and practice (Mintzberg, 2004; Weick, 2001), they argues that
knowledge can only be created in the actual practice of dealing with each particular situation
(Nonaka et al., 2008; p.13).
According to Nonaka and his colleagues (2008), Organizational knowledge creating theory
can answer two questions. First question is how knowledge is continuously created to change
the organization and the environment (p.14). Second question is how this creative capacity
develops in interactions with the environment (p.14).
Nonaka and his colleagues tried to build the knowledge-creating process model (SECI
model) for answering first question (Nonaka and Takeuchi, 1995; Nonaka et al., 2008). This
model is focus on process of conversion between tacit and explicit knowledge. This process
model has four modes (Socialization, Externalization, Combination and Internalization) and ten
steps (see fig. 1). According this process model, narrative has important role in externalization
activities which convert tacit knowledge into explicit knowledge.
Fig.1. The knowledge-creating process (Modified Nonaka et al., 2008: p.19)
Furthermore, Nonaka and his colleagues focus attention on leadership the knowledge
creating organization for answering second question. They relied on Aristotle’s concept (2002),
“Phronesis” as practical wisdom or prudence (Nonaka and Toyama, 2007; Nonaka et al., 2008).
Furthermore, they argued that phronesis is the ability to determine and undertake the best action
in a specific situation to serve to the common good (Nonaka et al., 2008). They suggested six
abilities of phronesis for leading the knowledge-based organization: (1) Judge goodness, (2)
Grasp the essence of particular situations/things, (3) Realize concept for the common good, (4)
Reconstruct the particulars into universals and vice versa using language, concepts and
narratives, (5) Share contexts with others to create Ba, (6) Foster phronesis in others to build a
resilient organization (Nonaka et al., 2008). I tried to correlate the knowledge-creating process, a
process model of the knowledge-based organization and abilities of phronesis for leading the
knowledge-based organization (see fig.2).
Fig.2. Six abilities of phronesis for leading the knowledge-based organization
(Modified Nonaka and Toyama, 2005: p.423)
I would like to discuss about similarities and differences between knowledge and narrative
based on Nonaka and his colleagues’ work. This challenge might be effective to relate narrative
approach with organizational knowledge creating theory.
There are four similarities between four concepts: (1) subjective rather than objective, (2)
process rather than substance, (3) depend on context that is created specific situation and
actuality, (4) need aesthetic judgment based on individual’s belief. On the other hand, I would
like to suggest two perspectives for discussing differences between these concepts: (1) include
practice or not, (2) pursue common good or individual’s quality of life.
References
Aristotle. (2002). Nicomachean ethics (Brouadie, S. and Rowe, C., Trans.). New York: Oxford
University Press.
John, E. (2001). Art and knowledge. Gaut, B. and Lopes, D. (eds). The Routledge Companion to
Aesthetics. London: Routledge, 329-52.
Mintzberg, H. (2004). Managers not MBAs: A Hard Look at the Soft Practice of Managing and
Management Development. San Francisco: Berrett-Koehler Publishers.
Nonaka, I., and Takeuchi, T. (1995). The Knowledge-Creating Company: How Japanese
Companies Create the Dynamics of Innovation. New York: Oxford University Press.
Nonaka, I., and Toyama, R. (2005). The theory of the knowledge-creating form: subjectivity,
objectivity and synthesis. Industrial and Corporate Change, 14(3): 419-36.
Nonaka, I,. Toyama, R., and Hirata, T. (2008). Managing Flow: A Process Theory of the
Knowledge-Based Firm. New York: PALGRAVE MACMILLAN, New York.
Polanyi, M. (1958). Personal Knowledge: Towards a Post-Critical Philosophy. Chicago:
University of Chicago Press.
Schön, D. A. (1983). The Reflective Practitioner: How Professional Think in Action. New York:
Basic Books.
Tayler, S.S. and Hansen, H. (2005). Finding form: Looking at the field of organizational
aesthetics. Journal of Management Studies, 42(6): 1211-31.
Weick, K.E. (2001). Making Sense of the Organization. Malden, MA: Blackwell.
Whitehead, A.N. (1978). Process and Reality, corrected edn. New York: Free Press.
Self introduction
y
Narrative based Knowledge Management:
My Major:
organization theory in business field
R&D management and innovation management
Æmain academic concern is knowledge and
intercultural management for organizational
change/development
Human/Social developmental change process through
organizational knowledge creation activities
y
July 1, 2009
y
Takashi YOSHINAGA, PhD
(Knowledge Science)
working experience at Japanese trust banking
for 2 years
My recent challenge
Action research on developing support system in
University of Toyama for students with developmental
disorder (high-function autistic spectrum disorder and
attention-deficit hyperactivity disorder)
Total Communication Support Initiative
Student Support Centre
University of Toyama
2
What is Knowledge?
Characteristics of knowledge
(Nonaka et al., 2008: pp.7-12)
y
y
Definition of “knowledge”
(Nonaka & Takeuchi, 1995: p.58)
A dynamic human/social process of justifying
personal belief toward the truth
Knowledge is subjective
human beings obtain new knowledge through their individual, active, and
subjective shaping and integration of experience.
ЊThe traditional Greek concept as “knowledge is justified true belief”
suggests that knowledge is objective, absolute, and context-free.
context free.
y
Tacit knowing: Michael Polanyi(1958)’s concept of knowledge
Characteristics of knowledge (Nonaka et al., 2008)
Knowledge is subjective
Knowledge is process-relational
Knowledge is aesthetic
Knowledge is created through practice
y
Subjective factors on Management: values, contexts, and power
Knowledge is process-relational
Process philosophy: Alfred North Whitehead
the world is an organic web of interrelated process.
Rather than substance, knowledge is treated as process, created and used
in relation with the knowledge of other human being who exist in relation
with others.
Knowledge is born of the multiple perspectives of human interactions.
Æknowledge creating process is a social process of validating truth or
“common good.”
3
4
Characteristics of knowledge
(Nonaka et al., 2008: pp.12-14)
What is organizational knowledge-based
management theory? (Nonaka et al., 2008: p.14)
y
Knowledge-based management theory or a process theory of
the knowledge-based organization reveals;
Knowledge is aesthetic
Knowledge emerges in a series of value judgments. Such an judgment
depends on how we perceive truth, goodness, and beauty.
Aesthetics is concerned with knowledge that is created from our sensory
experiences.(Tayler and Hansen, 2005: p.1212)
Aesthetic knowledge offers fresh insight and awareness that may not be
possible to put into words, but nevertheless enables us to see in new ways.
(John, 2001)
y
y
How knowledge is continuously created to change the
organization and the environment?
Æthe knowledge creating process (SECI model) and a
process model of the knowledge-based organization
y
How this creative capacity develops in interactions with
the environment?
