"The Journal of Medicine and Philosophy", Vol. 14, No. 1, © 1989 by Kluwer Academic Publishers, pp. 97-102.
ANENCEPHALIC ORGAN DONATION:
A JAPANESE CASE*
ANENCEPHALIC ORGAN TRANSPLANTATION IN NAGOYA |
PHYSICIANS' ATTITUDE TOWARD ANENCEPHALIC NEONATES |
The Ethics Committee on Research and Clinical Practice has deliberated at length on the ethicality of and limits to the use of organs from aborted and stillborn fetuses and dead neonates in research. In light of the social and moral implications of the issue, Society members are advised to observe the following guidelines.
1. Regardless of the stage of gestation, the provisions of the Autopsy Law (Shitai Kaibo Hozon Ho) must be observed in the handling of dead fetuses and neonates. 2. The use in research of organs from dead fetuses and neonates should be limited cases where no other research method exists and the benefits from such research are expected to be extremely great. 3. In principle, research using organs from dead fetuses and neonates must be performed by a physician; all those who undertake such research, including collaborators, must be fully aware of its unique nature and social implications. 4. Those who wish to use organs from dead fetuses and neonates in research must fully explain the purpose of the research to the mother and the father (or legal guardian) beforehand and obtain their consent. Furthermore, the privacy of the fetus or neonate and their parents must be fully respected. The clinical treatment of living fetuses and neonates for research purposes, however, may be conducted only in cases where such treatment is considered certain to improve the prognosis, and the consent of the mother and the father (or legal guardian) has been obtained. |
Dr. Shinagawa, who in chairing the Society's Ethics Committee on Clinical Research was active in formulating these guidelines, mentions that the Committee discussed anencephalic neonates as sources for organ provision. He concludes that the issue is too complex and difficult to be encompassed by the present guidelines (Miwa, 1988, p. 170).
RECENT DEVELOPMENTS CONCERNING BRAIN DEATH IN JAPAN (1988) |
1. Brain Death (i.e., irreversible dysfunction of the entire brain) would be recognized as the death of an individual in addition to the traditional absence of heartbeat (circulation, pulsation, and respiration).
2. Minimum standard of brain death would be based on the standard adopted by the Special Task Force on Brain Death within the Ministry of Health and Welfare (whose chairperson is presently Dr. Kazuo Takeuchi). 3. The determination of Brain Death by brain-death criteria would be provided by physicians who respect the patient's and/or family member's wishes evidenced by a truly informed consent. 4. Determination of death by applying whole-brain-death criteria would be justified socially and legally if it (1) is grounded in the consent of the patient, (2) is determined by appropriate methods, and (3) is carried out by a physician in accordance with the guidelines of the Japanese Medical Association. 5. The time of death would be recorded no later than 6 hours after the initial determination of brain death. 6. Organ transplantation would be performed according to the guidelines of the Japanese Transplantation Society, which requires providing a full explanation for a free, uncoerced, and informed consent by the donor, the recipient, and the recipient's family members. |
CONCLUDING REMARKS |
NOTE |
* I gratefully acknowledge Dr. Stuart F. Spicker for helping me with the English idiom. Responsibility for contents remains, of course, all mine. |
REFERENCES |