Sunday, June 14, 2009

Organ Transplants, a Boy's Life, and Japanese Laws and Customs: This Catholic's View

The CNN headline tugs at the heartstrings: "Boy not allowed to get life-saving transplant in Japan," and so does the account of what Hiroki Ando and his family are dealing with:
"Eleven-year-old Hiroki Ando will likely die if he does not get a new heart.

"Hiroki suffers from cardiomyopathy, which inflames and impairs the heart. The same disease killed his sister five years ago....

"...'We were told by his doctor at the end of last year that the heart transplant operation was the only way for him to survive,' [Hiroki's father] Ando said.

"But the law in Japan prohibits anyone under the age of 15 from donating organs -- meaning Hiroki can't get a new heart in his home country...." (CNN)

Hiroki Ando, Heart Transplants, Feelings and Respect

(from CNN, used w/o permission)

My feelings - and, more to the point, prayers - are with Hiroki Ando and his family. Losing a child to death is a terrible loss. The prospect of going through that experience twice in a few years must be a severe emotional strain. Particularly when medical technology which might save Hikori's life is available, but illegal in the family's country.
Every Law is Made for a Reason: Sometimes a Good Reason
I like to believe that lawmakers generally mean well when they make up a new law. That doesn't mean that I think all laws make sense.

I don't know why Japan's lawmakers banned organ donations from youngsters, 12 years ago. I trust that there was what seemed like a good reason to do so.
Beware Unintended Consequences
Whatever Japan's lawmakers had in mind when they banned people under age 15 from donating organs, the effect was to limit organ transplant recipients among Japanese children to those whose parents could take them to a country where the life-saving procedures were legal.

Well-intentioned laws having unforeseen consequences is nothing new.

I once read of an English king who banned wooden plates and tableware. England was (and is) a maritime nation, and needed wood for shipbuilding. By requiring English families to use ceramic, the king thought he was keeping them from wasting precious wood on tableware. Eventually, England's rulers discovered that it takes more wood to fire a ceramic plate than it does to carve a wooden one.
Japanese, American Culture's View of the Heart - Not All That Different
The Euro-American culture I grew up in links the heart to emotions, and to life itself. We have phrases like "I know in my heart," and "as long as this heart beats."

When I was growing up, if someone's heart stopped beating, it had to be re-started - fast - or that person was dead. In my youth, newspapers and magazines published medically-illiterate headlines like "Doctors Bring Patient Back to Life," or "I Was Dead for an Hour on the Operating Table."

That was when the cardiopulmonary bypass, or heart-lung machine, was becoming less of an experimental device, and more a standard piece of surgical equipment.

Around that time, the idea started catching on that the heart was a wonderfully effective pump - that could, if necessary, be stopped for an operation: or swapped out for another.

Americans still use phrases like, "two hearts beating as one," but I think most of us realize that the heart is a wonderfully effective pump. And that it can, if necessary, be stopped: or swapped out for another.

It's possible that Japanese society is dealing with that idea now.

"Brain Death," "Persistent Vegetative State," and Human Life

Brain death has been defined as:
"The total and permanent loss of all brain function; a medical and legal determination of death."
(Glossary, The Gift of a Lifetime)
I think there are three key words in that definition:
  • Total
  • Permanent
  • All
That's not the same as a phrase that still comes up now and again: "persistent vegetative state."

Patricia White Bull was in "persistent vegetative state" for 16 years. Then, she started talking again.
"...'Don't do that,' she blurted out when nurses were trying to fix her nursing home bed...."
Happily, nobody had decided to break her down for parts while she was out, so her family got her back.

An important point here, from a Catholic perspective: A human being doesn't become a vegetable. Even if our eyes stay closed for a long time.
"...The term "persistent vegetative state" was coined in 1972. Physicians said then that patients with this diagnosis had no consciousness or sensation, and could not recover once they had remained in this state for a certain number of months...."
By now, enough people who couldn't possibly ever emerge from a "persistent vegetative state" sat up and started talking, so that even doctors are conceding that maybe the condition isn't as persistent as they thought.

What's a bit unsettling is the fact that some of those people had their organs harvested before they could say: "Don't do that."

"Brain death" would seem to be on more solid ground: but even there, human life isn't as certain as we'd sometimes like.
"...As the June 1987 issue of Annals of Neurology has noted, there is no medical consensus on standards for determining "brain death" in newborn infants less than a week old, because infants' brains are much more resilient than those of adults and so more capable of regaining functions after a period of inactivity. The resiliency is even more apparent in the brain of the unborn, which is one reason why fetal brain cells are of such interest to transplant surgeons...."
The complete, total loss of all brain function - in an adult - does seem to be a fairly definite indication that the person is dead.

Still, it can't be easy to acknowledge that a loved one is, in fact, dead: when some of the other organs are still working.

Back to Japan. Apparently Japanese culture also associates life and the heart.
"...'Japanese cannot easily accept brain death as "death" . . . but I believe this plan would leave that opinion up to individuals, while opening the door for child organ donations,' [Liberal Democratic Party member Takumi] Nemoto said..."

"...Brain death is a sensitive issue, as many family members refuse to accept this if their loved ones' hearts are still beating....." (The Japan Times Online)

"...'For a long time, it's the heart that mattered in Japan. Some religions ask us not to declare being brain dead as death. But that is not the majority,' [lawmaker Taro] Kono said. 'So it is simply that we have been doing things this way and a lot of people are very skeptical about it.'..." (CNN)

This Catholic's View

This matter of deciding when a person is actually dead: and whether it's okay for a child to donate organs after death isn't simple, but that shouldn't be a surprise. As I wrote in another post, "...The Catholic Church deals with the real world, and simple it isn't...." (March 25, 2009)

(On the other hand, we've got the short form of the Bible that's in Mark 12:28-31. I've been told that the rest of Scripture can be seen as commentary on 'love God, love your neighbor.')

Organ transplants, from an adult who voluntarily donated his or her organs, are not merely okay, the Catholic Church recognizes donating organs as an act of charity (May 6, 2009)

When children are the donors and recipients, there don't seem to be obstacles either: apart from the Church's frowning on killing anyone for their parts. Although the Catholic Church recognizes that children are children, and not undersized adults, the Church also recognizes that children can think, and make decisions.

Answering a question about the age at which Confirmation may occur, a Licentiate in Canon Law wrote, "...the preference of the LAW is the age of discretion which is presumed at age seven (canon 891)." (October 3, 2004)

So, it would seem that there aren't barriers for Catholics to voluntarily donate their own organs. And, since it's clear that parents are sometimes expected to make decisions on behalf of their children (USCCB, in the context of experimental medical procedures), there doesn't seem to be a problem with parents allowing the organs of their child to be donated. Provided, of course, that the child is actually dead.

Finally, the Catechism quotes Saint Thomas Aquinas:
"...Age of body does not determine age of soul. Even in childhood man can attain spiritual maturity: as the book of Wisdom says: 'For old age is not honored for length of time, or measured by number of years.' Many children, through the strength of the Holy Spirit they have received, have bravely fought for Christ even to the shedding of their blood."
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What's That Doing in a Nice Catholic Blog?

From time to time, a service that I use will display links to - odd - services and retailers.

I block a few of the more obvious dubious advertisers.

For example: psychic anything, numerology, mediums, and related practices are on the no-no list for Catholics. It has to do with the Church's stand on divination. I try to block those ads.

Sometime regrettable advertisements get through, anyway.

Bottom line? What that service displays reflects the local culture's norms, - not Catholic teaching.