A “death-laden society”: The next stage of a hyper-aged Japan and health challenges ahead

From the next decade onward through the foreseeable future, Japan will become a “death-laden society,” in which the whole society is overwhelmed with the lasting trend of the ballooning deaths of those in advanced age at a scale unparalleled in history. In following with the country's decades-long experience as the world's leader in population aging, Japan will phase into this next stage of aging society, preceding the rest of the aging world. Based on administrative survey data and original interview data, this paper discusses main characteristics, causes, and consequences of a death-laden society and highlights key challenges in relation to medicine and health with which Japan will contend in the decades to come. On top of the enduring issues from preceding stages of aging society, a death-laden Japan will contend with a variety of unprecedented challenges including (1) shortages in basic medical resources; (2) possible dilemma between “dying in place” and “lonely death”; and (3) urgency to develop a national framework for end-of-life decisions. The coming of a death-laden society will significantly hinder Japan's national efforts to protect the wellbeing, safety, and dignity of its citizens, particularly those about to die as well as their relatives. This paper calls for further research to explore policy suggestions that would contribute to future policymaking not only of Japan but also of other countries that will likely follow Japan's path to become death-laden societies in the decades ahead.