Legal

Japanese Brain-Dead Donor Law On Organ Recovery Now In Effect

TOKYO, Oct 23 (Reuters) - Japan's new law that allows procurement of organs from brain-dead donors took effect October 16th, according to an article in The Japan Times.

A person whose brain has stopped functioning can be defined as dead in cases in which the individual has given prior consent to donate organs for transplant, according to The Asahi Evening News published July 18th. At least two physicians not involved in the transplant operation must determine brain death. And, the donor's family can veto a patient's wish, the newspaper added.

To help create and implement the new law, Japanese physicians have turned to the University of Florida, according to a recent university press release.

Since 1994, Dr. Charles McCluskey, executive director of the University of Florida's Organ Procurement Organization, has traveled to Japan to teach physicians and politicians about brain death. In turn, Japan has sent more than 30 visitors--including health officials, physicians, organ procurement coordinators and members of the news media--to Dr. McCluskey's institution and to Shands Hospital to shadow its transplant team.

"They want to know how we keep track of donor and recipient information and how we share that information with other procurement organizations and transplant centers," Dr. McCluskey said. "The coordinators themselves are particularly interested in how we communicate with and counsel donor families."

Japan's new law permits the transplant of hearts, livers and other vital organs from donors aged at least 15 years who are declared legally brain dead, according to the University of Florida press release.

Some Japanese physicians are skeptical about the wording in the new law. "We got a law which appears rather curious. However, we can make the first step from now," Dr. Kikuo Nomoto of Kyushu University in Fukuoka and Chairman of the board of directors of the Japanese Society for Organ Transplantation told Reuters Health.

"Following this law, we can say 'he is dead' only to persons who accepted the judgment of brain death and agreed to be organ donors," Dr. Nomoto explained. "If some persons do not describe their will in some cards, we cannot say 'he is dead.' From medical stand of view, both populations should be dead."

Many practical questions remain. For example, hospitals differ in defining who is a relative with veto powers over a would-be donor's written wishes, according to results of a Kyodo News survey in Japan, The Japan Times reported recently. Also, one medical professional has voiced concern about the possibility of pain consciousness of the brain-dead donor at the time of organ removal, according to the October 16th issue of The Japan Times.

The Japanese Association for Acute Medicine, a national group of medical experts, chose 23 medical facilities to remove organs from brain-dead donors for transplants based on the new legislation, according to The Japan Times. A number of medical professionals claim that transporting a would-be donor to these facilities violates the priorities of that patient, which should take precedence over a would-be organ recipient, according to the October 18th issue of the Mainichi Daily News in Tokyo.

by Sandra Katzman