Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-03T02:01:48.720Z Has data issue: false hasContentIssue false
  • English
  • Français

Culture, Conflict, and Cost: Perspectives on Brain Death in Japan

Published online by Cambridge University Press:  10 March 2009

Eric A. Feldman
Eric A. Feldman
Affiliation:
Yale University
Get access Rights & Permissions [Opens in a new window]

Abstract

Japanese surgeons have performed only one heart transplant in the quarter century since the procedure was developed. Possessing the requisite training and technology, transplant surgeons have been stymied by several factors that elude professional and political solution. Most critically, the lack of a brain death standard limits the availability of transplantable organs. Mistrust of the medical profession, traditional outlooks on death, and the primacy placed on consensual decision making have fueled debate about brain death and transplantation. Volatile and value laden, these issues have overwhelmed the discussion of health care resources, equal access to high-technology medical procedures, and insurance coverage for transplantation.

Type
Special Section: Assessing Nursing and Technology
Information
International Journal of Technology Assessment in Health Care , Volume 10 , Issue 3 , Summer 1994 , pp. 447 - 463
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

1.Akatsu, H.The heart, the gut, and brain death in Japan. Hastings Center Report, 1990, 20, 2.Google Scholar
2.An Act Relating to Cornea Transplantation, Act #64, 04 17, 1957.Google Scholar
3.An Act Concerning the Transplants of Cornea and Kidney, Act #63, 1979.Google Scholar
4.Article 190 of the Japanese Penal Code.Google Scholar
5.Asahi Evening News. Health ministry seeks clearer definition of brain death. 05 14, 1985, 1.Google Scholar
6.Asahi Shimbun. Nōshi kenkai de funkyū tsuzukeru gakujutsu kaigi (Complications continue over brain death position in Science Council of Japan). 04 24, 1987.Google Scholar
7.Asahi Shimbun. ‘Nōshi wa hito no shi,’ tōshin (‘Brain Death is Death,’ says report). 01 23, 1992, 1.Google Scholar
8.Asahi Shimbun. Nōshi rippoka ni nao kadai (Legalization of brain death still a task). 01 23, 1992, 3.Google Scholar
9.Asahi Shimbun. Tomen wa shisei kawaezu (For now, positions remain unchanged). 01 23, 1992, 3.Google Scholar
10.Asahi Shimbun. ‘Kanemochi dake’ no osore: Hoken tekiyō ya kikin motomeru koe (Fear of “for the rich only”: Insurance fund sought). 01 25, 1992, 3.Google Scholar
11.Bai, K. Nōshi ron no ronri: ‘Saigo hokokusho’ hihan (The logic of brain death: Criticism of the final report). Sekai, 1988, 10, 32–46.Google Scholar
12.Bai, K., & Hirabayashi, K.The legal situation in Japan, and whose consent shall make organ removal lawful. In Symposium: A comparative legal study of organ transplantation: Requirements for organ removal from cadavers. Comparative Law Journal, 1984, 46, 290–99.Google Scholar
13.Daily Yomiuri. Indecision plagues organ donor issue. 07 11, 1990, 3.Google Scholar
14.Daily Yomiuri. Health insurance to cover liver transplants. 07 18, 1992.Google Scholar
15.Dando, S.Japanese criminal procedure. George, B. J., trans. South Hackensack, NJ: Fred B. Rothman & Co., 1965, 94, 323.Google Scholar
16.Doerner, D. L.Comparative analysis of life after death in folk Shinto and Christianity. Japanese Journal of Religious Studies, 1977, 4(2–3), 160.Google Scholar
17.Fujimoto, T. Hōken shoken kara mita shin ishoku (Heart transplants from the perspective of autopsy). Saishin Igaku (Modern Medicine), 1969, 03.Google Scholar
