Commentary on Seewald

- Masahiro Morioka
CIAS, Osaka Prefecture University,
Gakuencho, Sakai, Osaka, 599-8531 Japan
International Network for Life Studies (http://homepage1.nifty.com/lifestudies/)
Email: PBI01055@nifty.ne.jp

Eubios Journal of Asian and International Bioethics 10 (2000), 76-77.


Ralph Seewald did interesting research on ideas of brain death and organ transplantation among Japanese nurses. This "Japanese attitudes towards brain death and transplantation" problem has been discussed repeatedly, but we have not reached a consensus yet. One of Ralph's conclusions is that many nurses are willing to donate organs, but not if it means the body must be operated on to do so. This point is interesting.

However, I would like to criticize his other points. First, the author divided the nurses into two categories, DONOR and NON-DONOR. But by so doing he result in ignoring the gray zone, that is to say, he ignores the emotional dimension of such nurses who think that donation is good, but at the same time, who have a profound emotional reluctance toward it. According to my experience, many people feel life this and sway between the two poles. And in the midst of this gray zone there is a mixture of emotions that must be the subject of us researchers.

Since I published a book, "Noshi no Hito," in 1989, I have stressed the importance of human relationships between a brain dead person and his/her family members, because these relationships have an influence on family members' judgement on the death of the brain dead person. From this point of view, the closeness of family-patient relationship is the point. I wrote about it elsewhere (1). Ralph cites responses from nurses, such as "if organ donation is done against the will of the family, the family is the one that suffers", and "the body is not just something of the person himself, but also something of the family." These sentiments clearly show they think this kind of closeness very important. I must say Ralph should have paid more attention to this dimension.

The author concluded that "the idea that the Japanese have some special affinity with one part or organ of the body and therefore oppose to organ donation is not supported by the data gathered." However, the author fails to see the possibility that the Japanese have some affinity with the whole body, or even the relationships that are established between a brain dead person and the family members, hence, some of them have a reluctance to cut the brain dead body. In Table 15 Ralph asked "which organ do you think is emotional the most essential organ of the human body?" In this manner, respondents can only choose one or two organs; never express their emotions toward the whole brain dead body, or the relationships.

As for Table 15, it is very interesting that those who chose "heart" are twice as number of those chose "brain." Even among the DONOR nurses, the same tendency is observed. I can not help thinking that this shows the gray zone effect mentioned above, that is to say, two third of the DONOR nurses think it ethical to donate, and at the same time, feel uneasiness because they think the heart, not the brain, is the most emotionally essential part of the human body. And this might be one reason of the Japanese reluctance against brain death.

Ralph writes, "for many Christians organ donation is not a sacrifice, but something that one ought to help a fellow-creature." But in order to say this, Ralph must research on Christians, not their philosophy, but what they are really acting in clinical settings.

I have pointed out several things, but I think Ralph's paper provides us very important views on comparative cultural anthropology. Researches like this should be continued in the field of bioethics.

Japan's transplantation law is about to be revised this year. The point is the case in which the brain dead patient has not had a donor card. Other points are the evaluation of family consent, and the case of a child. I object to this revision. I am now doing an action against this revision. Before revising we have lots of things to discuss. I am going to report this at TRT6 this year. (Concerning the anti-revision activities, please visit my Japanese site: http://member.nifty.ne.jp/lifestudies/. You need Japanese language set on your browser.)

(1) Masahiro Morioka, "Two Aspects of Brain Dead Being", EJAIB 10 (2000),10-11.


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