Philosophical study of life, death, and nature
Brain Death and Transplantation in Japan
|1987||Yomiuri Shimbun Newspaper||46%||28%|
|1991||Mainichi Shimbun Newspaper||45%||23%|
|1992||Asahi Shimbun Newspaper||47%||41%|
|1997||Asahi Shimbun Newspaper||40%||48%|
|1999||Asahi Shimbun Newspaper||52%||30%|
About "donor's prior declaration" and "family consent": according to the poll by the Prime Minister's Office in May, 2000.
If "donor's prior declaration" exists that is sufficient.
"Family consent" is not necessary. 20.6%
Both "donor's prior declaration" and "family consent" are necessary 69.9%
If "family consent" exists that is sufficient.
"Donor's prior declaration" is not necessary. 2.1%
Cf. In most countries, if family's consent exists that is sufficient unless the brain dead person previously refused to be a donor. This means that if you have not written down on a donor card an agreement to transplantation, your organs will be removed if the family says "yes." One of the reasons is that brain death is legally determined to be human death without exception in these countries.
"Family's attitude" to the brain dead donor's prior declaration:
According to the poll by the Prime Minister's Office in July, 2002.
"Do you respect your brain dead family member's prior declaration and agree to organ donation?"
Probably Yes 22.4%
I don't know until I am in the situation 26.2%
Probably No 4.6%
4.Various proposals for the revision
a) Machino proposal (Feb.and Aug., 2000: a professor at Sophia University, and a sub-director of a research group funded by the Ministry of Health and Welfare. Several recipient groups support this proposal.)
Brain death is equal to human death without exception. If family consent exists that is sufficient for organ removal unless the brain dead person has previously refused to be a donor. In the case of a minor, if the consent of persons in parental authority exists, that is sufficient unless the minor brain dead person has previously refused to be a donor.b) Proposal by Japanese Council for Transplant Recipients (December 20, 2000)
c) Morioka & Sugimoto proposal (Feb.14,2001: Morioka = professor at Osaka Prefecture University, the director of this website; and Sugimoto = associate professor at Kansai Medical University)
Brain death is equal to human death without exception.
Adult = donor's prior declaration+ family consent are necessary
Child under 15 = consent of persons in parental authority is sufficient
Adult = donor's prior declaration + family consent are necessary
Child under 15 = donor's prior declaration + prior consent of persons in parental authority are necessary
In children between 6 and 12, in addition, ethics committee or the court must confirm that there was no sign of child abuse etc.
In children under 6, legal brain death diagnosis and organ removal are prohibited
In children under 12, legal brain death diagnosis and organ removal are prohibited
*Maintains the framework of the present law concerning pluralism of human death.
d) Proposal for legalization that enables organ removal from "living brain dead donors" (originally proposed in 1980s, in 1991, and in 1997 by Seiichi Kaneda, A Member of Parliament, and maintained by several people since then.)
Human death should be the permanent cessation of respiration and circulation. A brain dead patient is still alive. If there are “donor’s prior declaration” and “family consent”, organs can be legally removed from a “living brain dead donor.”Cf. Robert D. Truog published a paper, "Is It Time to
*(I am not sure their opinion about a child.)
e) Proposal for the abolishment of the law itself (This has constantly been announced by citizen groups plus a Member of Parliament, Tomoko Abe. Plus a new religion sect, Oomoto-kyo.)
Brain death is not human death. Organ removal from brain dead patients is a homicide. It must be prohibited.
5. Revision of the Law in 2009
After a long and twisted political process from 2001-2008, the law was finally revised in July 13, 2009. The revised law is very similar to Machino Proposal cited above. Brain death is human death when it is diagnosed for the purpose of organ transplantation. In this newly revised law, only family consent is needed to establish the legal diagnosis of brain death and thus allow for organ removal. This is on the condition that the individual did not, beforehand, express his/her objection to organ donation. Organ donation from brain dead children becomes possible by family consent. A curious point is that in the law there is a clause for a priority donation to the brain dead donor's family members. It was included to the law, although many scholars objected such clause, including prof. Machino himself.
English materials and discussions on this topic can be found in my papers,
Reconsidering Brain Death: A Lesson from Japan's 15 years of experience (2001)
Bioethics and Japanese Culture(1995)
Brain Dead Person(1989)
You can read Machino proposals, Morioka&Sugimoto proposal, and other related materials on my Japanese web page:
http://www.lifestudies.org/jp/ishokuho.htm (in Japanese)
European situation: Danish Council of Ethics, Organ donation.- Informed or presumed consent? (1999)
Report on anaesthesia on brain dead persons
Islamic situations: Ebrahim Moosa "The Body in Muslim Ethics: The Dissonance of the Gaze(s)" (2000)
The Nikkei Weekly newspaper reported this topic on Oct.23,2000.
Read their article, "Organ-transplant Laws Draw Fire."
Foreign Press Center reported on my Japanese paper, "Japan's Brain-Death Laws Are the Most Advanced in the World" (Chuo Koron Feb.,2001).
Mona Newsome Wicks reported this topic on MedScape (2000).
"Policy & Practice Brain Death and Transplantation: The Japanese"