Æleadership with phronesis
Knowledge is created through practice
Knowledge can only be created in the actual practice of dealing with each
particular situation.
Management is more art or craft than science because it is based on insight,
vision, and intuition, and relies on experience. (Mintzberg, 2004) It requires
the ability to react quickly and appropriately to an unpredictable situation
(Weick, 2001)
5
6
The knowledge-creating process: SECI model
(Nonaka and Takeuchi, 1995; Nonaka et al., 2008Უ
Socialization:
Externalization:
Sharing and creating tacit knowledge
through direct experience
Articulating tacit knowledge through
dialogue and reflection
1. Perceiving the reality as it is
2. Sensing and empathizing with
others and the environment
3. Transferring of tacit knowledge
4. Articulating tacit knowledge using
metaphor and analogy, abduction
of hypotheses, and narrative to
give context and time frame
5 Translating tacit knowledge into
5.
a concept or prototype
Internalization:
Combination:
Learning and acquiring new tacit
knowledge in practice
Systemizing and applying explicit
knowledge and information
6. Gathering and integrating explicit
knowledge
7. Explanatory analysis of the
concept and finding relationships
among concepts
8. Editing and systemizing explicit
knowledge
9. Embodying explicit knowledge
through “reflection in action”
(Schön, 1983)
10. Using simulation and experiments
explicit knowledge
explicit knowledge
explicit knowledge
tacit knowledge
tacit knowledge
A process model of the knowledge-based
organizationᲢmodified Nonaka & Toyama, 2005Უ
explicit knowledge
e
tacit knowledge
tacit knowledge
Externalization:
From Individual to group
(e.g., department, division)
Dialogue
g
Why? Combination:
From Individual to Individual
Internalization:
Organization
From organization back to Individual
Knowledge assets
Externalization & Combination:
Reconstruct the particulars
into universals and vice
versa using language,
concepts and narratives
Æ Independent of context, time and space (explicit knowledge)
y
phronesis is prudence, ethics, practical wisdom or practical
8
Environment
Vision
What?
Judge goodness
validity principle in the practice of modern science.
techne is technique, technology and art.
Ba
shared context
in motion
Practice
How?
6 abilities of phronesis for leading the knowledgebased firmᲢmodified Nonaka et al., 2008Უ
Aristotle distinguished three types of knowledge
y episteme is universal truth corresponding to the universal
y
From group to organization
(e.g., firm)
Driving
objectives
Socialization:
7
Leading the knowledge-creating organization:
Phronesis (practical wisdom)
(Nonaka and Toyama, 2007; Nonaka et al., 2008Უ
Environment
Ecosystem
Vision
What?
It is the know-how
or practical
ti l skill
kill required
i d to
t be
b able
bl to
t create
t
Dialogue
g
Why?
Æ Dependent of context (tacit knowledge)
Socialization:
Grasp the essence
of particular
situations/things
rationality. It is the ability to determine and undertake the best
action in a specific situation to serve to the “common good.” It
is the high-quality tacit knowledge acquired from practical
experience that enables one to make prudent decisions and
take action appropriate to each situation, guided by values and
ethics.
Driving
objectives
Practice
How?
Internalization:
Realize concept for
the common good
Organization
Ba
Share contexts
with others to
create Ba
Foster phronesis in
9
Discussions: What is similarities and differences
between “knowledge” and “narrative” ?
y
Similarities
Subjective rather than objective
Process rather than substance (cf. light is both
wave and particleᲣ
Depend
p
on context ((specific
p
situation/actuality)
y)
Need aesthetic judgment based on individual’s
belief
y
Differences
Relationship with knowledge/narrative and
practice
Knowledge indwells practice. How about narrative?
Need for common good or individual’s quality of
life?
11
Knowledge assets others to build a
resilient organization
10
Choice and loss in infertility experience: the narratives of Japanese
women who accepted their lives as childless women.
Ms. Kazumi Takeya (Kyoto University)
Greetings, everyone, it’s a great pleasure to be here today. I’m Kazumi Takeya of Kyoto
University.
Today, I’ll be talking about ‘Choice and Loss in Infertility Experience: The narratives of
Japanese women who accepted their lives as childless women’.
In this presentation, first I’m gonna talk about the motivation.
Then, I’ll share with you some of the interesting results of investigation.
Finally, I’ll mention my opinion about this subject.
Since 1978 in Britain, the birth of the first IVF baby in the world, great progress has been
made in assisted reproductive technologies.
Today infertility treatments have become popular in Japan, as a result over 17000 IVF babies
were born for 1 year.
It’s however still difficult to produce a child using the treatments. The success rate should be
20~30% in Japan. If the treatment doesn’t lead to the birth of a child, the patient has to decide
whether to continue.
A number of researches regarding infertile women have been done to realize the better
support for patients in nursing. Of course, those studies are very useful and practical. In that case,
a woman should be a patient and only the birth of a child should be considered to be the success
story.
In fact, a good few women quit the treatments, even though motherhood should be lost in her
life. Despite a kind of crisis, their voices tend to be had a disregard.
So, I’ve interviewed Japanese women who decided to remain childless after unsuccessful
infertility treatments. While she has lost her story of motherhood, how does she organize her
experience in narrative terms? From the viewpoint of life-span development, I’d like to
understand her meaning of infertility experience in her life. In my presentation, I’ll be talking
about ‘choice and loss in infertility experience’ through analyses of their narrated life-stories.
The primary method of my research is the life-story interview. I’ve done the life-story
interviews with over 20 childless women. Their narratives had diversity and uniqueness, on the
other hand, they had a few common important features of their experiences.
First, 3 common factors of their infertility experiences are ambiguity, temporality, and otherness.
Once a woman decided to receive the infertility treatment, she had to face a lot of ambiguity,
such as her cause of infertility and possibility of her succeeding. The ambiguity brought her into
conflict and thus increased her anxieties or impatience.
Infertile women are conscious of temporality. In other words, they are always conscious of the
time limit of reproductive age. Therefore, in particularly middle aged childless women should be
very sensitive to the temporality.
Otherness should be a sense of unusual.
In Japan, there’s the social expectation for married women of it’s natural to have babies. For
women who are internalized by such social expectation, the unsuccessful infertility treatments
should be crises. They are becoming empty, lonely and unstable female identity because of
absence of motherhood. I’d like to emphasize that differently from the others, the otherness tend
to continue after quitting infertility treatment. Thus, many women cannot be released from
infertility after that so long.
Second, I’m gonna talk about their meanings of the infertility experiences. They told me
about their changes through infertility, including both sides of positive and negative. Especially,
what is very important were as follows: expansion a sense of acceptance, change in values, and
Generativity. I’m sure that those changes which told by themselves are their meanings of
experiences.
This slide shows that the 3 changes have a synergistic effect cyclically.
