Section: News

                      JAPAN TO ALLOW ORGAN TRANSPLANTS

The lower house of the Japanese parliament has voted to officially
recognise the concept of brain death, paving the way for heart transplants
to occur for the first time in the country.

Japan's major law making body voted by 320 to 148 to allow a person to be
declared dead when his or her brain stops functioning. Previously, a
person's heart had to stop for death to be declared, which made heart
transplants impossible.

For many years the issue was considered to be too controversial to bring to
parliament. Although Japan's two main religions, Buddhism and Shinto, do
not ethically object to the concept of brain death, there has been
considerable cultural resistance to donating or receiving organs. Many
people believe that a person's body and soul are linked and that, in giving
up an organ, a person gives up his or her soul. There are also
superstitions about "defiling" the body before it reaches the next world.

Doctors say that this resistance to organ transplants has cost thousands of
lives that could have been saved. In one of the most technologically
advanced countries of the world many critically ill patients have had to be
flown to the United States and elsewhere for what has become a relatively
routine operation.

The upper house of parliament must still approve the bill, which is
believed to be likely but not certain. However, approval by the powerful
lower house is seen as a major landmark in public opinion that could have
enormous effects on Japanese medicine. Pakistan and Poland are the only
other major countries that do not designate brain death as actual death in
law or practice.

There has not been a single heart operation in Japan since 1968, when a
Japanese surgeon who performed the operation was investigated for murdering
the donor. Even though the doctor was not found guilty, the long court case
put a stop to all further operations.

The legalisation of brain death means that thousands of patients could be
taken off artificial life support. The Health and Welfare Ministry
estimates that more than 8000 people in Japan would be declared brain dead

PHOTO (COLOR): Resistance to organ transplants in Japan has cost many lives

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By Jacqui Wise, BMJ
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