A needed practice but the Japanese usually don’t follow it
One thing I have found during my research on all things Japanese is the need for tradition. Traditions almost govern modern Japanese society and can be observed at every level. However, tradition costs lives.
What I specifically mean by that is traditional practices takes precedence over life in some circumstances. For example, it is culturally expected that a body is to be cremated whole without anything missing. The problem with this is simple, that body is to be disposed via cremation- it is to be burnt and all organic material with it. Why should I be concerned with this- you may wonder. Simple- statistically there are only 0.7 transplants per million or 64 took place in 2016 (for all organs) and in 2019 there have been 102 donors and 372 recipients ( https://www.jotnw.or.jp/ ).
The bright side, the numbers have increased by 38 over a two year period. Alas, the number of people waiting for an organ is 13,948 as of Halloween 2019. This looks especially terrible when you consider that over 1,000,000 Japanese people due annually and many bodies are ‘put on ice’ until there is room at crematoria. I do realize that not all bodies are suitable for transplants- but which ones are?
Under Japanese law, anatomical gifts (organ donations) can be given under 2 conditions: brain death and cardiac death. But the rules governing organ transplantation are possible the strictest in the world. Organ transplantation may only be considered under the following circumstances:
- Organ donation or 臓器提供 is based upon explicit permission where people have to opt in. The individual has stated (in writing) that they wish for their organs to be donated.
- The family is in agreement
- The only causes of death accepted are brain or cardiac death (cases involve suicide to try and help another will NOT be accepted)
In fact, donations from brain-dead donors (脳死）still makes headline news especially donors under 18. In February, the parents of a boy under 6 (his exact age was not given) made the difficult decision to donate the organs of their son- who was always looking to help others. Recipients were almost immediately chosen- highlighting the need further.
There are still problems with this system and again it is cultural. Many doctors still do NOT recgonise brain death as a cause for human death in Japan and if the cause of death is declared as anything else, organ donation is not possible.
Brain death under Japanese law is cited as the following:
Brain death will only be declared if organic injury is observed in the brain with attributable cause and if the following criteria are met:
Dilated and fixed pupils
Loss of brain stem reflex
Flat brain waves
Loss of spontaneous respiration
Two or more doctors with requisite expertise and experience confirm no changes after a second test conducted six or more hours later.Japanese organ transplantation network
There are ongoing campaigns to either change the law in Japan to allow donations from a wider pool of donors and campaigns to raise awareness. The green ribbon campaign works with one core principle:
Yes is okay. No is okay. It is your intention [choice].Green ribbon campaign
This campaign shows the difference organ donation has on many lives and has a section on the website to share the stories of recipients so you can see what a difference it has made.
Families that have not been able to receive a new organ have only a few options.
Firstly, do nothing. For patients who need a major organ (heart, liver, lungs etc) they can choose to do nothing. This would result in their death.
Secondly, secondary care options e.g. dialysis for kidney issues. The problem with this option is the expense. Dialysis costs 6 Million yen a year- for the rest of their lives- whereas transplantation costs 6 Million yen and only requires blood tests and doctors appointments instead. This is a cheaper option which takes us to option 3.
Travelling abroad in hopes of paying for a transplant. This method is expensive as in remortgage your house expensive. The problem is that no country has a stockpile of spare organs- but these organs need to be sources from somewhere. This may be the black market or taking organs from others in that country that also need them.
This is an extremely complicated issue in Japan where tradition and human life fight against each other. Japanese law was changed in 2010 and even though may younger Japanese are filling out organ donation forms and, as an outsider, I feel more still needs to be done in order to help more people survive.
What do you think about organ donation in Japan?
Thank you for reading and happy exploring.