Let me say it a different way. A woman who quitted the infertility treatment has lost her life as a
mother. She needs a new life, but she can’t restart because of the otherness. When she’ll find the
value in her life as a childless woman, then her sense of acceptance should be expanded. At the
same time, she’ll able to affirm her own self. In the process of her those changes, she can
develop her Generativity. Generativity is related to self acceptance and raises her self-esteem.
As you all may well know that the Generativity should be defined as follows: an adult’s
concern for or commitment to the well-being of future generations, as evidenced in parenting,
teaching, mentoring, and engaging in life activities aimed at leaving a positive legacy of the self
for future.
Finally, I’m gonna talk about how they could overcome their infertility as childless women.
As shown here, there’re various ways, such as to get employed, to enter a graduate school and to
do volunteer activities. Some became a psychotherapist or nurse of nursery school, others
organized the self-help group. What is common is socialization. In other words, they have made
relationships with others through their work or activity, then they could return for society their
knowledge and experience.
In closing, I’ll mention my opinion about this subject. I’ve shown you what’s the most
important to overcome infertility are the relationship and Generativity. Naturally I know there
are many women can’t recover from infertility. Nevertheless, I desire that my research
contribute to their recovery and well-being, because I had the same experience. My research
might be my Generativity for me.
Thank you for your attention. I wish to express my sincere gratitude to the conference
organizers.
Choice and Loss in Infertility Experience:
The narratives of Japanese women
who accepted their lives as childless women
⁆⁓⁔⁞⁗‒⁘‒‵⁗
1. Motivation
1) The present state of infertility treatment in
Japan.
2) The present state of women who decided to
remain childless after unsuccessful infertility
treatments in Japan.
Symposium on Narrative Research in Health and Illness
Julyy 1st,, 2009,, University
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Results of investigation
1) Common Factors of their Infertility
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2) Meanings of the experience of Infertility
3) Choice of a life as a woman without
children: How to overcome the infertility
My own opinion
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1978 in UK the birth of the first IVF baby in the world!!
‿⁛⁓⁛‒․‛
Still difficult to produce
a child using infertility
treatments
Success rate: 20-30%
as a result of IVF
Success story =
The birth of a child
Infertile women
= Patients
(IVF: In Vitro Fertilization)
‵⁞⁛⁛⁕⁓⁞
⁞⁖
1983 the
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first IVF
baby in Japan!
Childless women
= Non patients
Today over 17000 IVF babies
should be born in Japan
for one year.
Crisis!!
How does she organize her experience?
Alternative stories
⁄⁗⁞‒⁘‒⁛⁗⁛⁙⁓⁛‒․‛
⁄⁗⁞‒⁘‒⁛⁗⁛⁙⁓⁛‒‣‛
Common Factors of their Infertility Experience
Meanings of the experience of Infertility
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Generativity
Otherness
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⁉⁚⁓‒⁛‒‹⁗⁗⁓⁛⁛‱
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Choice of a life as a woman without children
›‒‒⁗⁕ ⁗‒⁚⁗‒⁛⁘⁗⁛⁞⁛
• An adult’s concern for or commitment to
the well-being of future generations, as
evidenced in parenting, teaching,
mentoring, and engaging in life activities
aimed at leaving a positive legacy of the
self for future.
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חΈΙΒΥ͑ΚΤ͑ΥΙΖ͑ΞΠΤΥ͑ΚΞΡΠΣΥΒΟΥ͑ΥΠ͑ΠΧΖΣΔΠΞΖ͑
ΚΟΗΖΣΥΚΝΚΥΪ͑ΒΣΖ͑ΥΙΖ͑ΣΖΝΒΥΚΠΟΤΙΚΡ͑ΒΟΕ͑ΖΟΖΣΒΥΚΧΚΥΪ͟
Ϳ חΒΥΦΣΒΝΝΪ͑ͺ͑ΜΟΠΨ͑ΥΙΖΣΖ͑ΒΣΖ͑ΞΒΟΪ͑ΨΠΞΖΟ͑ΔΒΟΥ͑
ΣΖΔΠΧΖΣ͑ΗΣΠΞ͑ΚΟΗΖΣΥΚΝΚΥΪ͟
חͺ͑ΕΖΤΚΣΖ͑ΥΙΒΥ͑ΞΪ͑ΣΖΤΖΒΣΔΙ͑ΔΠΟΥΣΚΓΦΥΖ͑ΥΠ͑ΥΙΖΚΣ͑
ΣΖΔΠΧΖΣΪ͑ΒΟΕ͑ΨΖΝΝ͞ΓΖΚΟΘ͟
ͳ חΖΔΒΦΤΖ͑ͺ͑ΙΒΕ͑ΥΙΖ͑ΤΒΞΖ͑ΖΩΡΖΣΚΖΟΔΖ͟
; חΪ͑ΣΖΤΖΒΣΔΙ͑ΞΚΘΙΥ͑ΓΖ͑ΞΪ͑ΖΟΖΣΒΥΚΧΚΥΪ͑ΗΠΣ͑ΞΖ͑͟
⁄⁗⁘⁗⁗⁕⁗
• Erikson,E.H.(1950). Childhood and society.
New York: Norton.
• McAdams,D.P.,& de St. Aubin,E. (1998). (Eds.).
Generativity and adult development: How and
why we care for the next generation. Washington,
DC: American Psychological Association.
䅇Thank you for your kind attention!
[email protected]
How midlife women imagine the mother–self–daughter relationship:
Drawings of the “care” story.
Naoko Nishiyama (Kyoto University)
Background
This study discusses three-generation maternal kinship relationships, focusing on
the visualized life stories of midlife mothers. A popular metaphor depicts a
sandwich generation, represented by a midlife mother who strives to meet the
needs of both her young adult daughter and her own elderly mother. According to
Erikson (1950, p.266), generativity vs. stagnation is the psychosocial centerpiece of
the middle-adult years, and care is the central virtue of this developmental stage
(Erikson, 1964, p.115). The purpose of this study was to explore generativity and
care as they appear in the visualized life stories of midlife mothers.
Methods
Seventy-one midlife women, aged 41 to 61 years (M = 48.8 years), provided
information on their families, focusing especially on maternal kinship relations. All
participants had at least one daughter (mean age = 19.8) attending a Japanese
college. Participants drew images of their past (during the daughter’s early
childhood), present, and future relationships with their mothers and daughters.
The data were analyzed using qualitative methods.
Results
Two fundamental patterns of images were identified in these visualized life
stories: looking after the next generation and taking care of the former and the
future generations. While the daughters were children, most of the grandmothers
had helped the mothers. Now, the mothers support their daughters and are also
committed to caring for their own mothers.
Conclusions
According to Erikson, the focus of generativity is establishing and guiding the next
generation (1963,p.267). However, the visualized life stories of these mothers
suggest that reciprocal relationships across generations are beneficial to all, with
patterns of mutual support and caring that include role reversals. The concept of
care involves concern not only for the future generation but also for the former
generation. This interactive care is passed from generation to generation.
