Rissho Kosei-kai's Statement on the Proposed Revision of the Organ Transplant Law
Ten years have passed since Japan's Organ Transplant Law was enacted in 1997, and there has been an increasing call for its revision from many quarters. In 2004, the Liberal Democratic Party's Research Commission on Brain Death, Life Ethics, and Organ Transplants finalized its proposal for the revision of the Organ Transplant Law, and in 2006, Diet members of the ruling coalition parties presented the Lower House with two proposals for revision as lawmaker-initiated legislation. Through loosening the restrictions on the conditions required for organs to be donated, the proposed revisions aim to promote the spread of organ donation.
The Chuo Academic Research Institute, an organization affiliated with Rissho Kosei-kai, from an early date established a study group on the subject of bioethics, and has submitted its views and recommendations to the Prime Minister's Ad Hoc Commission on Brain Death and Organ Transplantation and members of the Diet, adding to its own research religious, social, and cultural insights on the issue of brain death and organ transplants.
In response to the submission of the two proposals for revision of the Organ Transplant Law, Rissho Kosei-kai in December 2006, in the name of Rev. Katsunori Yamanoi, chairman of its board of directors, submitted to Diet members it has endorsed and who sit on the Lower House Committee on Health, Welfare, and Labor "An Opinion on the Proposals for Revision of the Organ Transplant Law." It calls for respect for the basic principles of the current law from the standpoint of protecting the dignity of life. An abridgment of its contents follows.
An Opinion on the Proposals for the Revision of the Organ Transplant Law
(abridged)
In Japan, a person's death has traditionally been determined by three signs: cardiac arrest, respiratory arrest, and dilation of the pupils. Taking "brain death" as an indication of a person's actual death has not achieved a public consensus. The current Organ Transplant Law, in effect since 1997, was enacted following widespread debate in many quarters among people of differing viewpoints on the question of life and death. It did not accept brain death as equivalent to a person's actual death, but it did define it thus: "only in cases of organ transplantation shall brain death serve to indicate actual death," and it was established with the basic premise of "respecting the deceased person's own wishes."
The recently submitted Plan A, which says "Brain death shall be uniformly taken to indicate a person's actual death, and, as long as that person has not expressed disapproval, organ transplants from the person's body shall be possible with only the consent of the family members," essentially ignores the debate on which the current law is grounded. And even in the case of Plan B, in which the framework of the current Organ Transplant Law remains unchanged but the minimum age for a donor would be lowered from fifteen to twelve, concern has arisen over the lack of a legal basis for this.
An organ transplant from a brain-dead patient is a special type of medical intervention that is based on the premise that one person's death can save another person's life. The fundamental human rights of the donor and the right of someone to decide whether or not to become a donor must be given full and careful consideration.
As religionists, we revere all life as sacred, and from the standpoint of defending the dignity of life, concerning the proposals for revision of the Organ Transplant Law we submit the suggestions that follow. It is our strong hope that, based on a wide range of opinions from people in all walks of life and at all levels of society, there will be cautious and rigorous deliberations within the Diet.
(1) Brain Death and Actual Death
We cannot define brain death uniformly as actual death. In the case of organ transplants, we should respect the wishes of the would-be donor and defer to the views on life and death of each person.
(2) Confirmation of One's Consent to Become a Donor
The removal of organs from a patient declared brain-dead is a practice of medical intervention that is legally accepted on the condition that the patient's voluntary will to donate his or her organs is respected; the patient's consent must therefore be an essential condition.
(3) Declaration of Intent for Persons under Fifteen Years of Age
Concerning the declaration of intent of young people under fifteen years of age, in addition to the consent of the parents or a legal guardian, appropriate legal measures need to be set up. Children under six years of age should be exempted from organ donation.
(4) Determination of Brain Death
For a determination of brain death, it is necessary as in the past to have the wishes of the patient in writing, as well as the consent of the patient's family.
(5) Education and Knowledge concerning Organ Transplant Medicine
Detailed information about organ transplant medicine must be sufficiently conveyed to the public from humanitarian, cultural, and social standpoints with the general agreement of all concerned.
(6) Medical Ethics and Comprehensive Measures
The forming of a comprehensive plan for medical treatment and subsequent patient care that are fitting for Japan as a nation that seeks to ensure the health and welfare of all citizens must be actively pursued through such means as the enhancement of holistic medical education to restore ethical morality and trust in medical treatment as a benevolent art and the development of medical techniques that can be used in place of organ transplants.
(7) The Understanding and Cooperation of the People
It is dangerous to make revisions to the law that only address the current situation and that emphasize speed over quality. It is hoped that the understanding and cooperation of the general public will be obtained through full and adequate discussions with people of varied opinions and viewpoints.
Before revision of the Organ Transplant Law is undertaken, we humbly urge all the legislative and administrative bodies involved to obtain the opinions and cooperation of the general public from all quarters and at all levels, and to try their utmost to bring about a suitable medical care system for our country as a nation that holds the basic principle of seeking to ensure the health and welfare of all its citizens.
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