Editorial
More deliberation needed on new organ transplant law
The revised Law on Organ Transplantation passed by the House of Councillors on Monday differs greatly in principle from the current organ transplant law.
The newly passed bill does not merely change the definition of legal death. It makes donor consent unnecessary in the case of those who have been pronounced brain dead. Moreover, if the donor so desires, their relatives can be given priority in receiving organs.
A decision on the new law should only have been reached after past cases and the possible effects of the amendments had been thoroughly considered. However, both the Lower and Upper Houses rushed through their deliberations.
One cannot help feeling that this has been too rash a process for a law that impinges on human life. If the bill was passed in haste as a means to prevent its being scrapped in light of the approaching dissolution of the Lower House, legislators cannot avoid criticism over their selfish behavior.
The process leading up to the passage of the current organ transplant law in 1997 involved wide-ranging debates, including discussion on some of the same issues that emerged with the latest bill. As a result, the current law -- which accommodates those who do not believe that brain death equals a person's death -- was established.
Have the public's views changed in the 12 years since? In a public opinion poll conducted by the Mainichi Shimbun in June, the majority of respondents stated that brain death should be considered legal death only in the case of individuals who have expressed the wish to donate organs, as stipulated under current law.
At the same time, a majority of those polled said they supported the legalization of organ transplantation from children under 15 years of age who have been pronounced brain dead, if the parents offer their consent. This will be made possible with the revisions, while under the current law, such transplants are possible only in cases where the donors have given their consent. The new law seems to be consistent with public opinion concerning the public's desire to help children suffering from illness.
Still, in the case of organ transplantation from young brain dead donors, there is much to be considered, especially in terms of the donors' welfare. It is said that diagnosing brain death in children is much more difficult than it is in adults. How should diagnosis standards be set? What about the possibility of families of children who have been rendered brain dead as a result of child abuse consenting to organ donation? How do we identify such cases?
For both adult and child organ transplantation, challenges remain to secure support for donors and to determine who constitutes "family" with the authority to give consent. The concern that treatment will be abandoned in the case of patients who have been pronounced brain dead and are not expected to donate organs is something that also needs to be addressed.
Establishing procedural guidelines that citizens find satisfactory before the new law goes into effect a year from now is not an easy task. In particular, giving priority to relatives as organ recipients has the potential not only of undermining fairness, but also of promoting morally questionable transplants, and a fundamental re-examination of the issue is imperative.
Behind the push for the latest amendments was speculation that the World Health Organization (WHO) would be issuing restrictions on overseas travel for organ transplants. On a separate note, as live organ and tissue transplantation are among the issues deliberated by the WHO, inserting a clause on live organ transplantation in Japanese law should also be a part of the country's agenda.
(Mainichi Japan) July 14, 2009