recycling

Human recycling.  I think that's what organ transplant is in the end.  The concept of brain death only emerged when human recycling started.  Before that, no one was dead unless their heart stopped beating.  Human recycling is wonderful as it saves many lives, but at the same time, it is not the most natural phenomenon on earth and I totally understand that there are many families who have difficulties accepting the fact that a patient's brain death means their death.  And if that is why Japan has such a low transplant rate, I think we just have to accept it.  But maybe I'm wrong.

Japan is said to have the best skill when it comes to organ transplant and yet we have the worst transplant rate among developed countries.  The US still provides 5% of their transplant organs to foreign patients, and the majority goes to Japanese patients who come with hundreds and millions of dollars.

Today, a brain surgeon came to talk to us about organ transplant.  It was his 123rd time to give the talk, and he said he was here to give us some "correct knowledge".  He seemed to have some very strong feelings towards doctors who didn't present the option of organ transplant to the patients' families, and towards journalists who critisized that families were often unfairly "urged" to consent under some kind of pressure.  These people were being the obstacles in preventing the growth of transplant industry in Japan.

According to him, doctors never "urged" families.  A doctor's job is to tell the family that the patient will soon be dead and ask if they would consent to organ donation.  I think the point the surgeon wanted to make was that we should all accept that it was natural to be asked about organ donation at times of death -- it is out-of-date to regard this type of "request" as insensitive "exploitation".  After all, we're living the age of human recycling.

I do understand at a very logical level, but I was not convinced at all on an emotional level (maybe because he spoke so fast and came on pretty strong).  I personally think many families will more or less feel that they are "urged", as some journalists (and lawyers) point out.  If you dissent, it's literally the same as being asked if you would save someone's life and saying no.  The surgeon said doctors were the same as waiters at Mc Donalds -- they offer cheese burgers and chicken nuggets for customers to choose, while we offer the chance of saving a life or not saving a life, for families to choose.  I don't think it's the same at all.

He also said the Japanese were too emotional when it came to the definition of death.  Being brain dead means being dead in the context of organ transplant, just like red means stop in the context of traffic lights.  I don't think it's the same at all.  It's easy to accept the latter; it's much much harder to accept death.

A doctor's job is to save patients -- not only those who are right in front of them, but also those who they haven't met.  As the surgeon insisted strongly, Japanese doctors do need to learn to bring this subject up in front of families.  However, I think it's also important to realize that some families will, in fact, feel urged or even forced to consent.  We have to know that it's not the same as offering burgers and nuggets.  And we should acknowledge that we are asking families to think about saving someone they don't even know, when all they can think about is the fact that they are about to lose someone they love.  It's obviously important we reassure that families who decide not to consent will not be blamed for "killing" anyone.