18.Haberman, C.Heart transplants: A soul searching. New York Times, 1987, 02 10, 4.Google Scholar
19.Haberman, C.Ruling on death opens way for transplants. New York Times, 1988, 01 14, B7.Google Scholar
20.Higuchi, N.The patient’s right to know of a cancer diagnosis: A comparison of Japanese paternalism and American self-determination. Washburn Law Journal, 1992, 31(3), 455–73.Google Scholar
21.Honda, K., & Andoh, H. Brain death and patient’s rights. Presented at the International Conference on Health Law and MedicineSydney, Australia20 08 1986, 17.Google Scholar
22.Ikeda, D.Nōshi mondai ni kansurū ikkosatsu (Thoughts on the problems of brain death). Toyogaku kenkyu (Journal of Oriental Studies), 1987, 26(2), 129–49.Google Scholar
23.Ikegami, N.Japanese health care: Low costs through regulated fees. Health Affairs, 1991, 10, 87–108.Google Scholar
24.Japan Times. Brain death = human death, science committee decides. 02 26, 1987, 2.Google Scholar
25.Japan Times. Science council rejects brain death report. 04 24, 1987, 2.Google Scholar
26.Japan Times. Ministries to mull brain death. 06 30, 1987, 2.Google Scholar
27.Japan Times. Brain death dispute delays organ removal. 02 1, 1992, 3.Google Scholar
28.Johnson, C.MITI and the Japanese miracle. Stanford, CA: Stanford University Press, 1982.Google Scholar
29.Kass, L.Death as an event: A commentary on Robert Morison. Science, 1971, 173, 694–702.Google Scholar
30.Kato, I.Nōshi mondai: Shakaiteki gōi wa shinkirō (Brain death: Social consensus is a mirage). Bungei Shunju, 1988, 4, 106–15.Google Scholar
31.Koseisho kenkyuhan ni yoru nōshi no hantei kijun (Brain death determination criteria of the Ministry of Health and Welfare's research group), 12 6, 1985.Google Scholar
32.Krueger, H.Economic analysis of solid organ transplantation: A review for policy makers. Health Policy, 1989, 13, 1–17.Google Scholar
33.Lock, M., & Honde, H. Reaching consensus about death: Heart transplants and cultural identity in Japan. In Weisz, G. (ed.), Social science perspectives on medical ethics. Dordrecht: Kluewer, 1990, 99–119.Google Scholar
34.Luker, K.Abortion and the politics of motherhood. Berkeley, CA: University of California Press, 1984.Google Scholar
35.Mainichi Daily News. Organs removed from woman without consent. 12 24, 1984, 12b.Google Scholar
36.Mainichi Daily News. Nat'l insurance OKd for partial liver transplants. 07 30, 1992, 12.Google Scholar
37.Makino, v. The Red Cross Hospital, Nagoya District Court Judgment, 05 29, 1989, 1325Hanji 103.Google Scholar
38.Maruyama, E.History and theories of brain death in Japan since 1985. Journal of Behavioral and Social Sciences, 1992, 41, 47–48.Google Scholar
39.Miyahara, M. Shinzō ishoku toki ni okeru seishi hantei (Determination of life and death at the time of heart transplants). Naikia (Internal Medicine), special issue, “Rinshoka no tame no seishi hantei” (For clinicians who make determinations of life and death), 1969, 05.Google Scholar
40.Morison, R.Death: Process or event? Science, 1971, 173, XX.Google Scholar
41.Nihon Bengoshi Rengokai (Japan Federation of Bar Associations). Nihon Ishikai Seimei rinri kondankai ‘Nōshi oyobi zōki ishoku ni tsuite no saigo hokoku’ ni taisuru Ikensho (Opinion paper regarding the Japan Medical Association's ‘Final Report Concerning Brain Death and Organ Transplantation'), 07 1988.Google Scholar
42.Nihon Gakujyutsu Kaigi, Iryo Gakujyutsu to Ningen no Seimei Tokubetsu Iinkai Hokoku (Science Council of Japan, Special Committee on Medical Science and Human Life). Noshi ni kansuru kenkai (An interpretation of brain death), 10 23, 1987.Google Scholar
