When Is an Organ Donor Card Not an Organ Donor Card?

[Mulboyne]

[floatr][/floatr]Perhaps when it's a Japanese organ donor card. The images here are from the English site of the Japan Organ Transport Network. As you can see, the holder must select from three options: a list of organs available if brain death is declared; a list of organs in the event cardiac death is declared, lastly, no organs. Organ donation is still in its infancy in Japan. In particular, there are concerns about whether brain death is a sufficient condition for organs to be removed. It's possible that the third option is a legal requirement, or some other safeguard, to confirm a donor's true intention. You would expect cardholders to select one or both of the first two options. However, this Yomiuri article says differently:

The percentage of people refusing to donate their organs if they are declared brain-dead increased from 2 percent to 10 percent in August, among those who newly registered with the Japan Organ Transplant Network Web site. On Aug. 9, in the first case approved under the revised Organ Transplant Law, organs were harvested from a brain-dead patient with the consent of the patient's family, but without confirming the intent of the patient. The sharp increase in network registrants who chose not to become organ donors likely was triggered by the incident... Until August, only 2 percent of registrants chose the third category. However, after Aug. 9, the number of overall registrants grew while the percentage of those choosing not to become organ donors jumped to 10 percent.

As far as I can understand - and I may be mistaken - some people are actively registering with an organ donor association to get a card which says they will not donate organs under any circumstances, not simply that they don't want to do so when brain dead. Presumably, they are concerned not having anything which expresses their preference might leave them open to some misunderstanding should the worst happen. Personally, I'm inclined to think whatever slim chance of confusion there might be would more likely occur if I was carrying any kind of donor card, regardless of which option I'd selected.

I don't know about organ donation schemes in countries other than Britain, where we have no such third option on a donor card. Perhaps it's a common feature elsewhere. I can't help feeling a pang of sympathy for a medical professional who is briefly elated to find the card only to flip it over and find out nothing is available.

[IparryU]

I don't know about organ donation schemes in countries other than Britain, where we have no such third option on a donor card. Perhaps it's a common feature elsewhere. I can't help feeling a pang of sympathy for a medical professional who is briefly elated to find the card only to flip it over and find out nothing is available.

in the US, when you get your driver's license or State ID, they have a sticker that you have to put on the back of your card to declare you as an organ doner.

if the sticker is no longer visable, legible, or looks all jacked up, i believe that it is voided. prolly case by case, but whatever.

would suck for the Dr. to find a blank organ doner card... sorta like when you get a gift card but there are no points/money on it. fucks the whole day up

[Samurai_Jerk]

in the US, when you get your driver's license or State ID, they have a sticker that you have to put on the back of your card to declare you as an organ doner.

Like everything in the US, it depends on the state. In Washington, for example, there's a heart mark on state IDs if you're a donor so there's no seperate sticker to apply. Not a donor, no heart mark. Generally in the US if there's no record of your wishes it's up to the family.

[Greji]

Generally in the US if there's no record of your wishes it's up to the family.

You're spot on SJ and since now you have mentioned it, if something should happen to me I thought I decided to record my wishes and took out a card to help out AO....

[American Oyaji]

You're spot on SJ and since now you have mentioned it, if something should happen to me I thought I decided to record my wishes and took out a card to help out AO....

If I had any more help in that area, I'd need stilts to walk Grejiji.

[Mulboyne]

I've worked out what's going on and I'm sure some of you got there before me. Here's a recent article;

Yomiuri: 10th brain death under new law / Transplants from 9th donor with only relatives' approval go forward

A man in his 30s was diagnosed as brain dead Saturday under the criteria stipulated by the revised Organ Transplant Law, representing the 10th such diagnosis since the law came into effect in July, the Japan Organ Transplant Network said. The man had been hospitalized in the Kinki region. He had not expressed in writing a desire to be an organ donor, but his family agreed to the harvest of his organs -- the ninth case of organ donation with only a family's consent under the new law. The revised law made it possible to transplant organs from a brain-dead person with only his or her family's permission, as long as the person had not clearly expressed the wish not to donate or be declared brain dead.

The organ transplant network quoted one of the man's relatives as saying the man had told his family: "Organ transplants can save people's lives. We wanted to respect his will. We're proud that parts of his body will be alive in other people and help them," the relative was quoted as saying. The man's heart, lungs, liver, kidneys and pancreas will be transplanted into six patients nationwide.

