Importance of Individualized Disaster Preparedness for Hospitalized or Institutionalized Patients: Lessons Learned from the Legal Revisions Made to the Basic Act on Disaster Management in Japan Following the Fukushima Nuclear Disaster

T he global occurrence of natural and human-made disasters and emergencies is increasing.The fundamental goal of disaster preparedness, management, and recovery is to minimize damage to victims.However, disasters continue to affect billions of people and cause losses of lives and assets every year.Compared to other groups, vulnerable groups, particularly the elderly, people with disabilities, and institutionalized patients (living in hospitals and nursing and retirement facilities), experience heavier disaster burdens that prevent the normal provision of health services.To date, only limited legislation governing the provision and prosecution of specific mechanisms to protect the health of hospitalized/institutionalized patients during major disasters have been enacted.The establishment of a disaster-specific legal foundation to support the decisionmaking process and the necessary protective infrastructure, which should be developed in collaboration with medical professionals, as well as individuals with ethical and legal expertise, is a prerequisite to the protection of such populations during and after disasters.Japan, a disaster-prone country, has been continuously addressing and strengthening disaster risk management efforts, risk reduction frameworks, and relevant policies.