Article 1The purpose of this Act is to improve the qualities of Public Health Nurses, Midwives, and Nurses, and to thereby promote and improve medical care and public health.

Article 2The term "public health nurse" as used in this Act means a person who has acquired a public health nurse license from the Minister of Health, Labour and Welfare to use the title of public health nurse and provides health guidance as a profession.

Article 3The term "midwife" as used in this Act means a woman who has acquired a midwife license from the Minister of Health, Labour and Welfare to practice midwifery or provides health guidance for pregnant women, puerperal women, or newborn babies, as a profession.

Article 4Deletion

Article 5The term "nurse" as used in this Act means a person who has acquired a nursing license from the Minister of Health, Labour and Welfare to provides medical treatment or assists in medical care for injured and ill persons or puerperal women, as a profession.

Article 6The term "assistant nurse" as used in this Act means a person who has acquired a nursing assistant license from the prefectural governor to nursing practice what is set forth in the preceding Article under the direction of a physician, dentist, or nurse, as a profession.

Article 7(1)A person intends to become a public health nurse must pass the National Public Health Nursing Examination and the National Nursing Examination and acquire a license from the Minister of Health, Labour and Welfare.

(2)A person intends to become a midwife must pass the National Midwifery Examination and National Nursing Examination and acquire a license from the Minister of Health, Labour and Welfare.

(3)A person intends to become a nurse must pass the National Nursing Examination and acquire a license from the Minister of Health, Labour and Welfare.

Article 8A person intends to become an assistant nurse must pass the Nursing Assistant Examination and acquire a license from the prefectural governor.

Article 9A person who falls under any of the following items may be granted the license under the provisions of the preceding two Articles (hereinafter referred to as a "license"):

Article 10The Public Health Nurse Registry, the Midwife Registry, and the Nurse Registry are kept by the Ministry of Health, Labour and Welfare, and the registration dates, the particulars of dispositions under the provisions of Article 14, paragraph (1), and other particulars of public health nurse license, midwife licensure, and nursing licensure are registered therein.

Article 11An Nursing Assistant Registry is kept by the prefectural government, and the registration dates, the particulars of dispositions under the provisions of Article 14, paragraph (2), and other particulars of nursing assistant license are registered therein.

Article 12(1)A public health nurse license is registered in the Public Health Nurse Registry, upon application filed by a person who has passed the National Public Health Nursing Examination and the National Nursing Examination.

(2)A midwife licensure is registered in the midwife registry, upon application filed by a person who has passed the National Midwifery Examination and the National Nursing Examination.

(3)A nurse licensure is registered in the Nurse Registry, upon application filed by a person who has passed the National Nursing Examination.

(4)A nursing assistant license is registered in the Nursing Assistant Registry, upon application filed by a person who has passed the Nursing Assistant Examination.

(5)When the Minister of Health, Labour and Welfare or the prefectural governor grants a licensure, the minister or the prefectural governor issues a public health nurse license, midwife license, nursing license, or nursing assistant license respectively.

Article 13(1)When the Minister of Health, Labour and Welfare finds that an applicant for a public health nurse licensure, midwife licensure, or nursing licensure falls under a person set forth in Article 9, item (iii) and decides not to grant the license pursuant to the provisions of that Article, the minister must notify the applicant of this, and, if so requested by the applicant, the minister must have the official(s) designated by the minister hear the opinions of the applicant.

(2)When the prefectural governor finds that an applicant for a nursing assistant licensure falls under a person set forth in Article 9 item (iii) and decides not to grant the nursing assistant licensure pursuant to provisions of that Article, the prefectural governor must notify the applicant of this, and, if so requested by the applicant, the prefectural governor must have the official(s) designated by the prefectural governor hear the opinions of the applicant.

Article 14(1)If a public health nurse, midwife, or nurse falls under any of the items of Article 9, or engages in discreditable conduct as a public health nurse, midwife, or nurse, the Minister of Health, Labour and Welfare may implement the following dispositions:

(2)If a nursing assistant falls under any of the items of Article 9, or engages in discreditable conduct as a nursing assistant, the prefectural governor may implement the following dispositions:

(3)Even if a person whose license has been revoked pursuant to the provisions of the proceeding two paragraphs (excluding a person whose license has been revoked pursuant to the provisions of the preceding two paragraphs as a person falling under item (i) or (ii) of Article 9 or as a person engaged in discreditable conduct as a public health nurse, midwife, nurse, or nursing assistant, and for whom five years have not elapsed since the date of disposition), the person may be granted a license for the second time when the person does not fall under the particulars of the grounds for revocation, or when it is otherwise found to be appropriate to grant the person a relicense due to subsequent circumstances.In this case, the provisions of Article 12 apply mutatis mutandis.

