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January 26, 2007

John Harris, Immortal Ethics, generational cleansing

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John Harris's paper, "Immortal Ethics," published in Annals of New York Academy of Sciences, 1019, pp.527-534, (2004), is a short essay on the ethics of life extension. He talks about various points concerning this topic, and his discussion is interesting and thought-provoking. Basically, I don't like his extremism and optimism, but this time I enjoyed his philosophical writing.

Harris criticizes the negative views on life extension that Leon Kass and his followers have strongly maintained so far. One thing he shares with the conservatives is the need for the turnover of generations, because if the older generation live for more than a hundred years working actively at the front in their workplace, the younger people would lose their opportunity to act as a leader in their middle age.

Harris writes:

.... and if the generational turnover proved too slow for regeneration of youth and ideas and for the satisfactions of parenting, we might face a future in which the fairest and the most ethical course might be to contemplate a sort of "generational cleansing." (p.532)

Generational cleansing? What does he mean by these words? He explains:

This would involve deciding collectively how long it is reasonable for people to live in each generation and trying to ensure that as many as possible live healthy lives of that length. We then would have to ensure that, having lived a "fair innings," they died at the appropriate time to make way for future generations. (p.532)

What a totalitarian worldview this is! In such a society, those who have lived out their fair innings are expected to voluntarily die or commit suicide. Isn't this a society a conservative philospher would likely imagine? If there is a difference between conservatives and John Harris, it would be that while conservatives hope that this turnover will occur as the result of a natural biological process, Harris (and other liberals) does not. Instead, Harris prefers to attain this turnover by means of an artificial manner, such as suicide or euthanasia.

Reading his argument, I have come to feel that the coming long life society might be filled with an unspoken expectation that older people will voluntarily choose suicide or euthanasia to make way for the young, and this expectation indirectly forces them to actually choose such actions. And similar things should perhaps be observed in today's nursing homes. In this sense, the dark side of life extension already do exist in the society we live in now.

Related post: *Is More Life Always Better? The New Biology of Aging and the Meaning of Life, David Gems
                    *An old man and me and life

Photo: Kyoto Seika University, Kyoto, Japan

  -- M.Morioka www.lifestudies.org

January 16, 2007

Brain dead childen can grow taller

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The following is the second part of my paper, "Is it morally acceptable to remove organs from brain-dead children?," published in The Lancet Neurology, vol.6, January 2007, p.90.

Is it morally acceptable to remove organs from brain-dead children?
Masahiro Morioka

Part 2 (Part 1 is here)

Second, concerning the donor’s prior declaration principle, Dr. Tateo Sugimoto and I have proposed to revise the current law and allow children between 6 years and 15 years to be able to have donor cards and express their wishes on brain death and organ transplants. A Donor card without the signature of a person with parental authority should not be accepted (4). This approach is the only way to remove organs from brain-dead children, maintaining the donor’s prior declaration principle. In the Article 12 of “Convention on the Rights of the Child,” we can find this expression, “States Parties shall assure to the child who is capable of forming his or her own views the right to express those views freely in all matters affecting the child.” This is the basic idea of our proposal.

Then, what about when a brain-dead child does not have a valid donor card, or when the child is younger than 6 years of age? I think in this case the organs should not be removed from a brain-dead child even if the parents wish to do so. The silent child might have been thinking that a brain-dead person is not really dead, or it might be that organ removal was against the child’s inner wish. Organ removal from such a child is equivalent to exploitation of a “living” child. Children have the right not to be exploited by the desire of adults. When a brain dead child has said nothing about brain death, we have to think that the child has a right to live and die peacefully, fully protected against the interests of others. One might say that this means to discard babies with severe diseases who can’t survive without transplantation. Last year (2005) a 1 year old Japanese baby received five organs in the USA, but unfortunately she lived only 5 months and died early this year (2006). By contrast, the brain-dead baby, mentioned above, “lived” 4 years with her parents in a hospital. Every year her birthday was celebrated by the medical staff. No one can decide which life is superior to or more valuable than the other. It is time to reconsider organ transplantation from brain-dead children.

1) Masahiro Morioka, “Reconsidering Brain Death,” Hastings Center Report 31, no.4 (2001): 41-46
2) D. A. Shewmon, “Chronic ‘Brain Death,’” Neurology 51 (1998): 1538-45.
3) Chisen Kamei, Hidamari no Byoshitsu de. Medica Shuppan, 2002.
4) Masahiro Morioka and Tateo Sugimoto, “A Proposal for Revision of the Organ Transplantation Law Based on a Child Donor’s Prior Declaration,” EJAIB 11 (2001):108-110. http://www.lifestudies.org/transplantation01.html

What do you think, especially about the last part of this paper? Most people do not know the fact that a brain dead child sometimes continue to "live" for more than a year and grow taller and taller, and move their hands and legs frequently, without the function of his/her brain. In many countries such facts are not disclosed to the family. They are just told that their brain dead child is dead and there is no hope of recovery, hence, the final option is to donate organs for transplants. In Japan, organ transplants from brain dead children are prohibited under the current law, and as a result, some family members can live with their brain dead child in hospitals for more than a year happily. The problem is that the current law is scheduled to be revised to enable organ transplants from brain dead children without their own wishes.

This paper will be uploaded to the main website soon.

