It is important to understand that an individual's perspective of death and dying is greatly impacted by their culture. In this paper I will discuss how the Japanese culture approaches death and dying. I will also discuss the unique concept of organ transplantation that surrounds that Japanese culture. This paper presents the law of organ transplantation in Japan, which allows people to decide whether brain death can be used to determine their death in agreement with their family. Japan could become a unique example of individual choice in the definition of death if the law is revised to allow individuals choose definition of death independently of their family. The death and dying rituals involved in the Japanese culture will be discussed.
Overview of the Japanese Culture
In the latter half of the twentieth century, developed countries of the world have made remarkable strides in organ donation and transplantation. However, in this area of medicine, Japan has been slow to follow. Japanese ethics, deeply rooted in religion and tradition, have affected their outlook on life and death. The Japanese have only recently started to acknowledge the concept of brain death and transplantation of major organs has been hindered in that country. Currently, there is a dual definition of death in Japan, intended to satisfy both sides of the issue. This interesting paradox, which still stands to be fully resolved, illustrates the controversial conflict between medical ethics and medical progress in Japan. The Japanese culture considers a human being both alive and dead, an integrated body, mind, and spirit (Dennis, 2009, p.12). Therefore removing an organ from a brain-dead person involves a disturbance in this natural integrated unit. In the Japanese culture organ donation and organ transplantation are unpopular and rare (Dennis, 2009). According to Dennis (2009), the Japanese culture believes that a dead body must remain whole because if they are not whole, that dead person will be unhappy in the next world. Japanese Culture on Death and Dying
It is crucial to understand that an individual's perspective of death and dying is greatly impacted by their culture. Japan is the only country, which permits individual choice in death definition for the purpose of organ transplantation, and in agreement with the person's family. The Japanese organ transplantation law of 1997 is a long debate on brain death and organ transplantation. Over almost three decades, medical, legal and public discussion has occurred; a lack of consensus on the definition of human death caused a long delay in adopting a law on organ procurement (Akabayashi, 1997). Finally, policy makers in Japan have adopted a law with unique features, such as giving an opportunity to individuals to choose the definition of death based on their own views. Therefore, in Japan individuals may choose either cessation of cardio‐respiratory function or loss of entire brain function for their death pronouncement (Morioka, 2001). However, the choice is permitted in Japanese law only if organs can potentially be used for transplant with the agreement of the family, which means that although individuals can choose the definition of death based on their own views, the law gives power to the family to confirm or reject the choice. The law allows the family to override the individual choice in death definition (Akabayashi, 1997). The first effort to pass a law on organ transplantation following brain death failed in 1994. The main reason why the proposed law was rejected in 1994 is said to be because it stated that brain death is equal to death, and also because it approved surrogate decision making by the family. These issues raised serious arguments and concerns among some members, resulting in defeat of the legislation (Akabayashi, 1997). However, the situation has changed since then and, as public polls show, the number of people who accept...
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