Bagheri Alireza, Shoji Shin'ichi
Department of Neurology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba Science City, 305-8575 Japan.
J Int Bioethique. 2005 Mar-Jun;16(1-2):79-90, 194-5.
Organ replacement therapy is a part of medical practice in today's world and many countries have adopted the required guidelines and regulations. Establishing the basis on which organs can be removed, is still one of the most controversial issues of health policy making in the debate. The critical disparity between supply and demand in organ replacement therapy, even with the existence of social acceptance and organ transplantation law, turns attention towards the importance of an appropriate model of organ procurement. This model should be able to expand the donor pool and increase the organ retrieval rate by converting potential donors to actual ones. In Japan the organ transplantation law which was enacted in 1997 allows organ procurement from brain death as well as non-heart beating cadavers according to restricted conditions. One such condition includes the necessity of both the donor's and the family's written consent. Under current organ procurement policy, organs from only 29 brain death cases have been so far procured. In this paper after examining the current organ procurement system in Japan and the moral justifications behind different organ procurement models we conclude that the Japanese system does not clearly fall into one of the popular organ procurement models.
器官替代疗法是当今世界医学实践的一部分,许多国家已经采用了所需的指导方针和法规。确定器官可以被摘除的依据,仍然是健康政策制定辩论中最具争议的问题之一。即使存在社会接受度和器官移植法,器官替代疗法中供需之间的严重差距仍将人们的注意力转向适当的器官获取模式的重要性。这种模式应该能够通过将潜在捐赠者转化为实际捐赠者来扩大捐赠者群体并提高器官获取率。在日本,1997年颁布的器官移植法允许在受限条件下从脑死亡者以及非心跳骤停尸体获取器官。其中一个条件包括捐赠者和家属的书面同意。根据目前的器官获取政策,到目前为止仅从29例脑死亡病例中获取了器官。在本文中,在审视了日本当前的器官获取系统以及不同器官获取模式背后的道德依据之后,我们得出结论,日本的系统并未明确归入常见的器官获取模式之一。