Article 15(1)When the Minister of Health, Labour and Welfare intends to implement any of the dispositions provided for in paragraph (1) or paragraph (3) of the preceding Article, the minister must hear the opinions of the Medical Ethics Council.

(2)When the prefectural governor intends to implement any of the dispositions provided for in paragraph (2) or paragraph (3) of the preceding Article, the prefectural governor must hear the opinions of the Nursing Assistant Examination Board.

(3)When the Minister of Health, Labour and Welfare intends to revoke a license pursuant to the provisions of paragraph (1) of the preceding Article, the minister may request the prefectural governor to hear the opinion of the person subject to the disposition, and may substitute the relevant hearing of opinion for the hearing to be conducted by the Minister of Health, Labour and Welfare.

(4)The provisions of Chapter III, Section 2 (excluding Article 25, Article 26, Article 28) of the Administrative Procedure Act (Act No.88 of 1993) apply mutatis mutandis to cases when the prefectural governor hears an opinion pursuant to the provisions of the preceding paragraph. In this case, the term "hearing" in that Section is deemed to be replaced with "hearing their opinions,"; the term the "administrative authority" in Article 15, paragraph (1) of that Act is deemed to be replaced with the "prefectural governor"; in paragraph (3) of that Article (including as applied mutatis mutandis pursuant to Article 22, paragraph (3) of that Act) the phrase the "administrative authority must" is deemed to be replaced with the "prefectural governor must," the phrase the "administrative authority" is deemed to be replaced with the "prefectural governor," and the phrase "of the administrative authority" is deemed to be replaced with "of the prefecture"; the phrase "the administrative authority" in Article 16, paragraph (4) and Article 18, paragraphs (1) and (3) of that Act is deemed to be replaced with the "prefectural governor"; the phrase an "official designated by the administrative authority or other persons specified by Cabinet Order" in Article 19, paragraph (1) of that Act is deemed to be replaced with an "official designated by the prefectural governor"; the term the "administrative authority" in Article 20, paragraphs (1), (2), and (4) of that Act is deemed to be replaced with the "prefecture"; and the term the "administrative authority" in paragraph (6) of that Article and in Article 24, paragraph (3) and Article 27, paragraph (1) of that Act is deemed to be replaced with the "prefectural governor."

(5)If so requested by the prefectural governor, the Minister of Health, Labour and Welfare must promptly send the documents proving the facts that constitute grounds for the relevant disposition and other documents necessary for the hearing of opinions to the prefectural governor.

(6)If the prefectural governor conducts a hearing of opinions pursuant to the provisions of paragraph (3), and receives the record referred to in Article 24, paragraph (1) of the Administrative Procedure Act and the written report referred to in paragraph (3) of that Article that have been submitted pursuant to the provisions of paragraph (3) of that Article, as applied mutatis mutandis pursuant to paragraph (4) of this Article following the deemed replacement of terms, in addition to preserving the record and written report, the prefectural governor must prepare a written opinion providing their opinion about a decision to implement the relevant disposition, and must submit this written opinion, along with copies of the record and the written report, to the Minister of Health, Labour and Welfare.

(7)If the Minister of Health, Labour and Welfare finds it necessary to do so in light of the circumstances that have arisen after the official heard the opinions, the minister may return the written opinion that have been submitted pursuant to the provisions of the preceding paragraph and request the prefectural governor to order the presiding official to reopen the hearing of opinions. The provisions of the main clause of Article 22, paragraph (2) and paragraph (3) of the Administrative Procedure Act apply mutatis mutandis in this case.

(8)The Minister of Health, Labour and Welfare must make a decision on the disposition only after the minister gives due consideration to the contents of the written opinion and the copies of the record and written report submitted pursuant to the provisions of paragraph (6).

(9)When the Minister of Health, Labour and Welfare intends to issue an order to suspend the license pursuant to the provisions of paragraph (1) of the preceding Article, the minister may request the prefectural governor to hear the explanation of the person subject to the disposition, and may substitute the hearing for the grant of an opportunity for explanation by the minister.

