The revised Organ Transplant Law went into force July 17. The revision is aimed at increasing the number of organ transplants in Japan. But it may increase the burden on doctors, especially at emergency medicine departments.

Before the revision, organs could be taken, with family approval, only from people aged 15 or over who had accepted brain death as actual death and indicated in writing their intention of becoming a donor. Now, organ transplants are possible from a brain-dead person of any age if the person has not openly rejected becoming a donor and if his or her family members approve.

Under the revised law, if a person is declared brain dead, the chance of his or her family members having to decide whether to allow removal of organs for transplants may increase.

It will be wise of people to make clear to their family members in daily conversations whether they are willing to become a donor. Their statements on the issue become the basis for their family members’ judgment in case of brain death. People can also use “green cards” distributed by the Japan Organ Transplant Network to indicate their agreement or nonagreement to become donors.

One problem caused by the revised law concerns how to handle children who are unable to form an opinion about whether to become a donor. Utmost care must be taken to ensure that their human rights are not violated. It must be remembered, too, that children’s brains have a stronger chance of recovery than adult brains. An effective system also must be put in place to prevent transplants of organs from victims of child abuse.

At hospitals designated as capable of removing organs for transplants, the burden on doctors, especially emergency room doctors, may increase because they will have to ask relatives of brain-dead patients whether they consent to removing organs for transplants. The government should consider setting up in each area a team specializing in brain-death diagnosis, legally required prior to a transplant operation, to relieve doctors of the burden of conducting the diagnosis.

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