The freedom of expression has its roots in human rights and constitutions, which have their roots in religion, especially in protestant Christianity. Even the Japanese constitution, is based on the US Constitution, which was based on a protestant theology. The idea being that all human beings are made in the image of God, therefore they have freedom of faith and choice. In medical terms we could call this informed choice. We should distinguish informed choice from informed consent.
Consent implies agreement, in a relationship where the doctor is above the patient.
Informed consent as a concept is in the stage of being accepted as an idea in Japan, and is gradually being introduced to practice. Significant changes are beginning in the last few years, particularly in the growing social consensus seen in the media, television talk shows and magazines, and newspapers. The concept of informed choice can be expected to continue this transition. Implicit in the idea of informed choice is a relationship where the patient is above the doctor. This will shock the doctors in many countries, but I would predict the social transition of patient rights will move the relationship to this situation.