(10)If the explanation is to be heard pursuant to the provisions of the preceding paragraph, the prefectural governor must notify the person subject to the disposition of the following particulars in writing, by giving the person sufficient time before the date on which the explanation is heard:

(11)Other than the case prescribed in the preceding paragraph (9), the Minister of Health, Labour and Welfare may have a member of the Medical Ethics Council hear the explanation of the person subject to the disposition, instead of granting an opportunity for explanation by the minister.In this case, the phrase "preceding paragraph" in the preceding paragraph is deemed to be replaced with "following paragraph," the phrase the "prefectural governor" is deemed to be replaced with the "Minister of Health, Labour and Welfare," and the provisions of that paragraph apply.

(12)A person who has received the notification referred to in paragraph (10) (including as applied mutatis mutandis pursuant to the provisions of the second sentence of the preceding paragraph following the deemed replacement of terms), may have a representative appear in the office, and may submit documentary evidence or articles of evidence.

(13)If the prefectural governor or a member of the Medical Ethics Council has heard an explanation pursuant to the provisions of paragraph (9) or the first sentence of paragraph (11), in addition to creating and preserving the hearing record, the prefectural governor or member of the Medical Ethics Council must prepare a written report containing an opinion about the decision on the relevant disposition and submit this to the Minister of Health, Labour and Welfare.

(14)If the prefectural governor hears person's opinion or explanation pursuant to the provisions of paragraph (3) or paragraph (9), the Minister of Health, Labour and Welfare must notify the prefectural governor of the following particulars in advance:

(15)The notification referred to in Article 15, paragraph (1) of the Administrative Procedure Act, as applied mutatis mutandis pursuant to paragraph (4) following the deemed replacement of terms, or the notification referred to in paragraph (10) that is to be issued when an explanation is to be heard pursuant to paragraph (9), must be based on the contents of the notification issued pursuant to the provisions of the preceding paragraph.

(16)When the prefectural governor intends to issue an order to suspend nursing practice pursuant to the provisions of paragraph (2) of the preceding Article, the prefectural governor may have a member of the Assistant Nursing Examination Board hear the explanation of the person subject to the disposition, instead of granting an opportunity for explanation by the prefectural governor.

(17)The provisions of paragraph (10), paragraph (12), and paragraph (13) apply mutatis mutandis to cases where a member of the Nursing Assistant Examination Board hears an explanation pursuant to the provisions of the preceding paragraph.In this case, the phrase the "preceding paragraph" in paragraph (10) is deemed to be replaced with "paragraph (16)" and the phrase "paragraph (1) of the preceding Article" in that paragraph is deemed to be replaced with "paragraph (2) of the preceding Article"; the phrase "paragraph (10) (including as applied mutatis mutandis pursuant to the provisions of the second sentence of the preceding paragraph following the deemed replacement of terms)" in paragraph (12) is deemed to be replaced with "paragraph (10) as applied mutatis mutandis pursuant to paragraph (17)"; the phrase the "prefectural governor or a member of the Medical Ethics Council" in paragraph (13) is deemed to be replaced with a "member of the Nursing Assistant Examination Board", the phrase "paragraph (9) or the first sentence of paragraph (11)" in that paragraph is deemed to be replaced with "paragraph (16)," and the phrase the "Minister of Health, Labour and Welfare" in that paragraph is deemed to be replaced with the "prefectural governor."

(18)If the prefectural governor hears person's opinion or an explanation pursuant to the provisions of paragraph (3) or paragraph (9), when a member of the Medical Ethics Council hears person's explanation pursuant to the provisions of the first sentence of paragraph (11), or when a member of the Nursing Assistant Examination Board hears person's explanation pursuant to the provisions of paragraph (16), the provisions of Chapter III (excluding Article 12 and Article 14) of the Administrative Procedure Act do not apply to the relevant disposition.

Article 15-2(1)The Minister of Health, Labour and Welfare may order a public health nurse, midwife, or nurse who has been subject to the disposition set forth in Article 14, paragraph (1) or paragraph (2), or a person intends to acquire a license for the second time pursuant to provisions of paragraph (3) of that Article for a public health nurse, midwife, or nurse, to undergo the training specified by Order of the Ministry of Health, Labour and Welfare as a training regarding maintaining ethics of public health nurses, midwives, or nurses, or as a training regarding the knowledge and skills required for a public health nurse, midwife, or nurse (hereinafter referred to as "refresher training for public health nurses, etc.").

