WHO says no more shopping for organs get your own

EDITORIAL: Revising the organ transplant law

2009/4/27

The Diet has suddenly become quite active about revising the law on organ transplants to allow organ donations from children.

In Japan, the current law prohibits transplanting a child's heart to another patient. This has led a string of Japanese patients to travel to the United States and other countries to receive transplant operations.

However, the World Health Organization (WHO) in May is expected to adopt a resolution restricting people from receiving organ transplants overseas. That is why there is the sudden rush in the Diet toward a new bill.

Organ transplantation is a unique branch of medicine that requires the death of a donor, and is inseparable from our individual views on life and death. We hope the lawmakers will debate carefully, based on a wide variety of perspectives, and arrive at an answer acceptable to a majority of the public.

Japan's Law on Organ Transplantation was created in 1997 to allow for organ transplants from brain dead donors.

After heated debate in the government's ad hoc committee on brain death, the government concluded that Japan had not reached a social consensus that brain death was indeed unconditional death. The compromise option was to recognize brain death as termination of human life only when organ transplants were called for.

In such cases, for the deceased to be recognized as an organ donor, the person would have had to leave his or her written consent. Therefore, based on the Civil Law that does not recognize a child's right to leave a will, it became impossible for anyone under 15 years old to become an organ donor.

But now, lawmakers from the ruling parties have submitted a bill that uniformly recognizes brain death as the definition of death for all people. The bill would also allow organ donations from brain-dead patients who had not refused to donate organs, as long as there is family consent.

Ruling party lawmakers have also proposed a bill that lowers the age limit of organ donors to 12, rather than the current 15, while maintaining the framework of the exiting transplant law.

The first proposal opens the door to child organ donations. But there is strong opposition even within the ruling parties against changing the fundamental framework of the current law.

In contrast, opposition lawmakers have submitted a bill that introduces more rigorous criteria for determining brain death.

Some lawmakers are also attempting to put together yet another bill.

We hope the lawmakers will try their best to come up with a bill that maintains the fundamentals of the current law and yet paves a path toward allowing child organ transplants.

The debate within the Lower House committee on April 21 can be viewed on the Diet website.

A transplant surgeon argued that it is unfair that Japanese children cannot receive transplants in their own country.

A pediatrician said there are cases of child patients surviving for months after being pronounced brain dead as well as cases in which the brain functions recover. There is no such thing as a fail-proof brain death diagnosis, the pediatrician said.


The doctor added that in the case of children, it takes time for parents to come to terms with their child's sudden death.

Last year, there were zero organ donations from children under 16, even after cardiac arrest. During the previous two years, there were only one each.

2004 saw the largest number of organ donations from minors after cardiac arrest in recent years. But the figure was only five. The number of child organ donations is not likely to increase easily.

On the other hand, an emergency physician recognized the necessity of brain death transplants, but he also referred to the stark realities of emergency rescue medicine.

It is absolutely necessary for doctors to do their utmost to save the child's life before the organs are donated. The same goes for adult donors.

If the emergency rescue medical staff are too tired to perform well, that can also throw a shadow upon organ donations.

Ever since the transplant law came into effect, there have been only 81 cases of brain death transplants. There is no question this figure is extremely small by global standards.

Now that debate over this issue is becoming increasingly active, this is a great opportunity to reach a social consensus. We will closely watch how the Diet will work out a compromise.

--The Asahi Shimbun, April 25(IHT/Asahi: April 27,2009)