How to narrate the transmission of traditional Japanese dance.
Mr. Kazuma Takeuchi
(Graduated School of Education, Kyoto University )
This study sought to clarify how a master positions skills acquired through his mastery within
the relationship among generations through narratives. The life cycle model developed by
Erickson focuses on the development of the individual, independently of later or previous
generations. Even the role of generativity has been studied in individual development, such as in
motivation. The other hand, some researchers hold to the generative life cycle model (GLCM),
which regards life as being situated in a relationship with generations. It is no exaggeration to
say that this perspective extend the development to before one’s birth or after one’s death. The
aim of this study is to examine how masters of a traditional art interpret their skill in the
relationship between generations.
Firstly, I undertook fieldwork to Japanese traditional dancing art to examine how the master
had taught to the later generations. And then, based on the field data, the master was interviewed
to clarify how the mater positions skills now and also how the master positions that the previous
generation had taught skills before.
The data showed that the master did not teach skills as previous generations had taught them,
but repositioned the skills based on narratives of previous generations through the process of
mastery, and then taught skills to the later generation with the meaning of the master.
I propose that the master can maintain the continuity of skill-learning through narratives. This
conclusion shows a new role of narrative which connects the relationship among generations.
ࡓࠣࡠࡊع㧦Narrative in Mental Health Care:Applications in
Therapy and Training
Day 3: Thursday 2nd July 9.30-17.00
Title: Narrative in Mental Health Care: Applications in Therapy and
Training
Venue: Studio B, Tavistock Centre, 120 Belsize Lane, London NW3 5BA
Convenor: Dr. John Launer (Tavistock Clinic)
Proposed programme:
9.30: Welcome by Dr. Rob Senior, Medical Director (Tavistock Clinic)
9.45: Exploring experiences of living in more than one language. Dr. Charlotte Burck
(Tavistock Clinic)
10.30: Narratives of women who experienced infertility treatment: From the quest
story for having children. Ms. Yuko Yasuda (Kyoto University)
10.45: Introduction of Naikan therapy as a narrative-based approach. Prof. Akira
Nakagawa MD (Osaka Sangyo University)
11.00: Discussion
11.15: Coffee
11.30: Semantic analysis of anxiety. Dr. Norifumi Kishimoto MD (Kyoto University
Hospital)
12.00: Personal narratives and popular genres. Prof. Corinne Squire (Centre for
Narrative Research, University of East London)
12.45: Discussion
13.00: Buffet lunch with address from Mrs Trudy Klauber (Dean of Postgraduate
Studies, Tavistock Clinic)
14.00: How do family physicians use systemic and narrative ideas? Dr. Helen Halpern
(Tavistock Clinic)
14.30: Dialogic construction of collaborative care in school. Dr. Hideaki Matsushima
PhD (University of Shiga-Prefecture)
15.00: Discussion
15.15: Tea
15.30: Group work: Reflections on the week, including cultural differences in relation
to the training of doctors and psychotherapists (Studio B / Committee Room)
Facilitators: Dr. John Launer, Dr. Helen Halpern, Dr. Hiroshi Amino, Dr. Hideaki
Minagawa (Tavistock Clinic)
16.45: Final plenary
17.00: Reception (Fifth floor lecture theatre)
Additional participants for Day 3: Dr. Tsuyoshi Shoji (a.m. only), Ms. Junko
Wakitani, Dr. Kate Cabot, Dr. Loma Estreich, Dr. Victoria Holt, Dr. Sarah Divall
(Tavistock Clinic), Dr. Yuriko Morino (Tokyo)
Narratives of women who experienced infertility treatment:
From the quest story for having children.
Ms. Yuko Yasuda (Kyoto University)
‘Methodologyofclinicalsupportanddialogicaleducationbasedonpolyphonicnarrativefieldworkcultures’LONDONPROGECT:
Methodologyofclinicalsupportanddialogicaleducation:
Basedonpolyphonicnarrativefieldworkacrossmultiplecultures
Conference:HowtoBuildtheBridgebetweenTavistockandJapan
2/7/2009
Narrativeofwomen
whoexperiencedinfertilitytreatment
:Fromthequeststory
From the quest story
forhavingchildren
YukoYasuda,
(KyotoUniversity)
Email:[email protected]
Background
:Whatisinfertility?
¾InJapan,infertilityisdefinedasthe
inabilitytoconceiveachilddespitemore
thantwoyearsofattemptingtodoso.
h
f
i
d
¾ Oneinsevencouplesiscurrentlyinfertile.
Theconstruction
ofthispresentation
1. Background
Infertility,Infertilitytreatment,Psychological
characteristicsandIdentityasinfertility䊶䊶䊶
y
y
2.Thefocusandpurposeofmypresentation
3.Method
4.Analysis
5.Results
6.Myopinion(Asconclusion)
Factsaboutinfertilitytreatment
inJapan
¾Infertility treatment has become popular.
¾In 1978, Baby was born by IVFET in UK.
In 1983, IVFET succeeded in Japan.
䊶IVFET is Assisted Reproductive Technology (ART).
䊶139,467 cycles of ART were performed, and 19,587 babies
were born as a result of ART in 2006. (The success rate is less
than 15%)
䊶The total number of babies born as a result of ART reached
174,456 in 2006.
¾ One baby in 55 was born as a result of ART.
Psychologicalcharacteristicsof
womenseekinginfertilitytreatment
¾ Womendealingwithinfertilityexperienceavarietyof
stressors whichinclude:
䊶painassociatedwithinfertilityexaminationsandtreatments
䊶fearandanxietyabouttheoutcomeofinfertilitytreatments
䊶envyandjealousyofpeoplewithchildrenorof
pregnantwomen
䊶disappointmentatrepeatedfailuresofinfertilitytreatments
䊶feelingsofbeinginferiortoanddifferentfromthosewith
children
䊶pessimismabouthavingchildren
LowsuccessratesassociatedwithART
¾ExpectationsforARTareincreasingamong
infertilecouples.
¾However,thesuccessrateofARTisnothigh.
Infertilityasacorepersonalidentity
¾ Womendealingwithinfertilitytrytorejectanidentity
asinfertilebyobtaininginfertilitytreatmentand
becomingpregnant.
¾ However,devotingalltheirenergytoinfertility
However devoting all their energy to infertility
treatmentincreasestheiridentificationwithbeing
infertile,whichincreasinglybecomestheircore
identity.
¾ Undersuchcircumstances,womendealingwith
infertilityareoftenunabletocopecalmlywiththe
particularfeelingsassociatedwithinfertility.
Alternativestoanidentity
asinfertile
¾ Overcome:rejectanidentityasinfertilebycuringthe
infertilitywithinfertilitytreatments.
