Abstracts of Teruteru Proposal for Revision of the Organ Transplanatation Law

2003.11.11. by てるてる

This is the abstracts of "A Proposal for the Revision of Organ Transplantation Law Based on the Anti-brain-death Argument (Noshi Hiteiron ni motozuku Zoki Ishoku Ho Kaiseian ni tsuite)," Yutaka Teruteru Nishimori, Gendai Bunmeigaku Kenkyu 3 (2000): 139-79.

「脳死と臓器移植における倫理的問題に関する国際会議(20031102)」が終わった後、つくばから東京へ帰るバスのなかでりんごさんと話しているうちに、てるてる案の英語のabstractsを作ってみようか、という話になりました。 それで、英語の文章を書くのが苦手なてるてるが、四苦八苦することになりました。





(3)臓器提供の条件における基本原則 「臓器提供は、臓器提供希望者が、生前に、移植医療に関する充分な情報を与えられ、変更の自由を保障され、かつ、いかなる経済的対価も伴わずに、自由意志と倫理的判断とに基づき、自発的な、任意の、書面による意思表示を行った場合にのみ、許される」 この原則を、生体間の臓器移植にも適用する。


(5) さらに、提供する臓器を特定する臓器提供意思表示カード、臓器提供意思登録カード、そして、脳死後の臓器提供を選択している人が、脳死と身体死の違いについて理解していることを確認するためのチェックカードをつくる。



(1) Principle

The removal of organs and / or tissues from human body is only permitted when any person who wishes to donate his or her one, informed enough about transplantation, guaranteed freedom of alteration, without any consideration, founding on free will and ethical decision, voluntarily, and optionally, put his or her prior declaration in writing.

Because no human being was born or is living or die in order to become the medical resource.
Every human being has the moral right or the right to be let alone. Whether he or she is living or die.
The organ transplantation become possible by organ donation. And donation must not be coerced, nor persuaded, nor motivated by money, nor be permitted by anyone's family's decision. It is the principle to anencephalic infant, persistent vegetative state patient, brain dead one*, and cardiac dead**one, too.

* Brain death is also called irreversible coma, it is irreversible cessation of all functions of the brain, including the brain stem.
**Cardiac death is irreversible cessation of respiratory and circulatory functions. It occurs when a person's heartbeat and breathing stop.


(2) Condition of donation

Any brain dead or cardiac dead adult who is over 20 years old can donate his or her organs and / or tissues by prior declaration without his or her family consent.

Any brain dead or cardiac dead child who is over 3 years old can donate his or her organs and / or tissues by prior declaration with his or her parent's consent.

Any brain dead or cardiac dead adult or child must not be removed his or her organs and / or tissues without prior declaration.


(3) Legal definition of death

Teruteru proposal is founded on the idea that we did not have to define brain death as human death in order to remove organs from brain dead donors.
This proposal states that the legal definition of death is the permanent cessation of respiration and circulation, and the time of notification of death is when the organs or / and tissues are removed from donor.

A lot of Japanese and some American think that a brain dead person is not dead.***

***Masahiro Morioka, "Reconsidering Brain Death: A Lesson from Japan's Fifteen Years of Experience," Hastings Center Report 31, no.4 (2001): 41-46.


(4) Terminal choices card

Brain death is terminal, and organ donation is one of terminal choices.

Anencephalic infant or persistent vegetative state patient is not terminal. If anyone wishes to donate his or her organs and / or tissues when he or she becomes persistent vegetative state, or if any parent wishes to donate his or her anencephalic infant's organ and / or tissues, both are living organ donation. Living organ donation by prior declaration or without donor's own permission should not be admitted..****

****Japanese organ transplantation law that was established 1997 has no clause about living organ donation. Jiro Nudeshima presented the proposal for the revision of organ transplantation Law adding clauses about living organ donation, "Ikiteiru Teikyosha no Hogo no Tame no Zouki Ishokuhou Kaiseian / Shian," CLSS, No.1, September (2003).

Terminal choices card:
Organ donation is one of choices when a person becomes brain dead.
You can choose being cared to be cardiac arrest or putting respirator off, or donating organs and / or tissues on respirator, by this card.


(5) Organ donation card, organ donation registration card, check list card

Organ donation card:
You can choose to donate which organ and / or tissue, when you become brain dead or cardiac dead, by this card.

When you become brain dead, you can donate heart, lungs, liver, kidneys, pancreas, bone, skin, heart valves and eyes.
When you become cardiac dead, you can donate kidneys, bone, skin, heart valves and eyes.

You should be assured by anyone whom you trust.
You and your trustee should sign this card.
You can indicate only one person who will be able to take objection to your organ donation when you become really brain dead. For example, your mother, or your grand mother, and so on.
If you are under 20 years old you need your parent's or guardian's permission.

Organ donation registration card:
You can register your intention of organ donation.
When you want to register, you need to have explanation by transplant coordinator.

Check list card:
The check list card is to check the knowledge of brain death and organ transplantation.
A lot of items of data about brain death and organ transplantation are written on this card.
When you want to donate which organ and / or tissue on brain dead, you must read the check list card and check all items.