My friend Joseph over at "Tame Goes Wild" has been studying Japanese at university for the past several years. It's a staggering amount of work becoming fluent in Japanese and I really respect how hard he both tries to accomplish his goals and become a better person. He often uses his Japanese speech and presentation opportunities to discuss important social issues. He's a gentle, kind soul and I hope you'll all make his Daily Mumble a regular read. He'll inspire you to try to be a better person, too. Sometimes when things in life make me feel down and discouraged, reading about his efforts lift my spirits.
In today's post, Joseph mentioned some interesting facts about organ donation in Japan and I made a huge comment containing some information I was eventually going to get around to posting, but hadn't gotten there yet. Google sent up error messages each time I tried to send the comment (with an attractive hexadecimal code to send along so they'd know what went wrong). I figured I'd try and salvage the (potentially) lost comment and just make the post I was going to make anyway.
A very long time ago, there was a legal drama called "L.A. Law" by David E. Kelly. This is the same man who currently makes the television drama/comedy "Boston Legal" and previously made the (abysmal in my opinion) "Ally McBeal" and (brilliant, again in my opinion) "The Practice". One of the things Kelly does in a lot of his legal shows is use real life cases as fodder for the dramatic situations on his shows. One of the memorable cases on L.A. Law was about a friend of one of the attorney's on the show who needed an organ donation or she would die. She was on a waiting list, but a 50 something Japanese man was being given the next available donation because he had paid a lavish sum of money for the privilege. The attorney argued about the ethics (or lack thereof) of allowing financial capability to determine who gets organs rather than need and how this created a situation where the rich and privileged received disproportionately better care. The way this worked, by the way, was that the donor was bribed to offer their organs to the highest bidder. She lost the case and ended up paying a bribe to another donor in order to keep her friend alive despite her own disapproval of this practice and that of her colleagues.
The reason this little drama was written into the show is that this is exactly what happens when many Japanese people need organ donations. As Joseph's statistics show, a staggeringly low number of Japanese people are willing to donate organs despite the fact that a very high percentage claim to approve of them. It is clear that they approve of them as recipients, not as donors themselves and to this day it's common for Japanese people who need organs to go abroad and pay big money to get them.
If you think I'm wagging a finger or criticizing the Japanese, you'd be wrong. While the imbalance is obvious (they're receiving and not giving), there are cultural reasons for their reluctance to donate organs and, despite cases where people can pay for the organs they get abroad, I'm sure that there are far more cases where people die in need of organs. In the end, they only harm themselves, and it's not really about fault but about belief systems which they have grown up with and a medical system which gives power to the families rather than respecting the wishes of the deceased.
My husband and I have discussed the topic of organ donation many, many times with students as there's a lesson on it in one of the textbooks both of us use (Impact Issues) about the topic. There's a cultural reason for the Japanese not donating organs (likely based in Buddhism according to my students). They do not believe the body should be cut into after death and feel the removal of any parts inhibits their ability to reach heaven. As it was explained to me, they have to cross a river after death and not being intact makes it hard to do so. In fact, I recall a gruesome murder case awhile back where a little girl was murdered and her hands were cut off by the killer and the comment the mother made to the paper was something like 'how can my little girl get to heaven without her hands?'
While Japanese people are not religious, they can be superstitious and also become more spiritually minded as they get older (as do most people). They may not exactly believe in their faiths, but they figure it's better to be safe than sorry, especially about the afterlife. They're not the only ones who feel this way. Some people who are raised as Christians and abandon their faith will still baptize their children "just in case". The fears and ideas you are indoctrinated in can be very strong and it's something all cultures share, not just the Japanese.
The other problem is that organ donation doesn't only come down to what the person who died wanted. If an individual signs up for organ donation and his family decides they don't want him to donate his organs, they can cancel his request, so even open-minded, "fearless" people who go against the grain of their cultural beliefs can be trumped out of making donations after death by a family who is uncomfortable with the idea of organ donation. Given cultural notions about cutting up the body after death, I have to imagine that most families would opt not to allow for donations.