¾ Circumvent:rejectanidentityasinfertileby
becoming pregnant through ART in the absence of a
becomingpregnantthroughARTintheabsenceofa
cure.
¾ Reconcile:decidetoliveone’slifewithoutbearingor
toadoptchildren.
(Olshansky,1987)
¾ Thethirdalternativeinvolvesstoppinginfertility
treatments.
Thefocusandpurpose
ofmyresearch
¾㪠㩷examined㫋㪿㪼㩷㫅㪸㫉㫉㪸㫋㫀㫍㪼㫊㩷㫆㪽㩷㫎㫆㫄㪼㫅㩷㫎㪿㫆㩷㫎㪼㫉㪼㩷
㫌㫅㪸㪹㫃㪼㩷㫋㫆㩷㪹㪼㪺㫆㫄㪼㩷㫇㫉㪼㪾㫅㪸㫅㫋㩷㫎㫀㫋㪿㩷㫀㫅㪽㪼㫉㫋㫀㫃㫀㫋㫐㩷㫋㫉㪼㪸㫋㫄㪼㫅㫋
㪸㫅㪻㩷㫎㪿㫆㩷㫊㫌㪹㫊㪼㫈㫌㪼㫅㫋㫃㫐㩷㪺㫆㫅㫊㫀㪻㪼㫉㪼㪻㩷㪸㪻㫆㫇㫋㫀㫆㫅㩷㪸㫊㩷㪸㫅㩷
㪸㫃㫋㪼㫉㫅㪸㫋㫀㫍㪼㩷㫋㫆㩷㫄㪼㪻㫀㪺㪸㫃㩷㫋㫉㪼㪸㫋㫄㪼㫅㫋.
¾Iexaminedthedecisiontostopinfertilitytreatment
andattemptedtounderstandexperiencesof
infertilityalongatimeline.
¾Mypurposewastocomprehendhowthe
respondentshadgivenmeaningtonothaving
childrenafterundergoinginfertilitytreatment.
Method
¾ Lifestoryinterview
¾Participants:Night women(orcouples)
¾Eightwererecruitedataprivateadoption
g
p
p
agency.Andoneisacquaintanceofmine.
¾Allparticipantsconsideredadoption
becausetheirinfertilitytreatmentshadbeen
unsuccessfulbuttheyhadwantedtofoster
children.
Analysis
¾Interviewdatawererecordedwiththe
permissionofparticipants.
䋨Oneparticipantrefusedtoberecorded䋩
¾Theaveragedurationoftheeightinterviews
¾Th
d ti
f th i ht i t i
was105minutes.
¾Therangewas40–205minutes.
Analysis
¾Thepsychologicalprocessesbywhichwomen
cametotermswithnotbeingabletohave
theirownchildrenwereverydiverse.
¾However,Iwasabletoorganizethenarrative
¾However,
I was able to organize the narrative
databyfocusingonthepointatwhichthey
decidedto“stopinfertilitytreatments
stopinfertilitytreatments”,which
representedamomentinwhichtheymadean
importantpersonalchoice.
¾Ifirstcodedthenarrativedataaccordingto
unitsofmeaning,towhichIassignedtitles.
¾Next,Ifocusedonthedecisionto“stop
stop
infertilitytreatment”andarrangedthese
infertilitytreatment
narrativesalongatimeline.
Results
:Fromonecase
¾ 䈀Duringinfertilitytreatment䈁
䊶”Developingexpectationsaboutthetechnologyforinfertility
treatment.”
䊶”Tryingtobecomepregnantwhileexperiencinggreatphysicalpain.”
䊶”Becomingawareofhavingdifficultygettingpregnant.”
¾ 䈀Stoppinginfertilitytreatment䈁
䊶”Thinkingrepeatedlyaboutkillingmyunbornchildren”after
sheexperienced12or13miscarriages.
¾ 䈀Afterstoppinginfertilitytreatment䈁
䊶”Pursuingotherwaysofhavingchildrenwithbeingsupported
byherhusband.”
䊶”Makingachoicetoformaconnectionwithanonbiologicalchild.”
Meaningsofthe
infertilityexperienceofthiscase
Meaningsoftheexperienceofinfertility
forotherpersonsconcerned
¾Meetingachildwithnoparentsanddeveloping
arelationshipnotbasedonbiological
connections.
¾Reexaminingthemeaningoffamilyfromthe
perspectiveofacouple.
¾Repayingsocietybyeducatingothersdealing
withthepainofnothavingbiologicalchildren
aboutinfertilityexperienceofherselfandthe
existenceoftheprivateagency.
¾Redefiningpersonalidentitiesandlivingwith
authenticity.
¾Encounteringreligion,findingredemptioninthe
doctrineof“thingsastheyare,”andrelyingon
thisphilosophyasatouchstone.
Myopinion
:Thenarrativeasactions
¾ Narrativesincludetwoaspects:contentandaction.
¾ Intervieweesconstructthemselvesbynarrating,forming
thenarrativeastheiractions.
¾ Narratingexperiencesofnothavingchildrenafter
N
ti
i
f th i
hild
ft
infertilitytreatmentandofsubsequentlytryingtoadopt
representsactingtofindmeaning.Suchqueststoriesare
relatedtotheformationofself.
¾ Thisresearchreliesonlifestoryinterviews.
Ithinkthattheshakingofnarrativeofactionsinalife
storyinterviewisrelatedtobeneficialeffectsintherapies.
Thankyouverymuch
foryourkindattention.
Introduction of Naikan therapy as a narrative-based approach.
Prof. Akira Nakagawa MD (Osaka Sangyo University)
Good morning ladies and gentlemen. I 'd like to thank you all for giving me this
opportunity to present the findings of my research. My name is Dr. Akira Nakagawa. I 'm a professor in the Humanities Department in Osaka Sangyo University. My
specialties are medical psychology and psychosomatic medicine. I give lectures at my
university as well as having a practice for outpatients in my surgery. I treat patients with
depression, neurosis, and psychosomatic diseases and so on. Psychosomatic disease
may sound strange, because DSM-Φ haven't adopted that concept. But I think that is
because of the cultural differences between western and eastern world. Anyway, let me
start my presentation.
Naikan is used as a traditional therapy and a way of training Buddhist monks in
Japan. It's challenging to complete the full week of the therapy. It involves an
interviewer and patient. The interviewer returns to the patient to ask about the three
themes every 2 or 2 and a half hours for only 5 minutes or so. The patient has to report
in detail to an interviewer about Naikan's themes in relation to the object person, that is
the patient's mother, caregiver or family member, etc.
The 3 themes are; Number 1: How you have been cared for and what you have
received from the object person. Number 2: What you have given back to the object
person, and Number3: How you have caused trouble or problems for the object person.
