Organ Transplantation in Japan and UK
In many countries, organ trafficking is illegal, yet the incidence is on the increase. Examine the legal, ethical and sociological issues involved in procuring human organs for transplant operations, comparing two countries with very different approaches. Organ transplantation is the most effective method to cure cardiac failure, uremia, and Diabetes mellitus type I in the modern world. However, even most developed countries do not have impeccable legal system and advanced technology to handle organ transplantation operations well.
As a developed country, UK should have high organ donate rate, however, it has the lowest organ donate rate in the world, whereas Japan, which is also one of the most developed country in the world, has much higher organ donate rate than UK. Differences in organ transplantation systems from legal, ethical, sociological, and technological perspectives determine that Japan has superior organ transplantation system than UK. Unlike UK, Japan has more supportive laws on relatives’ permission and donor card setting, which determines that Japan has better organ transplantation system.
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According to the amendment of Japanese organ transplantation laws, except people who show that they strongly refuse to donate their organ before they die, relatives could donate organs belong to people who do not show their obvious will to donate their organs or not. On the contrary, in UK, even though people are willing to donate their organ, if their parents still refuse to organ donation, the process of organ opt-out have to be stopped.
On the other hand, the law regulates that in Japanese Medicare cards, which every Japanese has, should contain organ-donating information. When accidents happen, potential donors could easily show their will to donate their organ by filling the backside of their Medicare cards. This action hugely increased potential organ donor. In contrast, British have to get special organ donate card in hospitals, and sign their names on the card after series of medical check. The process is much more complex than Japanese organ donate card.
Both UK and Japan have to deal with ethical issues of organ transplantation, such as criterion of death and high expenses of organ and long waiting list leads to organ trafficking. In Japan, people who are diagnosed with brain death, which means patients’ hearts are still beating but lose the function of brain forever, are considered dead. However, in UK, cardiac death, which means the heart stop beating, is the common definition of death. Also, according to UK’s organ transplantation law, only when people heart stop beating for at least 5 minutes, (UK’s guideline) the organ removal could begin.
Even though there is minute chance to brain death people recovered, the organ from brain death patients, which received more oxygen supply from heart beats highly increase the effectiveness organ transplantation operation in Japan. On another hand, the expenses of organ transplantation operation are not affordable for everyone in Japan and UK. The average cost of one kidney transplantation operation in Japan is about 100,000 US dollars; moreover, in UK, the cost may be higher because of the lack of organ resources. As for the waiting lists in both countries are quite long.
Even though the average periods that receiver should wait in Japan and UK are nearly the same (2~4 years), those two countries use different method to decide the order of receivers. In Japan, doctors rate different patients by how long they can live; if the patient only can live less than one month, they will give the patient 9 points, if they can live between 6 to 1 month, they will get 6 points, and so on. On the other hand, if the organ is perfectly fit the patient, the patient will receive extra 1. 5 points to get the organ faster. China daily, 2012) In UK, the National Health Service and Organ donation and transplantation committee in charge of the allocation of organs and the whole process of organ transplantation system. (Parliamentary Office of Science and Technology, 2004) Also, there are groups of experts that analyze the fitness between different organs and patients on the waiting list. Even though those methods sound fair enough, there are a lot of subjective factors may influence the fairness of allocating of organs, such as bribing the doctor in Japan to get higher rating in order to get the organ faster could be possible.
Those two factors leads to organ trafficking, which provides cheaper organs and shorter waiting time in both countries, especially in UK, which required more illegal organs than Japan. Religious factors make the effectiveness of UK organ transplantation system lower than Japan. Most Japanese are Buddhists, who believe that they should donate the “temporary” body to save others’ life. Also, according to Dr. Shi, Buddhist always believe if they save others’ life in this life, they will receive happiness in their next life.
Therefore, most Japanese are willing to donate their organs after they dead. However, most British are Christian. They believe that their body should be return to the god, and they do not have the right to give god’s belongings to others. For this main reasons, the organ donors who have strong religious background in UK are less likely to donate their organ when compare to Japanese. From technological perspective, Japan has more sophisticated technology to handle organ transplantation operations. The survival rate of organ receiver reached 73% in Japan.
However, one third of receivers in UK die within the 30 days period after organ transplantation operations (Jiang, 2008). Also, Japan has mature technology to remove organ from brain death, whereas UK are still testing this specific technology. Even though both governments built specific fund of organ transplantation technological project, Japan receive more effective result than UK. In conclusion, even developed countries like UK and Japan have severe problems in their organ transplantation system,it is not hard for people to imagine how many severe issues existing in developing countries’ systems.
On the one hand, UK could learn positive method and technology from Japan on the issues of organ transplantation, but it is not possible that UK uses the same organ transplantation system as Japan uses due to its heavy Christian background, less willing of adapting, and not enough population to handle the system. On the other hand, even though Japan has more advanced technology, more supportive religious background, and legal system of organ transplantation system, there are still a lot of problems to be solved.