Organ implant

¡¦It is said that Japanese Buddhism is ¡ÈFuneral Buddhism.¡É This word shows the importance of death in Japan well. The most specific example is the way Japanese treat the dead human body. They take care of them as diamonds until cremation. Generally speaking, most Japanese think it is a good custom, but this has a bad effect on organ donation cases these days.

A story about a liver donor
¡¦ Taro Kohno, a lawmaker in the house of representatives, donated a part of his liver to his father in 2002. He was reluctant to be a donor, because he was scared to have surgery and thought he could find another donor. Unfortunately, he couldn¡Çt find any donor, so finally he had no choice but to be a donor. He tried to be positive by thinking donors would never die or his liver would recover in half a year.
He remembers his donor life as follows.¡ÉI am a fortunate donor compared to others. I didn¡Çt have to take time off from work and suffer from the aftereffects of surgery. I saw several donors who became sick after surgery, and struggled with pressure from relatives¡Ä.
I didn¡Çt realize how hard it is to be a donor is¡É.


Enviroment of donation from living persons and neomorts
¡¦ There were about 450 liver donations from living persons in 2004. According to some expers, about half the donors sufferd from some aftereffects or got sick after surgery. As Kohno said, he was a lucky donor.On the other hand, liver donations from neomorts were only 2 cases, even though about 80 cases had been waiting for surgery. Why is donation from neomorts difficult ?

The reason why is that current law demands two conditions: consent of donors and relatives. Even though relatives deny donors¡Çwill before death, they can do as proxies after death.
When this law was enacted, politician didn't think most Japanese had reached a consensus of brain death.
Some philosophers who were against concept of brain death insisted as follows. ¡ÉSome Japanese words show that they think not only animals but also material things have souls like human beings. Generally speaking, we don¡Çt discriminate lives based on whether they have knowledge or not. If we think brain death is real death, we equate life with knowledge.¡É It sounds so good that most Japanese unconsciously accept it. As a result, relative¡Çs consent is strong and donor card system doesn¡Çt spread in Japan.


Law amendment
¡¦I think ¡Èconsent of relatives¡É is too strict for patients, so current law should be amended as follows.
­¡Donors¡Ç living will should be respected as principle and it can¡Çt be reversed without rational reasons.

­¢If brain dead patients didn¡Çt show their will, they aren¡Çt donors as aprinciple. However, if relatives approved, they can be donors. The chance for neomort donors will be larger than before by this.

­£Those who want to be donated have to register donor cards. It is clear that needs of patients waiting for organs outweigh the risks of being a donor, this system would motivate people to being donors.

­¤Criteria of brain death should be clearly decided. Under the law, thecriteria are ambiguous, because of la ck of clear definition of brain death.
Doctors now can¡Çt decide cleary when brain death has begun, and some may not try hard to save patients. Clearing up the law¡Çs ambiguities would be a deterrent to such a morally hazardous situation.

Donation in the future
¡¦Donation is a temporal way to save lives. Doctors, researchers are striving to invent artificial organs or make organs from ES cell (what we call ¡Èperfect cell¡É). Unfortunately such technologies are still rudimentary, it will take much time to put them to practical use. Technology gives us a lot of benefits, but also imposes many problems. Without implant surgery, we would have never argued about ethics of donation.
We have no choice but to wait for technological improvement to solve such problems, however we can think how to create a better life style or system at least. It is best for us to decide how to live not by technology, but by our own means.