The actual methodology is very simple, but the results are incredible. By the end
of the week, the patient resembles an entirely different person. I suppose that Naikan
therapy makes patients more reflective, and also helps them to easily access their own
narratives. That is why I recommend Naikan therapy prior to ordinary narrative therapy.
Now, I'd like to talk about one of my cases relating to narrative approach, she
experienced Naikan therapy just before my treatment of her.
A narrative therapist must not face the patient as a specialist. Instead, the therapist
should play the role of a listener. If the therapist remains a listener, the client is no
longer a patient, but can be reborn as a lively "story teller".
Let's look at the case of Ms. M who is a 27years old woman who has been
suffering from an eating disorder for 10 years. She has tried every conceivable treatment.
She began treatment with internal medicine, psychiatry, counseling, and Chinese herbal
medicine. After these treatments, she was admitted to a hospital to receive behavioral
therapy, but this had no effect at all. Then, she went to a famous family therapist to
receive family therapy with her parents which lasted for 2 years before she dropped out.
As for her disease, I diagnosed Anorexia Nervosa, the symptoms of which include
binge eating and vomit inducement. In other words, despite her strong desire to lose
weight, she had an overwhelming desire to overeat and could not control herself. She
ate everything in her refrigerator and cupboards. Though her stomach was filled with
food to bursting point, she could not stop herself eating. Her way of eating was quite
abnormal. Once, she bought a pile of bread and ate it. Amazingly, she ate 20 loaves of
bread with animal ferocity. After eating, the kitchen looked like a bombsite. Her mother
said that she couldn't stop her daughter, when the overeating attack struck. It was a
chilling sight for her mother.
Ms. M herself was aware that something was wrong but once she started her
overeating , she didn’t care about anything else. Soon after eating, she made herself
vomit. She vomited a lot of food, but she wasn't convinced that she had vomited
everything, so she took a huge amount of laxatives.
She is 167cm tall and her weight is 40kg. Recently most fashion models are said
to be very thin, and I suppose she could be a fashion model with her beautiful looks if
she gained more weight. But unfortunately, now her figure is far from beautiful. Her
eyes have recessed into her sockets deeply, and her ghost-like looks frightened me. As a
doctor, I could see her skull shape clearly.
She is a really talented person and very good at painting and writing poems. She
is also good at cooking and can bake excellent cakes. Her mother manages a cafe and
sometimes serves her daughter's cake which she bakes when she is in a healthy
condition, and these cakes are so delicious that the customers are really amazed by them.
One day, she brought me one of her strawberry tarts. I have many female outpatients in
my surgery, and sometimes they bring me their handmade cakes as a gift. Though to be
honest, just between us, they are not so delicious. To tell the truth, I have a sweet tooth
and I am slightly particular about cakes. But even for me, her tart was brilliant.
Her repeated overeating and vomiting were painful for her. A much bigger
problem was that she didn't have enough time to do her favorite things, because she
had just a few hours a day when she was healthy, and the rest of the time she was
confined by her anxiety and depression. In this short time, she kept herself busy doing
things such as baking cakes, painting, writing poems, etc. Her waves of terrible anxiety
and depression would soon return. Sometimes she was seriously depressed and couldn't
get out of bed by herself. At that time, she severely resented her mother because of the
way her mother had brought her up. Sometimes, she blamed her father for her disease
because he did not show her any affection, but she knew all her complaints were unfair.
When faced with this disease, specialists say various things, but still now, we don't have
any clear solutions.
When she appeared in front of me for the first time, she was terribly exhausted
and disillusioned. "I have been treated by many doctors and counselors but they could
not cure me at all . So, I can't expect much of you . Sorry if this sound rude. But I'm just
exhausted from my disease", Ms. M told me dejectedly.
There is no decisive treatment for Anorexia Nervosa. Some say that SSRI is most
effective. Some say that CBT is the best. With regard to the causes, there are many
theories but none are conclusive. There seems to be a complicated mixture of factors
including biological weaknesses, psychological weaknesses and social or cultural
contexts, but everyone agrees that this disease is difficult to cure. In the case of Ms. M,
I abandoned taking the position of a professional, because lots of famous professionals
had already tried that position but no one had succeeded.
So I listened to her experience as though it was a simple story. She has been
suffering for the last 10 years, but from a different point of view we can say that she has
been dealing with an awful disease for over 10years. I asked her "How have you battled
against such an awful disease?" She seemed not to understand the meaning of my
question at first, but finally she said "How have I fought it? um..., No I haven't fought
it, absolutely not" I asked "OK, then , how could you live with the problem?" She
seemed to be thinking about it deeply for some time and then answered with a little
hesitation. "WellI think I have just been carried along by the river for 10years"
Her response puzzled me, so I offered " I see, so you were carried along by the flow of
the river" "Yes, something like that. I 'm just a drifting leaf on the river "To this I said
"If I understand you correctly, these 10 years must have been amazingly long! By the
way, a river source originates at the top of a mountain, right? And it flows down and
finally arrives at the sea, doesn't it? If it’s true, what happens to you when you are
finally driven to the sea? Will you be cured at that time?" She did not answer. Only she
kept silent, but seemed to smile a little.
At first, she told me that her disease was like a river, and I encouraged her to
think of it as a story in which the river will arrive at the sea. After the first counseling,
she regularly came to my surgery every 2 weeks and we developed the story of the river
flow. The river started from a high mountain, became a water fall, a torrent or suddenly
became a rapid stream and eventually arrived at the sea. Arriving at the sea means that
the illness is cured. Her illness is also like a river. Sometimes it flows rapidly or
becomes turbulent. It has nothing to do with the amount of effort she puts in. We can
say just that rivers are going towards the sea. If she experiences some kind of hardship,
she should think of it as though she is approaching the sea step by step. It means that
she is approaching her goal step by step.
We decided not to fight against the dreadful eating episode, because every episode
will end after a while. There is an old proverb "If Winter comes can Spring be far
behind" 6 months have passed since we started our therapy. She can still not stop
overeating, but now she can reduce her anxiety and depression. And her smile seems far
better than before.
What do you think of the story of Ms. M? The final ending to her river story will
come when she arrives at the sea in the future. The river may sometimes be turbulent,
but now Ms. M is a different person from who she used to be. She was reborn as a lively
story teller. And every time she comes to me, her story progresses. The scenery around
the river has changed a lot. In the first stage, the river was running in dark, wild and
dreadful lands, but now we can see sunshine reflecting on the river surface. And, the
expression on her face seems to be calm, and I have remained just a listener, not a
therapist.
So, I'd like to sum up by saying. Firstly, we need the treatment to take into
consideration the way each patient see their illness. And secondly, if we use Naikan
therapy prior to narrative approach, there is a possibility, it can enhance treatment.
Thank you very much for your kind attention and patience.
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Dialogic construction of collaborative care in school.
