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Excerpt from The Nikkei Weekly Oct.23,2000 (Economy Section)
Organ-transplant Laws Draw Fire

Aya Furuta and Shigehara Furuta

     … Japanese law concerning organ procurement is the most stringent in the world. It does not allow doctors to take organs from a brain-dead person unless he or she left written consent and family agrees with the donation. Moreover, the law stipulates that only people aged 15 and older can give consent, presuming it too difficult for children to make their own decisions. As a result, the likelihood of children receiving hearts of the proper size is next to nil.
     … According to a recent survey by the Prime Minister’s Office of 3,000 people (2,156 of whom responded), 90% of Japanese people think that the consent of a donor is essential for organ procurement. Although the law itself calls for a revision, politicians are rather reluctant to undertake the difficult task of finding common ground on the matter, because of other commitments and the fear of opening a Pandora’s box of problems.

     … …

     From this point of view, the Japanese law is unique. It essentially allows people to choose the point in the dying process from which they are to be treated as the deceased. There are two options: the time their brains stop functioning, or the time their hearts stop beating.

     The act determines that brain death equals death only for those people who had previously agreed to accept a diagnosis of brain death and to donate his or her organs upon the diagnosis. Since the law does not mention other cases, brain-dead people who did not agree to accept the diagnosis are usually treated as living patients until their hearts stop.

     Brain death is not easily recognizable as death to the layperson, as a brain-dead person gives the appearance of being asleep, with the body remaining warm and the chest swelling and contracting as the body breathes. “I did not, and still do not, feel that my mother had already become a corpse when she was diagnosed as brain-dead,” said Ayako Ono, whose mother died in an accident some years ago. “If I had been asked, I would have agreed to donate my mother’s organs in that situation, as I understand that she could have never recovered. But I would not be happy if the law decided for me that brain death means death.”

     Reflecting the public’s concern over the issue, defining brain death as a new category of death has not only been discussed from a scientific perspective, but from social and ethical viewpoints as well.

     Many people still insist that the interpretation of brain death is largely due to an individual’s understanding of life and death and is therefore unsuitable to be prescribed by law.

     Widespread distrust of physicians and medical practices has also lead people to hesitate giving the final word on diagnosis of brain death to doctors. Controversy still shrouds the nation’s first heart transplant in 1968, as the hospital did not disclose clinical data to the public to prove that the donor was actually brain-dead.

     According to various surveys conducted by newspaper, roughly half of the population equates brain death with death, but about 30% consider it to be a step shy of death.

     “There is also a segment of people in Western countries who do not think brain death is death. I think the Japanese organ-transplant law is more democratic than Western ones, because it allows people to have different opinions on the matter, which is closely linked to each individual’s personal understanding of what constitutes the essence of human life,” said Masahiro Morioka, professor of life studies at Osaka Prefecture University.

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*This article was duplicated here for the purpose of academic research. You should note that the above is a part of the original article.

*For more information, see Brain Death and Organ Transplantation in Japan page.