Finally Done - Japan's Decision on Organ Transplantation

By Akabayashi, Akira | The Hastings Center Report, September-October 1997 | Go to article overview

Finally Done - Japan's Decision on Organ Transplantation


Akabayashi, Akira, The Hastings Center Report


The long-lasting debate on organ transplantation in Japan has finally reached its end. "PROCEED" is the answer. The original organ transplantation bill was voted for on 24 April 1997 in the Lower House of the Japanese Diet and passed with 320 for and 148 against. A revised version of the bill also passed in the Upper House with 181 for and 62 against on 17 June 1997. This bill was finally approved in the Lower House on the same day with 323 for and 144 against. The law will begin to be enforced in four months.

The debate has an almost thirty-year history that can be divided into three phases. The first fifteen-year phase was characterized by a standstill. The movement to legislate began in May 1968. However, the first heart transplant three months later was strongly criticized, muffling any discussion of organ transplantation both in the public and in the medical profession.

The next ten years can best be described as hard labor. Hot debate, sparked by journalism in the early 1980s, involved the public, civil organizations, and academic and professional societies as well as government commit tees. Japan had never experienced such critical discussion in the field of bioethics, making this, its first childbirth, a difficult delivery. Although it was the first time and it took a long time, Japan did a relatively good job of offering unique insights into cultural diversity and involving the whole country in the discussion.

The last five years has been characterized by hesitation, due to incompetence displayed by the political decisionmakers. In January 1992, the Prime Minister's Ad Hoc Committee on Brain Death and Organ Transplantation finally reported that a majority of the members accepted that brain death served as the criterion for an individual's death. It took more than two years for the earlier organ transplantation bill to be submitted to the Diet (April 1994). The earlier bill stated that brain death was an individual's death, and approved surrogate consent by the family for the donor. These two points provoked considerable argument. Two and a half years passed without substantial discussion in the Diet, and the bill failed to be acted on in September 1996. …

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