Dr. Hideaki Matsushima PhD
(University of Shiga-Prefecture)
MynameisHideakiMatsushimaandIamacertified
My
name is Hideaki Matsushima and I am a certified
clinicalpsychologistinJapan.Duringthepast10years,I
haveworkedmainlyinaJuniorHighSchoolasa
Psychologist.Intoday’spresentation,basedonmy
practiceasaclinicalpsychologist,Iwilltellyouacase
exampleandtrytoillustratehowadialogical
relationshipfacilitatesacollaborativeprocessamong
teachers.
Asaclinicalpsychologistworkinginaschoolcontext,Ihavefound
nonattendanceamongstudentstobeamongthemostimportant
problems.Indeed,schoolnonattendance[Futohkoh]constitutes
amajorproblemaffectingthecurrentJapaneseeducational
system.
Thedefinitionofschoolnonattendance,orSNA,ismorethan30
daysofabsenceperyear.Duringthepast20years,morethan
100,000juniorhighschoolstudentsaged13–15yearsdidnot
attendschoolanddidnothavealegitimatereasonfortheir
absences(MinistryofEducation,2008).
Thisproblemhasincreasedtheburdensplacedonteachersby
givingthemtheaddedresponsibilityofdealingwithstudentsand
theirfamiliesregardingthisproblem.Indeed,greaterteacher
dedicationtostudentsupporthasbeenassociatedwithagreater
riskforprofessionalisolation,burnout,andearlyretirement,and
supportforteachersofatriskstudentsrepresentsacriticalissue
intheJapaneseeducationalsystem.
StudentSupportTeams,orSSTs,havebeenconsidered
Student
Support Teams, or SSTs, have been considered
asagoodapproachtothisdifficultsituation(Ishikuma,
1999;Doherty,2004).Theseteamsenableustoattend
toSNAstudentsincollaborationwithotherteachers
andpsychologistssoastopreventteacherisolationand
decreasetheriskforburnoutandearlyretirement.
Towardthisend,I,asapsychologist,haveattemptedto
establishpositivecollaborativerelationshipswith
teachers.
The core activities of SSTs involve two types of
ThecoreactivitiesofSSTsinvolvetwotypesof
conferences.Thefirstisthebiweeklymeeting,in
whichparticipantsshareinformationconcerningall
SNAstudentsintheschool.Thesecondisthe
conference,whichisscheduledasneeded.
Thisismyresearchquestionconcerningtothis
This
is my research question concerning to this
research.
RussianphilosopherMichaelBakhtin
Russian
philosopher Michael Bakhtin hasconstructeda
has constructed a
uniquetheoryofdialogue.Theconceptof
“unfinalizability”isindispensableforgraspingthe
natureofBakhtin’s notionofdialogue.Althoughitis
possibletounderstandpeopleasiftheyarecompletely
known,Bakhtin alsorespectedthepossibilitythata
personcanchangeandthatapersonisneverfully
revealedorfullyknownintheworld.Accordingtoboth
MichaelWhite’snotionof“uniqueoutcome”and
Bakhtin’ss conceptof
Bakhtin
concept of “unfinalizability”
unfinalizability amutualinterest
a mutual interest
outsideofone’sownconsciousnesscanbeusedto
developalternativesolutions.
Howdoesthedialogicalrelationshipfacilitatethe
collaborativeprocessamongteachers?
collaborative
process among teachers?
Thisstudyadoptedavariationof
This
study adopted a variation of “action
actionresearch
research”as
as
itsmethod.Inthisapproach,theinvestigatorservesas
bothpractitionerandresearcher.Asapractitioner,I
consultedwiththecoordinatingteacherinorderto
fosteracollaborativecultureinXJuniorHighSchool.
Theresearchsiteforthisstudywasapublicjuniorhigh
The
research site for this study was a public junior high
school(XJuniorHighSchool)attendedbyabout700
studentsandlocatedinacentralpartofJapan.
Mrs C (an alias) the coordinator of this school’ssSST,
Mrs.C(analias),thecoordinatorofthisschool
SST
manageda“SPECIALROOM,”whichhousedtheSNA
students.
Thestudentsinthisroomwereabletoattendschool,
Th
t d t i thi
bl t tt d h l
buttheywerenotabletoengageinnormal
relationshipswithotherclassmembers.Atypeof
studentswhoapparentlydisobeyedtheschool
regulation : wearing retrofit design uniform, get their
regulation:wearingretrofitdesignuniform,gettheir
hairbleached,violenceagainstteacher.
Mrs.Chadmorethan20yearsofteachingexperience.
y
g p
Althoughshehadalwaysworkedwithregularclasses,she
waslicensedtoteachphysicallyandmentallyhandicapped
children.Mostteachersinthisschoolrecognizedherasa
goodandcaringteacherforSNAstudents.
However,shefeltlimitedinherabilitytorelatetoallthe
school’sSNAstudentsonherown.Shecomplainedthat
mosthomeroomteachers(HRTs)inherschooltendednot
torelatetotheirSNAstudentsandtojustkeepdelegating
theseissuestoher.
h
i
h
Although,shebelievedthatHRTsshouldbuildclose
relationshipswiththeirSNAstudentsiftheywantedthem
toreturntotheirclassrooms,Shethinkmostteacherin
thi h l did ’t d th t
thisschooldidn’tdothat.
During the third weekly meeting, a teacher in the SST
Duringthethirdweeklymeeting,ateacherintheSST
expressedhisfrustrationthatmostteachersinthe
schoolseemedtocareverylittleabouttheirstudents’
adversities.
Although,Hedidn’tnecessarilyknowhowhardMrs.C
worked,
HeproposedthatMrs.Cinformeveryteacherabout
H
d th t M C i f
t h
b t
howhardsheworkswithSNAstudents.Atfirst,Mrs.C
hesitatedandthenshereplied,“Noway,Idon‘twantto
hurtmyheart.”Mrs.Ctookthisstancebecauseshedid
not want to be exposed to the negative and
notwanttobeexposedtothenegativeand
uncooperativereactionsofotherteachers.
InJuly200x,acaseconferencewasheldtoaddresstheissueof
SATORU’sSNA.Satoru(analias)wasa14yearoldmalesecond
’
(
l )
ld l
d
graderinthisschool.
Hehadmovedintothisschooldistrictwithhismotherand
youngersistertwoyearsagowhenthefamilyhadrelocatedto
escapefromhisfather,whohadbeenabusivetohismother.
p
,
Althoughclearevidencewaslacking,Mrs.CandIthoughtitvery
likelythatSatoruhadbeenabusedbyhisfatheraswell.
Evenatthattime,Satoruwasperforminghouseworkthatwastoo
p
g
difficultforachildofhisagewhilehismotherwasatwork.Those
days,Hehadbegantodisregardedhismother’sorder.