(2)The prefectural governor may order a nursing assistant who has been subject to the disposition set forth in Article 14, paragraph (1) or paragraph (2), or a person who intends to acquire a license for a nursing assistant for the second time, pursuant to the provisions of paragraph (3) of that Article, to undergo the training specified by Order of the Ministry of Health, Labour and Welfare as the training regarding maintaining ethics of nursing assistants, or as the training regarding the knowledge and skills required for a nursing assistant (hereinafter referred to as "refresher training program for nursing assistants").

(3)The Minister of Health, Labour, and Welfare registers the persons who have completed the refresher training program for public health nurses, etc. under the provisions of paragraph (1) as those having completed the refresher training for public health nurses, etc., in the Public Health Nurse Registry, Midwife Registry, or Nurse Registry.

(4)The prefectural governor registers the persons who have completed the refresher training for nursing assistants under the provisions of paragraph (2) as those having completed the refresher training for nursing assistants, in the Nursing Assistant Registry.

(5)After having completed a registration referred to in the preceding two paragraphs, the Minister of Health, Labour, and Welfare or the prefectural governor issues a registration certificate of completion of refresher training.

(6)A person intends to be registered in the registry referred to in paragraph (3) or a person intending to acquire an updated registration certificate of completion of the refresher training for public health nurses, midwives, or nurses or intends to have the registration certificate reissued, must pay the fee specified by Cabinet Order based on the actual costs.

(7)The provisions of paragraphs (9) through paragraph (15) (excluding paragraph (11)) and paragraph (18) of the preceding Article apply mutatis mutandis to cases where the relevant person who intends to issue an order under the provisions of paragraph 1.In this case, the necessary technical replacement of terms is specified by Cabinet Order.

Article 16Beyond what is provided for in this Chapter, other necessary particulars for application for license; registration in, corrections to, and deletions from the Public Health Nurse Registry, Midwife Registry, Nurse Registry, and Nursing Assistant Registry; the issuance, updated issuance, reissuance, return, or submission of a license; and notice of address, are specified by Cabinet Order; and the necessary particulars for implementing the refresher training for public health nurses, etc. referred to in paragraph (1) of the preceding Article and the refresher training for nursing assistants referred to in paragraph (2) of that Article; for registration in the Public Health Nurse Registry, Midwife Registry, or Nurse Registry referred to in paragraph (3) of that Article or registration in the Nursing Assistant Registry referred to in paragraph (4) of that Article; or for the issuance, updated issuance, or reissuance of a registration certificate of completion of the refresher training referred to in paragraph (5) of that Article, are specified by Order of the Ministry of Health, Labour and Welfare.

Article 17The National Licensing Examination for Public Health Nurses, National Licensing Examination for Midwives, National Licensing Examination for Nurses, and Licensing Examination for Nursing Assistants, are conducted with regard to the knowledge and skills required for public health nurses, midwives, nurses, and nursing assistants, respectively.

Article 18The Minister of Health, Labour and Welfare holds the National Licensing Examination for Public Health Nurses, the National Licensing Examination for Midwives, and the National Licensing Examination for Nurses; and the prefectural governor holds the Licensing Examination for Nursing Assistants, at least once a year, in accordance with the criteria specified by the Minister of Health, Labour and Welfare.

Article 19Only a person who falls under any of the following items is eligible for the National Licensing Examination for Public Health Nurses:

Article 20Only a person who falls under any of the following items is eligible for the National Licensing Examination for Midwives:

Article 21Only a person who falls under any of the following items is eligible for the National Licensing Examination for Nurses:

Article 22Only a person who falls under any of the following items is eligible for the Licensing Examination for Nursing Assistants:

Article 22-2(1)The Minister of Health, Labour and Welfare must hear the opinion of the Medical Ethics Council when the minister intends to establish the methods for deciding the subjects, administration, and successful examinees with regard to the National Licensing Examination for Public Health Nurses, the National Licensing Examination for Midwives, and the National Licensing Examination for Nurses, and to establish the criteria provided for in Article 18.

(2)The Minister of Education, Culture, Sports, Science and Technology or the Minister of Health, Labour and Welfare must hear the opinion of the Medical Ethics Council when the minister intends to establish criteria provided for in Article 19, item (i) or item (ii); Article 20, item (i) or (ii); from Article 21, item (i) to item (iii); or item (i) or item (ii) of the preceding Article.

Article 23(1)The Ministry of Health, Labour and Welfare appoints the members of the Public Health Nurse, Midwife, and Nurse Examination Committee, in order to have the committee members handle the functions to implement the National Licensing Examination for Public Health Nurses, National Licensing Examination for Midwives, and National Licensing Examination for Nurses.