Related post: *BBC's biased report on organ transplants
                    *Removing organs from brain dead children

Photo: Kyoto Seika University, Kyoto, Japan

  -- M.Morioka www.lifestudies.org

January 13, 2007

Ethics of infant brain death

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My paper, "Is it morally acceptable to remove organs from brain-dead children?" was published in The Lancet Neurology, vol.6, January 2007, p.90. This is a summary of what I have been thinking about the morality of removing organs from "brain-dead" children. Currently, in Japan, two organ transplantation revision laws are being discussed in the Diet, both of which treat organ transplantation from brain-dead children as a main topic. (See Reconsidering Brain Death).

The following is the first part of the paper.

Is it morally acceptable to remove organs from brain-dead children?
Masahiro Morioka

In Japan, according to several surveys, around 30% of the population do not accept brain death as death of the human being. The current law on organ transplantation was established on the basis of the idea of pluralism on human death -- that is, people can determine beforehand, if they want, whether to choose brain death as their own death or not, and if they have not declared anything, their death is diagnosed by the cessation of heartbeat. Personally, I highly appreciate Japanese pluralism on human death because it shows a deep respect for the diversity of ideas on life and death (1).

The basic policy of organ transplantation from brain dead donors in Japan is: “From those who wish to donate to those who wish to receive.” This is called the donor’s prior declaration principle. According to this principle, only when a donor has declared his or her consent beforehand in the form of a donor card, both a legal brain-dead diagnosis and an organ removal become possible on the premise that the family does not refuse it.

However, this principle has created some difficult problems we had never imagined. The most difficult of which is organ removal from a brain-dead child. First, the current guideline stipulates that the legal brain-death diagnosis of a child younger than 15 years of age must not be performed because the statement of a child younger than 15 years of age written in a donor card is not deemed legally valid. This means that organ transplants from brain-dead children younger than this age are forbidden. Second, doctors and nurses continue caring for brain-dead children until their heart naturally stops beating because a brain dead child is regarded as legally alive under the current law for the above reason, and since most parents wish to continue caring for their brain dead child, sometimes the heart of a brain-dead child continues beating more than a month in a hospital. A doubt about the idea of infant brain death is beginning to arise among specialists.

How should we think about organ transplantation from brain dead children?

First, as I noted above, there are many people in Japan who think that a brain dead patient with a warm body should not be considered dead even if he or she has permanently lost consciousness. The 6 year old son of Dr. Tateo Sugimoto was hit by a car and became brain dead. Sugimoto was a neurologist; however, he could not accept the view that his brain-dead son was dead. He continued to think that his son was alive until his heart stopped beating. According to Alan Shewmon, brain-dead children are more likely than brain-dead adults to progress to a state of chronic brain death (2). In 1995, a Japanese baby became brain dead soon after she was born. She grew taller and “lived” until the age of 4 years in the state of brain death (3). These cases strongly suggest that it should be considered reasonable for the parents to believe that their brain dead-child is alive, especially when the child’s body is warm, the limbs move, or the child grows taller. Pluralism on human death should not be abandoned, especially in the case of children.

(Continues on the next post)

Related post: *BBC's biased report on organ transplants
                    *Removing organs from brain dead children

Photo: Kyoto Seika University, Kyoto, Japan

  -- M.Morioka www.lifestudies.org

January 03, 2007

Insensitive man and painless civilization

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The following is the second part of the draft I sent to a newsletter. (First part is here)

Well, then, what is life studies? I wrote the following text a couple of years ago, which can be found on the website of International Network for Life Studies at www.lifestudies.org.

"Life studies" is an interdisciplinary approach to life, death, and nature. We have gender studies, disability studies, and peace studies. I would like to propose one more interdisciplinary oriented approach, "life studies."

Our life in this world is limited. We are all going to die sooner or later. I want to live this life without regret. We need a variety of knowledge, intellect, and wisdom to support it. Life studies is an attempt to acquire an interdisciplinary, organized knowledge, intellect, and wisdom that help us live our limited lives without regret.

In order to attain it, we have to explore a new field in philosophy, humanities, and social sciences. We seek to promote research on the meaning of life, the essence of contemporary industrialized society that makes us lose sight of the fulfillment of life, and the fate of scientific technology that results in the exploitation of human life and the environment. Life studies is an open research program any person concerned can join.

The ultimate end of life studies is to support people to actually live their own lives without regret. We connect philosophical wisdom, academic research, and researcher's own life.

In 2005, a group of researchers who were strongly interested in life studies got together, and had a meeting in Kanazawa, Japan. The members included philosophers, sociologists, theologians, a Buddhist, a doctor, feminists, an artist, and others. We are now in the process of creating the basic framework of life studies, and trying to figure out the potential possibility of this approach in various fields. I think we will be able to have a joint research or an exchange with you over the topic of life studies and its impact on health related fields.

I have published books on life studies in Japanese. The most influential book is “Painless Civilization” (2003). In this book I analyzed the dark side of contemporary civilization with scientific technology and capitalism. This is the beginning sentences of the book: “A civilization without pain and suffering seems to be the ideal of the human race. However, I wonder if people might end up with losing sight of joy, and forgetting the meaning of life, in a society pervaded by pain reduction mechanisms and filled with pleasure.” A typical characteristic of painless civilization could also be found in contemporary medicine. The second influential one is “The Insensitive Man” (2005). I discussed the pathology of male sexuality, particularly, that arises from fetishism, men’s insensitivity, and rorikon (lolikon) phenomena. This book has been welcomed not only by young men but also by feminists. You can read the translation of part of the above two books on the website, www.lifestudies.org.

Photo: Stonehenge?

  -- M.Morioka www.lifestudies.org