[ISPHLT-SY2-3] Current status of pediatric organ donation in Japan: should organ donation from abused children be prohibited?
Although the number of brain-dead organ donations from pediatric patients has gradually increased since the enactment of the revised law, the actual number in Japan is still far below that of developed countries. Our research so far has revealed the following multifaceted issues: the process of confirming the will of children and their families to donate their organs, measures to exclude abuse, and care for the grieving families. We published a textbook on pediatric organ donation under brain death (to be published in July 2021), a proposal for a process to exclude abused children, a support system for patients' families, and many other results of the "Development of an educational program that contributes to the development of a system necessary for organ donation from children" in the Research Project for Infrastructure Development of Transplantation Medicine from FY2018 to FY2020. We will continue this research team system. We will continue this research team structure and further promote the above research, especially with the cooperation of pediatric societies.
In the Japanese system, organ donation from abused children is prohibited. As a result, when a patient becomes critically ill and reaches the end of life, it is necessary to deal with the family with a high level of care on the one hand, and on the other hand, to confirm whether there was any involvement of abuse in the child's injury, and to investigate the history of abuse in the past. While there are strong critics of this system, there are also those who believe that organ donation needs to be discouraged from the perspective of case investigation. In Japan, where there is no medical examiner, a bizarre barrier of exclusion from abuse stands in the way of children and their families who wish to donate their organs under brain death. Are abused children ineligible for organ donation? Should abused children be excluded? We would like to discuss these issues, including ethical considerations, while listening to the opinions of participants from overseas.
In the Japanese system, organ donation from abused children is prohibited. As a result, when a patient becomes critically ill and reaches the end of life, it is necessary to deal with the family with a high level of care on the one hand, and on the other hand, to confirm whether there was any involvement of abuse in the child's injury, and to investigate the history of abuse in the past. While there are strong critics of this system, there are also those who believe that organ donation needs to be discouraged from the perspective of case investigation. In Japan, where there is no medical examiner, a bizarre barrier of exclusion from abuse stands in the way of children and their families who wish to donate their organs under brain death. Are abused children ineligible for organ donation? Should abused children be excluded? We would like to discuss these issues, including ethical considerations, while listening to the opinions of participants from overseas.