(2)The particulars necessary for the members of the Public Health Nurse, Midwife, and Nurse Examination Committee are specified by Cabinet Order.

Article 24Deletion

Article 25(1)Assistant Nursing Examination Boards are established in The prefectural governments appoint the members of the Nursing Assistant Examination Committee, in order to have them handle the functions to implement the Nursing Assistant Examinations.

(2)The particulars necessary for the members of the Nursing Assistant Examination are provided by Prefectural Ordinance

Article 26Deletion (Act No. 87 of 1999)

Article 27A members of the Public Health Nurse, Midwife, and Nurse Examination Committee, a member of the Nursing Assistant Examination Committee, and any other person takes charge of functions to implement the National Licensing Examination for Public Health Nurses, National Licensing Examination for Midwives, National Licensing Examination for Nurses, or Nursing Assistant Examination, must maintain a strictly fair attitude in performing the functions, and must prevent any examination misconduct.

Article 28Beyond what is provided for in this Chapter, other particulars necessary for the designation of a school or training school under the provisions of Articles 19 through 22 are provided by Cabinet Order, and examination subjects, application procedures for the National Licensing Examination for Public Health Nurses, National Licensing Examination for Midwives, National Licensing Examination for Nurses, or Licensing Examination for Nursing Assistants, and other particulars necessary for examinations are provided by Order of the Ministry of Health, Labour and Welfare.

Article 28-2Public health nurses, midwives, nurses, and nursing assistants must undergo clinical training and other training (excluding refresher training for public health nurses, and refresher training for nursing assistants), must strive to improve their professional quality, even after having acquired the license.

Article 29No person other than a public health nurse may not practice nursing specified in Article 2 by using the title of public health nurse or any title similar thereto.

Article 30No person other than a midwife may engage in practice specified in Article 3; provided, however, that this does not apply if the person engages in the practice pursuant to the provisions of the Medical Practitioners Act (Act No. 201 of 1948).

Article 31(1)No person other than a nurse may engage in practice specified in Article 5; provided, however, that this does not apply if the person engages in the practice pursuant to the provisions of the Medical Practitioners Act or Dentists Act (Act No. 202 of 1948).

(2)A public health nurse or midwife may engage in the practice specified in Article 5, notwithstanding the provisions of the preceding paragraph.

Article 32No person other than a nursing assistant may engage in the practice specified in Article 6; provided, however, that this does not apply if the person engages in the practice pursuant to the provisions of the Medical Practitioners Act or Dentists Act.

Article 33A practicing public health nurse, midwife, nurse, or nursing assistant must notify their current name, address, and any other particulars as of December 31 of the alternating years specified by Order of the Ministry of Health, Labour and Welfare, to the governor of the prefecture in which they work, no later than January 15 of the following year.

Article 34Deletion

Article 35A public health nurse must be instructed by the family physician or dental practitioner, if an injured or ill person has any, in providing guidance to the person receiving medical treatment.

Article 36If a public health nurse is instructed about their practice by the director of the public health center having jurisdiction over the region in which the public health nurse works, the public health nurse must follow director's instructions; provided, however, that this does not preclude the application of the provisions of the preceding Article.

Article 37Except the cases where a public health nurse, midwife or nursing assistant is instructed by the family physician or dental practitioner, the public health nurse, midwife, Nurse, or nursing assistant may not use medical equipment, give a person medicine or give instructions about medicine, or take any other medical practice that may harm person's health unless it is done by a physician or dental practitioner; provided, however, that this does not apply when a public health nurse, midwife, nurse, or nursing assistant provides emergency first-aid treatment, or when a midwife cuts an umbilical cord, administers an enema, or provides any other treatment usually accompanied by midwifery practice.

Article 38If a midwife finds that a pregnant woman, parturient woman, or puerperal woman, or a fetus or a newborn baby has abnormality, the midwife is required to direct the relevant person to a physician for medical care, and may not personally provide treatment for the person; provided, however, that this does not apply to a midwife providing emergency first-aid treatment.

Article 39(1)If a practicing midwife is requested to provide midwifery care or health guidance for a pregnant woman, a puerperal woman, or a newborn baby, the practicing midwife must not deny the request without reasonable grounds.

(2)If a midwife who has assisted in a delivery or carried out a postmortem examination of a fetus may not, if requested to issue a birth certificate, certificate of stillbirth, or fetal postmortem examination certificate, the midwife must not deny the request without reasonable grounds.

