Organ transplants from brain dead patients are not uncommon in Japan. This article will look into the medical practices in the U.S. and Japan regarding organ transplants and investigate the ethics surrounding this procedure.

Is Brain Death is True Death?

Organ transplantation from brain dead patients in Japan was first permitted in 1997. October this year will mark 20 years of this practice. In that time there have only been 476 brain dead donors (Japan Organ Transplant Network Homepage). That is a very small amount compared to the U.S., which had 155,000 donors in the same period (U.S. HHS).

In a 2008 meeting, The Transplantation Society published a declaration stating, “Jurisdictions, countries and regions should strive to achieve self-sufficiency in organ donation.” This was a response to the problem of hospitals prioritising transplants for foreigners instead of citizens, despite the scarcity of organ donors. Countries such as Japan have been pushing for an increase in the number of donors.

However, the arguments for an increase in organ donors have missed a vital point. They have bypassed the question, “Are brain dead people really dead?”

To help us answer this question, let’s look at the story of a child who was pronounced brain dead three years , even though her heart is still beating.

Part 1

“My Daughter May Be Brain Dead, But She’s Still Alive”
A Mother, Her ‘Brain Dead’ Child And Their Three Years Together

Our journalist met five-year-old Nozomi Nishizu through the “You Are An Angel!” program, a support movement for handicapped children launched by Happy Science. When they met the girl was lying in bed and at first glance it seemed as if she had severe brain damage. Her mother, Satoko, explained that Nozomi had been pronounced brain dead.

Nozomi was in a traffic accident when she was 23 months old. An oncoming car crossed the centre-line and crashed front-on with Satoko’s car. Satoko was only lightly injured, but her daughter Nozomi wasn’t breathing when the medics arrived.

“I was mortified when the doctors at the hospital told me that my daughter may never return to normal,” recalls Satoko. “I broke down crying ‘I should have taken her place'”.

Despite being pronounced brain dead, Nozomi’s heart resumed beating with the aid of an artificial respirator, and her body felt warm. Her parents refused to accept that their daughter was dead.

Think She’s Dead? Think Again!

Usually a brain dead patient’s heart will stop beating within a week. This is because the brain stem, which is responsible for physical body functions, stops. Needless to say, when the heart stops, the body dies.

Nozomi’s heart, however, kept beating. At first doctors said her life expectancy was ‘one week’. That turned into ‘one month’, ‘six months’ and now they say she will live for another ’10 years’. She is currently being treated at home, and doctors come for a check-up twice a month. Since the accident, Nozomi’s weight has increased by 5.9 kg and she has grown 11 cm.

Satoko says that her daughter communicates through her body. “When I say, ‘we’re going for a walk’, her finger tremors,” explains Satoko. “When I put on her favourite music Nozomi flaps her hands, which doesn’t happen when I put on different music. Then I switch back to her favourite and she reacts again.”

The doctors thought Nozomi’s movements were reflex reactions, but they gradually came to understand that, “this girl is amazing.” She really is moving her body as a means of communication.

Satoko and her husband Masahiko learned of Happy Science through a friend, and decided to join in 2015. Happy Science teaches that the body is a vehicle and the soul is our true identity. Thus the couple learned that Nozomi was a soul residing inside a body.

“I always thought that the soul existed, but I thought it was some kind of ball of fire. I was so surprised when I learned that it can feel and think,” Satoko says.

A Firm Belief That Her Soul Is Healthy

Satoko had a hunch: their daughter may be brain dead, but her soul still resides in the body; she is probably aware of her surroundings. Satoko’s hunch became a conviction when she joined the “You Are An Angel!” movement.

“A local friend recommended me a book on You Are An Angel,” explained Satoko. “It said, ‘Even if their body does not move the soul is healthy, so even if they cannot talk they can understand when you talk.’ It confirmed my belief! I then read the section with testimonials from various mothers with disabled children, and felt great empathy.”

As for Nozomi, she learned to communicate through finger pressure language. Below is part of the interaction that our journalist witnessed:

 
Nozomi: “Where is this?”
Satoko: “We’re at a restaurant”
Nozomi: “It’s our first time here”

 
It is beyond doubt that Nozomi is aware of what is going on around her.

She also empathizes with the feelings of her family and those around her. At a “You Are An Angel” gathering in June at Happy Science Osaka Shoshinkan, Nozomi used her finger pressure language to say: “I know my mother is now relieved because she doesn’t make sad faces anymore. My mother is human: naturally she was often gloomy due to my condition. But she hasn’t been downcast at all lately, and that makes me really happy.”

Nozomi was recently liberated from long periods of hospitalization, and her condition has stabilized.

“I remembered that when I quarreled with my husband just after the accident tears trickled down Nozomi’s face, and when I would tend to her with a gloomy attitude she would cry then too,” Satoko says. “Her finger twitches when she knows I’m having fun. That’s why I realized that it’s best to live everyday with a sunny smile and positive attitude, and I’ve tried to do so. Our child has the power to draw out bright smiles and compassion from the family and those around her.”

Chronically Brain Dead Children

There have been numerous reports of chronically brain dead children whose hearts continued to beat for over 30 days. One case reported that it continued beating for five years. Some doctors at the Japan Pediatric Society have started to doubt the idea that being brain dead means someone has died.

In September, The Liberty Magazine interviewed Dr. Hidetaka Tanaka who pushes for a revision of the child organ transplantation policy. “There have been reports of babies whose respiration resumed after being pronounced brain dead, but neither transplantation advocates nor the state government accept this,” lamented Dr. Tanaka. “In medical science, brain dead people are not considered dead. I want the people to realize this.”

What is Brain Death?

Brain death occurs when the patient’s brain ceases to function, and he or she no longer shows any sign of consciousness or reaction.

A similar condition is a ‘coma’, with the single difference being that the part of the brain responsible for respiratory and circulatory functions remains active. With brain death, even these functions cease to work. Thus a brain dead patient cannot breathe without the aid of respiratory equipment, and often the heart stops within a matter of days.

Part of the reason why doctors erroneously want to deem brain death as true death is because organ transplants have a higher success rate if the organs are extracted before the heart stops.