Inthemeanwhile,Iunderstoodthereasonwhyhecouldn’tattend
schoolasfollows:Hehadlowselfesteemandcouldn’tfeel
efficacy for his school lives.
efficacyforhisschoollives.
TheHRTproposedthatSatorubeinvitedtothe“specialroom.”
Mrs.Crejectedthisideaandreplied,“Ifyouthinkyoucandump
SATORUonme,you'vegotanotherthinkcoming.”Shewas
outragedattheHRT’sapparentnonchalance.Although,she
realizedthatSatoruneedapositiverelationship,Shewas
concernedthatSatorumighthaveanegativeeffectontheother
students in the special room.
studentsinthespecialroom.
TheHRTwassurprisedbyheroutrageandtriedtoexplainthathe
hadnotintendedtoconveywhatMrs.Chadheard.
I
Iwasconcernedthatheroutragewouldisolateherfromher
d th t h
t
ld i l t h f
h
colleagues,soItoldher,“YouaresensitivetothepainofSNA
studentsbecauseyouhaveattendedtothemwithaffection.At
thesametime,HRTscanthinkaboutthemrealisticallybecause
theydonotrelatetotheirstudentsasempatheticallyasyoudo.
BothyourempathyandtheHRT’srealismareequallyimportantto
students.WeneedtofindawayofincorporatingtheHRT’s
thinking.”
despiteourconcernsaboutforSatoru
despite
our concerns about for Satoru’sshome
home
environment,mostteachersintheschool,includinghis
HRT,hadlabeledhimas“truancy.”
I advanced the perspective that Satoru had been a
IadvancedtheperspectivethatSatoruhadbeena
victimofmaltreatmentthatresultedinemotionaland
behavioralproblems,andthatheneededthesupport
oftheteachers.I
Asafirststep,itwasdecidedthatcertainteachers(e.g.,
theHRT)wouldvisithishousemorefrequently.The
HRTproposedthatadditionaldecisionswaituntilafter
implementation of this initial approach.
implementationofthisinitialapproach.
Thesecondconferencewasheldthreemonthlater.
Bythistime,theHRThadvisitedSatoru’shomemanytimesand
hadformedagoodrelationshipwithhim.Moreover,althoughthe
otherteacherswhohadvisitedSatoruhadneverreturnedwith
encouragingnews,theHRTnotedthatSatorudidhishomeworkat
times.TheHRTexplainedwhyhecouldseewhatotherteachers
p
y
didnot:EverytimeSatorudidhishomework,hediditwithinhalf
anhouranddidnotusehisnotebook;thismadehisefforts
invisibletothemajorityofteachers&evenhismother.
Inthissecondconference,wecanseethatbothMrs.C
In
this second conference, we can see that both Mrs. C
andtheHRTsharepositiveopinionsofSatoru.
Moreover,Mrs.CwassurprisedattheHRT’sdiligence
andrevisedherpreviousimpressionoftheHRT.
Thisinformationwasverysurprisingforeveryoneinthis
conference,includingMrs.C.
conference,
including Mrs. C.
Everyonethoughtthisistheappropriatetimethattheywould
inviteSATORUforschoolonceaweek.
TheHRTdeclaredthatheintended“tolethimdosomedrills”and
thathehad“alreadygivenhimtheanswerbook.”Mrs.Cagreed
withthisplanandaskedme,“Istheresomethingyouhavetosay,
i h hi l
d k d
“ h
hi
h
Mr.Matsushima?”
ThemeaningaccordedtoSatoru’sbehaviorgradually
g
g
y
changedoverthecourseofthelastsixmonths.
AfterthesecondcaseconferenceconcerningSATORU,Mrs.Cbeganto
provideinformationtothemajorityofteachers.Thefollowingstatement
id i f
ti t th
j it f t h
Th f ll i
t t
t
wasofferedbyMrs.CduringthedailymeetingheldonNovember200x+1.
Atfirst,Satoru’sbehaviorwasinterpretedastruancy.
Asyouwillsee,Mrs.CproposedtopostherrecordsofSNAstudentssothat
everyonecouldunderstandtheirproblems.Althoughtheadministrator
opposedthisproosition,Mrs.Cfirmlymaintainedheropinion.
Then,afterthefirstcaseconference,Satoru’sbehavior
begantobeinterpretedintermsofhishistoryof
maltreatment.Thisrevisedinterpretationledteachers
toadoptanactive,positive,andlesscriticalapproach
t hi
tohim.
Finally,Satoruwasidentifiedasapersonwho
occasionallydidhisbestorwhosoughtpositive
relationships.
relationships
TRANSCRIPT#1
Mrs.C:Ihavebeenkeepingrecordsconcerningstudentbehaviorforalong
time…IthinkeveryonewilllookifIputthemonthesharedspace.
Administrator:Idon’tthinkeveryoneismotivatedtoseetherecords….
[del] Even motivated teachers don’tthabituallylook;otherteachersnever
[del]….Evenmotivatedteachersdon
habitually look; other teachers never
look.
Mrs.C:Unnnn….But….NoonewillhaveachancetolookifIalwayshold
ontothem.
These sequences show that Mrs C began to recognize her tendency to
ThesesequencesshowthatMrs.Cbegantorecognizehertendencyto
assumealltheresponsibilityherselfandtounintentionallyrejecthelpfrom
otherteachers.
Mrs.C’sattitudetowardthemajorityofteachershadalso
graduallychanged.
Atthebeginning,sheexpectedthatmostteacherswouldbe
unreliablewithregardtohelpingSNAstudents.Forexample,
whenacolleagueadvisedhertoinformeveryteacherabouther
dailyworkload,shesaid,“Noway,Idon‘twanttohurtmyheart.”
Indeed,thishadbecomeaselffulfillingprophecy.Mrs.Candthe
HRTdifferedaboutSATORU.
However,inthesecondconference,shewassurprisedtolearn
th t S t
thatSatoru,whohadthereputationofnotstudying,occasionally
h h d th
t ti
f t t d i
i
ll
didhishomework.Atthesametime,sherealizedthattheHRT
wasreliableinthathehadmanagedtoestablishagood
relationshipwithSatoru.
Finally,sherecognizedhertendencytotakeeverythingonherself
Finally
she recognized her tendency to take everything on herself
andtoshunhelpfromotherteachers.
Collaboration is the process by which all members of a
Collaborationistheprocessbywhichallmembersofa
groupbegintoknowoneanother.
Atthebeginning,membersfeelthattheyknow
othersfully(Truancy,Unreliableteacher.etc).
However,duringtheprocessofcollaboration,they
However
during the process of collaboration they
realizethattheydonotknowothersfully.
thisrealizationbecomesausefulbasisfor
reflection.
Conflictdoesnotindicateafailureofcollaboration,but
C
fli t d
t i di t f il
f ll b ti
b t
ratherservesasavehicleforarrivingatcreative
solutions.