Article 40A midwife must not issue a birth certificate, certificate of stillbirth, or fetal postmortem examination certificate without having personally assisted with the delivery or carried out the postmortem examination of the fetus.

Article 41If a midwife, having conducted a postmortem examination of a stillborn fetus after 4 months of pregnancy, finds that the stillborn fetus has an anomality, the midwife must report this to the competent police station within 24 hours.

Article 42(1)When a midwife assists in a delivery, the midwife must enter the particulars of the delivery that the midwife has assisted in a midwifery record, without delay.

(2)The midwifery record of the delivery that a midwife working at a hospital, clinic or midwifery care center has assisted referred to in the preceding paragraph must be preserved for five years, by the administrator of the hospital, clinic, or midwifery care center, and the midwifery record for other deliveries that a midwife has assisted, must be kept for five years by the midwife personally.

(3)The particulars to be entered in the midwifery record under the provisions of paragraph (1) are specified by Order of the Ministry of Health, Labour and Welfare.

Article 42-2A public health nurse, nurse, or nursing assistant may not disclose the confidential information of any person they come to know in the course of their practice without reasonable grounds. The same applies even after the person ceases to be a public health nurse, nurse, or nursing assistant.

Article 42-3(1)No person other than a public health nurse may use the title of public health nurse or any other similar or misleading title.

(2)No person other than a midwife may use the title of midwife or any other similar or misleading title.

(3)No person other than a nurse may use the title of nurse or any other similar or misleading title.

(4)No person other than a nursing assistant may use the title of nursing assistant or any other similar or misleading title.

Article 42-4Functions that are to be administered by the relevant prefecture pursuant to the provisions of Article 15, paragraph (3), the first clause of Article 15, paragraph (7), and Article 15, paragraphs (9) and (10) (including as applied mutatis mutandis pursuant to Article 15-2, paragraph (7)); Article 15, paragraphs (1) and (3) of the Administrative Procedure Act (including as applied mutatis mutandis pursuant to Article 22, paragraph (3) of said Act), Article 16, paragraph (4) of that Act, Article 18, paragraphs (1) and (3) of that Act, Article 19, paragraph (1) of that Act, Article 20, paragraph (6) of that Act, and Article 24, paragraph (3) of that Act, as applied mutatis mutandis pursuant to Article 15, paragraph (4) of this Act; and Article 15, paragraph (3) of the Administrative Procedure Act as applied mutatis mutandis pursuant to Article 22, paragraph (3) of that Act, as applied mutatis mutandis pursuant to the second clause of Article 15, paragraph (7) of this Act; are Type 1 statutorily entrusted functions specified in item (i) of paragraph (9) of Article 2 of the Local Autonomy Act (Act No.67 of 1947).

Article 42-5(1)The authority of the Minister of Health, Labour and Welfare provided for in this Act may be delegated to the Director General of the Regional Bureau of Health and Welfare pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.

(2)The authority delegated to the Director General of the Regional Bureau of Health and Welfare pursuant to the provisions of the preceding paragraph may be delegated to the Director General of Regional Branch Bureau of Health and Welfare pursuant to the provisions of Order of the Ministry of Health, Labour and Welfare.

Article 43(1)A person who falls under any of the following items is punished by imprisonment with work for not more than two years, a fine of not more than five hundred thousand yen, or both:

(2)If a person who has committed the offenses referred to in item (i) of the preceding paragraph uses the title of public health nurse, midwife, nurse, nursing assistant, or any other similar title, the person is punished by imprisonment with work for not more than 2 years, a fine of not more than one million yen, or both.

Article 44A person who leaks examination questions intentionally or through gross negligence prior to the examination or who intentionally manipulates the examination scores, in violation of Article 27, is punished by imprisonment with work for not more than 1 year or a fine of not more than five hundred thousand yen.

Article 44-2A person who falls under any of the following items is punished by imprisonment with work for not more than six months, a fine of not more than five hundred thousand yen, or both:

Article 44-3(1)A person who discloses the confidential information of any person the person has come to know by professional conduct in violation of the provisions of Article 42-2 is punished by imprisonment with work for not more than six months or a fine of not more than one hundred thousand yen.

(2)A prosecution for the offense referred to in the preceding paragraph may not be instituted without a criminal complaint.

Article 45A person who falls under any of the following items is punished by a fine not exceeding five hundred thousand yen:

Article 45-2A person who violates the provisions of Article 42-3 is punished by a fine of not more than three hundred thousand yen.