Wednesday, April 13, 2011

First Child Organ Transplant Under New Law

"The Japan Organ Transplant Network said Tuesday a child under the age of 15 was declared brain dead earlier in the day, in the nation's first such case under the revised Organ Transplant Law.

"The declaration was made at 7:37 a.m. Tuesday for a boy in the 10-to-14 age range who had been at a hospital in the Kanto-Koshinetsu region after a traffic accident, the network said. Several of the boy's organs will be transplanted at Osaka University Hospital and four other medical institutions, it added.

"The boy is set to become the first brain-dead donor aged under 15 in line with the revised law that took effect in July to allow organ transplants from brain-dead people aged under 15.

"According to the organization, the boy was taken to the hospital after suffering serious head injuries in the traffic accident. On Monday morning, three members of the boy's family were informed by his chief doctor and a transplant coordinator that his brain was highly likely to have lost most of its functions. His family then gave consent to donate his organs.

"Based on the law, the patient's first brain-death diagnosis was made at 8:25 p.m. Monday and a second, confirmatory diagnosis was made Tuesday morning, the organization said.

"The hospital's abuse prevention panel confirmed there was no physical abuse of the boy involved in this case as required by law, it added.

"The organs scheduled to be donated are heart, lung, liver, pancreas and kidney. An operation to harvest the organs was set to be carried out beginning 5 a.m. Wednesday.

""Our son told us he wants to do a job that would be of great service to society," his parents said in a statement that was read by Juntaro Ashikari, the network's medical section head, at a press conference Tuesday. "His wish didn't come true as his brain didn't recover. But his body hung in there with all the strength he had left. We've all agreed this is an action that would suit him. If parts of his body continue to live on in someone else, we feel it will offer a small measure of comfort in the grief we feel at losing him."

"Under the revised law, organ donations from brain-dead patients aged under 15 are allowed with the consent of their families unless the child had previously clearly expressed a will to refuse to donate organs. In this case, the boy did not leave any instructions about organ donation before he died.

"The law also requires institutions harvesting organs from such brain-dead children to confirm the children were not victims of physical abuse.

"The revisions to the law were prompted by new guidelines set by the World Health Organization last year that call on people to receive organ transplants in their own countries rather than overseas. However, whether the number of organ donations from brain-dead children will rise is in doubt, as determining whether children's brain deaths were caused by abuse is difficult and many hospitals are not yet capable of handling organ donations from children.

"Soichiro Kitamura, president emeritus of the National Cerebral and Cardiovascular Center, said: "Children account for more than half the patients who have had organ transplants overseas. If child patients come to be able to receive organs from children [in Japan], that would be socially significant.""

By Yomiuri Shimbun (4/13/2011), Link to article (last visited 4/13/2011)

Wednesday, April 6, 2011

"Prosecutorial reform must reflect outside opinion

"Prosecutorial reform must be carried out at the initiative of the prosecutors, but outside opinions, however harsh, should be considered with wholehearted sincerity.

"An expert panel, established in the wake of a series of irregularities involving a special squad of prosecutors at the Osaka District Public Prosecutors Office, has compiled a report listing recommendations and handed it to Justice Minister Satsuki Eda.

"In examining how prosecutors should carry out their duties, the panel called on the judicial and prosecutorial authorities to conduct a sweeping review of their functions, ranging from organization to investigative methods.

"In 2009, the prosecutors arrested and indicted Atsuko Muraki, a former director general with the Health, Labor and Welfare Ministry, in connection with a postal discount abuse scandal, although she was innocent. The prosecutor in charge of the postal abuse case tampered with evidence, and his misconduct was allegedly covered up by his superiors. The incident revealed structural faults within the prosecutorial system.

"The special squad of prosecutors ignored their mission of "elucidating the truth based on law and justice" out of a desire to establish a case against a senior bureaucrat of a central government office. They resorted to coercive investigation methods repeatedly, such as trying to obtain depositions that fit their storylines.

"Senior prosecutors of the Osaka District Public Prosecutors Office as well as the Osaka High Public Prosecutors Office and the Supreme Public Prosecutors Office approved the arrest and indictment of Muraki without recognizing how thin their case was.


"Monitoring function required

"It was natural for the panel to place priority on bolstering the functions needed to monitor the investigation process.

"To improve transparency, it proposed the establishment of a system in which outsiders would be encouraged to offer advice and a department to accept and deal with complaints about interrogations.

"The panel also proposed transferring the right to indict to prosecutors not belonging to a special investigation squad. Up to now, cases undertaken by a special squad are conducted under the guidance of the lead prosecutor. As a result, evidence is often not given the thorough assessment it should receive.

"Based on the panel's recommendations, the judicial and prosecutorial authorities must carry out drastic reforms as quickly as possible.

"Prosecutors must ensure their investigations bring perpetrators to justice, and that the rights of suspects and defendants are protected.

"Audio and visual recordings of closed-door interrogations are effective methods to prevent false charges. But police and prosecutors are concerned that recording all questions and answers during the interrogation process will make it more difficult to arrive at the truth.

"To what degree could such recordings be permitted so as not to affect investigations? We suggest the prosecutors carry them out on a trial basis in various cases involving special investigation squads.


"Don't depend on depositions

"The excessive emphasis placed on depositions in investigations and trials also should be examined. It is important to look into methods of investigation to establish cases that do not necessarily depend on depositions.

"A plea bargain system exists in some countries under which punishment is reduced if a defendant admits a charge. It is unclear whether Japanese society would accept such a system.

"The panel proposed the establishment of a forum to discuss such institutional reforms as well as legislative preparations for the adoption of audio and visual recordings of interrogations.

"We hope the judicial and prosecutorial authorities discuss reforms from a wide perspective while listening to the voice of the people."

By Yomiuri Shimbun (Editorial, 4/5/2011), Link to article (last visited 4/6/2011)