A-bomb disease certification still awaits settlement

by Hiromi Morita, Michiko Tanaka, and Masakazu Domen, Staff Writers

Five years have passed since the class action lawsuits regarding the certification procedure for A-bomb diseases were filed nationwide. In the summer of 2007, then Prime Minister Shinzo Abe announced a revision of the certification criteria. The government’s willingness to relax the criteria has come as a result of this pressure brought by A-bomb survivors and their supporters. Still, despite ten judicial rulings against the government in the class action lawsuits, a resolution to this issue remains far on the horizon. To date, what has been achieved and what is yet unsettled in regard to the certification of A-bomb diseases?

Concerns regarding the new criteria

The screening of applicants for A-bomb disease certification, based on the new criteria, began in April 2008. The government has pledged that certification will be promptly granted to survivors if they meet certain conditions, such as their distance from the hypocenter, the time they entered the city center, and the specific disease contracted. Even if they don’t meet this first level of conditions, however, their cases can still be assessed individually and comprehensively. This sort of procedure marks a major change from the previous criteria used, which was far more rigid.

Mr. Abe’s announcement about revising the criteria took place on August 5, 2007 in the city of Hiroshima. The resulting standard followed, almost wholly, the recommendations made by a ruling party committee concerning relief measures for A-bomb survivors. This relaxed standard has enabled more survivors to obtain certification for their illnesses.

Presently, if survivors meet the stated conditions, they are certified without delay. Designated diseases for this recognition include malignancy of the digestive system or other malignancy, leukemia, thyroid dysfunction, cataracts, and myocardial infarction. Four teams of the Ministry of Health, Labor, and Welfare, by disease type, handle the certification process.

For the applicants, however, the new criteria still do not provide sufficient assurance that less clear-cut cases will be certified. If a survivor is not certified right away, the report on that survivor’s individual assessment will not be disclosed. In fact, there are cases in which applicants have won approval through a lawsuit but not through the government’s assessment procedure.

Although the central government has made concessions in relaxing the criteria for certification, the legal battle involving the class action lawsuits has continued. Behind this contradictory attitude of the government is the Ministry of Health, Labor, and Welfare’s basic refusal to revise their policy.

Apparently, Mr. Abe’s announcement regarding a review of the criteria came in the context of rulings against the previous certification standard by courts nationwide and the ruling party’s crushing defeat in the preceding upper house election. But the bureaucrats of the ministry have not been pleased with the politician-led change in certification criteria.

One reason the ministry cites is the gap in relief measures that exists between A-bomb survivors and other war sufferers. They argue that providing relief to survivors who contracted cataracts or cancer later in life, regardless of the level of their radiation exposure, cannot be fairly justified. In these arguments, the ministry’s intention to oppose further increases to their budget for A-bomb survivors can be inferred. They are averse to certifying all the plaintiffs of the lawsuits en masse, which is what these survivors are calling for.

Questions have been raised, too, about the fact that the same doctors and specialists, who were involved in the certification procedure using the former criteria, are now engaged in the screening process with the revised standard. Shizuteru Usui, 71, president of the Hiroshima Prefectural Medical Association, was a member of a subcommittee, from 2003 to 2005, which considered this matter. “I challenged this policy and was relieved of my role after my two-year term expired,” said Mr. Usui. “The terms of other members, though, have been extended repeatedly. I can’t help but be skeptical.”

The ruling party committee is proud of the progress they have made toward solving the problems related to the certification of A-bomb diseases. They are now, in fact, considering a review of the criteria for each particular disease. Still, there is a substantial difference between their achievements and the wish that the hibakusha hold for relief en masse.

Developments in the legal battle

The class action lawsuits currently pending before five high courts and 15 district courts nationwide were brought by the Japan Confederation of A- and H-bomb Sufferers Organizations. The organization’s intention, in filing these complaints, was to induce the central government to review the certification criteria.

