Review Legislation as Soon as Possible to Stamp Out Wrongdoing

The Yomiuri Shimbun

17:17 JST, March 31, 2023

An organization that mediated unauthorized organ transplants overseas was allowed to operate unchecked for many years. Problems with the legal system lie behind the matter. It is necessary to look carefully at the problems and review the existing framework.

Authorities have wrapped up an investigation into the Intractable Disease Patient Support Association. The nonprofit organization and its director have been indicted for arranging organ transplants without authorization in violation of the Organ Transplant Law.

The director proposed and mediated a liver transplant and a kidney transplant in Belarus for two Japanese patients without the required authorization from the Health, Labor and Welfare Ministry. The patients transferred large sums of money to the organization’s account, according to the indictment. The condition of one of the patients deteriorated after the operation in Belarus, and the patient later died in Japan.

Unauthorized overseas organ transplants have long been criticized but such operations have continued unchecked. This is the first time the practice has been dealt with as a criminal case. Authorities must use this opportunity to understand what is actually going on.

Unauthorized organizations are not screened under the current law: Only organizations authorized by the government are subject to supervision. People who mediate unauthorized transplants in violation of the Organ Transplant Law may face penalties ranging up to one year of imprisonment and a ¥1 million fine, prompting criticism that penalties are too lenient.

Prime Minister Fumio Kishida has expressed his intention to review the legal framework for organ transplants, saying the government “will consider effective measures.” The current situation in which sinister mediators are widespread must be fixed and strict regulations must be implemented to prevent similar cases from happening again.

The government should consider a system that would allow it to screen all related organizations, regardless of whether they are authorized.

The low number of organ donations in Japan has been cited as a reason behind the situation. Some patients who have no hope of recovery other than organ transplants can be easily swayed by the words of malevolent mediators. Another issue is how to improve the current situation of extremely low donor numbers.

It is said that Japanese hospitals often do not confirm with the family of brain-dead patients if the person wished to donate their organs in such a situation or if the family would consent to do so. It is also said that potential donors tend to go undiscovered partly because doctors find it difficult to talk about organ donation with grieving family members.

In South Korea and the United States, hospitals are required to report all brain-dead patients to government-authorized mediating organizations. In Spain, highly trained coordinators present the option of organ donation to family members and confirm their consent.

It is hoped that more people in Japan will be trained as specialized coordinators. It is also important to consider extending support to medical institutions to secure human resources through such measures as providing them with additional funds in the form of medical expenses.

The Japan Organ Transplant Network, the nation’s main organization for arranging organ donations, has been facing a serious shortage of personnel. To promote organ donation, the organization must get support to function better.

(From The Yomiuri Shimbun, March 31, 2023)