43.Nihon Ishikai Seimei Rinri Kondankai (Japan Medical Association Life Ethics Deliberative Council). Nōshi oyobi zōki ishoku ni tsuite chuukan hokoku (Interim report concerning brain death and organ transplantation), 03 25, 1987.Google Scholar
44.Nihon Ishikai Seimei Rinri Kondankai (Japan Medical Association Life Ethics Deliberative Council). Nōshi oyobi zōki ishoku nitsuite saigo hokoku (Final report concerning brain death and organ transplantation), 01 12, 1988.Google Scholar
45.Newman-Peddie, R. Transplant operations costs sky-high. Japan Times, 10 02 1992, 19.Google Scholar
46.Nudeshima, J.Nōshi/zōki ishoku to nihon shakai (Brain death/organ transplantation and Japanese society). Tokyo: Kobundo, 1991.Google Scholar
47.Ohi, G., et al. Why are cadaveric renal transplants so hard to find in Japan? An analysis of economic and attitudinal aspects. Health Policy, 1986, 6, 269–78.Google Scholar
48.Ohnuki-Tierney, E.Illness and culture in contemporary Japan. New York: Cambridge University Press, 1984, 70.Google Scholar
49.Ohnuki-Tierney, E.Socio-cultural dimensions of renal transplants in Japan. Health Policy, 1986, 6, 279–82.Google Scholar
50.Powell, M., & Anesaki, M.Health care in Japan. New York: Routledge, 1990.Google Scholar
51.Seimei rinri kenkyūkai, nōshi to zōki ishoku mondai kenkyu chimu (Life Ethics Study Group, Research Team on the Problem of Organ Transplantation and Brain Death). Zoki no tekishutsu ni kansuru horitsu (Law related to organ removal), Juristo 1001, 52–64.Google Scholar
52.Rinji Nōshi oyobi Zōki Ishoku Chōsakai Secchitto (Law to Establish the Ad Hoc Committee on Brain Death and Organ Transplantation), Law Number 70, 12 8, 1989.Google Scholar
53.Rinji Nōshi Oyobi Zōki Ishoku Chōsakai (Ad Hoc Committee on Brain Death and Organ Transplantation). Nōshi oyobi zōki ishoku ni kansuru jyūyō jiko ni tsuite (Chukan iken) (Important items related to brain death and organ transplantation [Interim report]), 06 14, 1991.Google Scholar
54.Rinji Nōshi Oyobi Zōki Ishoku Chosakai (Ad Hoc Committee on Brain Death and Organ Transplantation). Nōshi oyobi zōki ishoku ni kansuru jyūyō jiko (Important items related to brain death and organ transplantation). 01 22, 1992.Google Scholar
55.Tachibana, T.Nōshi (Brain death). Tokyo: Chuo Koron Shupansha, 1986.Google Scholar
56.Tachibana, T.NHK speshiaru: Nōshi (NHK special: Brain death). Tokyo: Nihon Hōsō Shuppan Kyōkai, 1991.Google Scholar
57. Tachibana, T. Nōshi to hito no shi (Brain death and human death). Asahi Gekkan, 1992, 03, 21–25.Google Scholar
58.Umehara, T.Gendaijin no sei to shi (The life and death of contemporary people). This Is, 1989, 6(10), 20–26.Google Scholar
59.Umehara, T. Watakushi wa naze, ‘Nōshi = Ningen no shi’ ni shitsuyō ni hantai shi tsuzukeru no ka (Why is it that I continue to obstinately oppose the idea of brain death as equal to human death?). Sapio, 1992, 01, 76–80.Google Scholar
60.Woss, F. When blossoms fall: Japanese attitudes towards death and the otherworld: Opinion polls 1953–1987. In Goodman, R. & Refsing, K. (eds.), Ideology and practice in modern Japan. London: Routledge, 1992, 73–100.Google Scholar
61.Yamauchi, M.Transplantation in Japan. British Medical Journal, 1990, 301, 507.Google Scholar
62.Yomiuri Shimbun. Nōshi ishoku yōnin o saigo tōshin (Final report approves of brain death, organ transplants). 01 23, 1992, 1.Google Scholar
63.Yonemoto, S.Sentan kakumei iryo (Advanced medical revolution). Tokyo: Chuo-Koron, 1988.Google Scholar