In August 2006, the Hiroshima District Court ruled in favor of all 41 plaintiffs involved in that suit. The ruling emphasized the fact that even those who were not near the hypocenter or who entered the city center after the bombing also suffered from acute symptoms that could not be predicted based on their estimated dose of radiation. Thus, the court declared “the need for comprehensive deliberation on the certification procedure to correspond with the actual conditions of the hibakusha.” The ruling also attributed to the A-bomb other health concerns such as prostate cancer, angina pectoris, and bone fractures, for which it had been difficult to obtain certification.

As with the case in Hiroshima, ten high courts and district courts nationwide have ruled against the government in class action lawsuits over the certification procedure for A-bomb diseases. However, in the Nagasaki district court ruling on June 23, plaintiffs with prenatal exposure, and in the Osaka district court decision on July 18, plaintiffs who were exposed to radiation while engaged in rescue operations, were both denied certification. Nevertheless, these rulings all point to the same conclusion: The judicial branch is pressing the central government to deal with the real conditions of the A-bomb survivors, despite the inability of modern science to provide explanation for all such conditions.

Plaintiffs in Hiroshima are dying

Since April, notices of certification have been sent to 41, or 64 percent, of the 64 plaintiffs involved in lawsuits at the Hiroshima District Court and the Hiroshima High Court.

But Sumio Shigezumi, 79, head of the plaintiffs in the Hiroshima lawsuits, reproached the Ministry of Health, Labor, and Welfare, saying “The ministry’s actions of not dropping the lawsuits already lost or expressing an apology, while sending out notifications as if nothing had happened, was unacceptable.”

Those plaintiffs who haven’t yet received certification are feeling distress. Five years have passed since the first lawsuit was filed. Mr. Shigezumi fears that the group might lose its unified front after growing weary from the long legal battle. The group has held two meetings this year to renew their vow to stand united until every plaintiff has received certification.

“This lawsuit is not about seeking my own certification,” said Mr. Shigezumi. “It is a struggle to make the world aware of the horror of nuclear weapons and eliminate them from our earth. For this reason, I must persist until the end.” Thus far, while the court cases are still unfolding, 13 plaintiffs have died without receiving their notice of certification from the government.


A-bomb disease certification
The A-bomb disease certification system is based on the Atomic Bomb Survivor Relief Law. If the disease or disability of an A-bomb survivor can be attributed to the atomic bombing of Hiroshima or Nagasaki, and they need medical support, the Minister of Health, Labor, and Welfare will officially recognize the person as suffering from an A-bomb disease. Those with this certification are then eligible to receive a special medical allowance of 137,000 per month. A-bomb survivors can apply for certification through local governments and a screening committee of the Ministry of Health, Labor, and Welfare is then in charge of the certification procedure. As of the end of March 2008, 2,188 survivors, or less than 1% of the 243,692 survivors nationwide, have obtained certification. The ministry estimates that 1,800 survivors will be certified annually, a ten-fold increase from the current figure. However, due to the rate of deaths, there will not be a significant increase in the overall number of certified A-bomb sufferers.

Probability of cause
Probability of cause was used as the key concept for screening until April 2008, when the new criteria for certification of A-bomb diseases were introduced by the central government. According to the type of disease, the probability of A-bomb radiation as the cause was determined on the basis of the estimated dose of radiation, derived from the person’s distance from the hypocenter at the time of the bombing as well as their age and gender. When the calculation resulted in a probability of 50% or higher, this was considered sufficient probability for having developed the disease because of radiation exposure. However, if the estimate was less than 10%, the probability of cause was deemed low. This procedure, though, was flawed in that it failed to take into account such factors as residual radiation or the effects of internal exposure from radiation. In the class action lawsuits, this rigid screening process was harshly criticized in court rulings.

(Originally published on July 23, 2008)

Related Articles
Surge in applications for the certification of A-bomb diseases creates screening backlog (July 29, 2008)
A-bomb survivors as the standard-bearer for all war sufferers (May 21, 2008)
Hibakusha express dissatisfaction with new standard for certifying A-bomb diseases (March 19, 2008)