The country's first organ transplant from a brain-dead donor was conducted in February 1999, about a year and four months after the initial Organ Transplant Law was put into force in October 1997. The 10th organ transplant from a brain-dead donor was not conducted until January 2001, about three years and three months later.

Before the law's revision, organs could not be donated from brain-dead individuals unless they had left a written statement expressing their desire to do so. The relaxation of the criteria has clearly contributed to a sharp increase in organ transplants. Among the nine cases in which organ transplants have been conducted with only the families' consent, brain-dead patients had verbally expressed desire to donate in just three.

In all the other cases, the families decided to donate the brain-dead persons' organs because they wanted parts of their loved ones' bodies to live on in others. "I believe the public's understanding of organ donations has deepened," said Prof. Atsushi Aikawa of Toho University, the top spokesman for the Japan Society for Transplantation.

If the current pace continues, the annual number of organ donations from brain-dead donors will likely rise sixfold, to about 60, from the number that took place each year before the law's revision. The figure is still far less than the United States and Europe. The United States sees about 2,000 heart transplants from brain-dead donors each year, and there are several hundred in Europe.

But if the number of organ donations from brain-dead patients continues to increase, it might make it difficult for workers in emergency medical care facilities and network personnel to follow all necessary procedures. Emergency facilities suffer from a chronic shortage of doctors, and the network has only 26 organ transplant coordinators.

Whether organ transplants in Japan will be able to take root in this country as a medical treatment conducted at a global standard depends on the nation's efforts to improve its medical services. "Without long-term observation, we can't know whether this pace can continue," said Jiro Nudeshima, a bioethics researcher at the Tokyo Foundation. "But even the current number is among the lowest in the world. If many people feel the current pace is high, it means [the concept of] organ transplants still haven't taken root in this country."

The people applying for a card to say they do not want to donate are hoping to ensure their relatives can't go against their wishes.

[Mulboyne]

Yomiuri: Brain death declared for organ donor under 15

The Japan Organ Transplant Network said Tuesday a child under the age of 15 was declared brain dead earlier in the day, in the nation's first such case under the revised Organ Transplant Law. The declaration was made at 7:37 a.m. Tuesday for a boy in the 10-to-14 age range who had been at a hospital in the Kanto-Koshinetsu region after a traffic accident, the network said. Several of the boy's organs will be transplanted at Osaka University Hospital and four other medical institutions, it added. The boy is set to become the first brain-dead donor aged under 15 in line with the revised law that took effect in July to allow organ transplants from brain-dead people aged under 15.

According to the organization, the boy was taken to the hospital after suffering serious head injuries in the traffic accident. On Monday morning, three members of the boy's family were informed by his chief doctor and a transplant coordinator that his brain was highly likely to have lost most of its functions. His family then gave consent to donate his organs. Based on the law, the patient's first brain-death diagnosis was made at 8:25 p.m. Monday and a second, confirmatory diagnosis was made Tuesday morning, the organization said. The hospital's abuse prevention panel confirmed there was no physical abuse of the boy involved in this case as required by law, it added.

The organs scheduled to be donated are heart, lung, liver, pancreas and kidney. An operation to harvest the organs was set to be carried out beginning 5 a.m. Wednesday. "Our son told us he wants to do a job that would be of great service to society," his parents said in a statement that was read by Juntaro Ashikari, the network's medical section head, at a press conference Tuesday. "His wish didn't come true as his brain didn't recover. But his body hung in there with all the strength he had left. We've all agreed this is an action that would suit him. If parts of his body continue to live on in someone else, we feel it will offer a small measure of comfort in the grief we feel at losing him."

Under the revised law, organ donations from brain-dead patients aged under 15 are allowed with the consent of their families unless the child had previously clearly expressed a will to refuse to donate organs. In this case, the boy did not leave any instructions about organ donation before he died. The law also requires institutions harvesting organs from such brain-dead children to confirm the children were not victims of physical abuse.

The revisions to the law were prompted by new guidelines set by the World Health Organization last year that call on people to receive organ transplants in their own countries rather than overseas. However, whether the number of organ donations from brain-dead children will rise is in doubt, as determining whether children's brain deaths were caused by abuse is difficult and many hospitals are not yet capable of handling organ donations from children.

Soichiro Kitamura, president emeritus of the National Cerebral and Cardiovascular Center, said: "Children account for more than half the patients who have had organ transplants overseas. If child patients come to be able to receive organs from children [in Japan], that would be socially significant."