Tuesday, July 19, 2011

"14 children pronounced brain dead in past year did not donate organs despite legal changes

"Headlines were made across Japan in April when a child pronounced brain dead became the first and so far only child to donate organs under legal changes implemented in July 2010. A Mainichi survey has discovered, however, that at least 14 other children have been pronounced brain dead over the past year but did not donate any organs.

"The Mainichi survey -- conducted July 1-15 and receiving responses from 46 of the 56 medical institutions across Japan queried -- found that children had been pronounced brain dead at 11 facilities. Organ donations were not performed, however, due mainly to lack of parental consent or doctors failing to mention the possibility of donations. Particularly in cases of very small children, there was unwillingness among parents and doctors to equate brain death with the death of the patient, the survey showed.

"Organ transplants from brain dead children aged 15 and under became legal under revisions to the Organ Transplant Law that went into effect on July 17 last year.

"Among the 14 children revealed in the survey to have been pronounced brain dead, four did not make donations because parents would not consent, four because attending physicians could not bring themselves to suggest organ donation to the grieving family, two because doctors could not rule out that the child had been physically abused at home, and one because the doctor chose not to mention donations for medical reasons.

"Regarding the fact that just one brain dead child has donated organs in the past year, half the respondents said they had expected such a low figure, citing "parents' inability to accept that their child is brain dead" and "difficulty in ascertaining the role of physical abuse in a child patient's brain death," among other possible reasons.

"As of Feb. 1 this year, there are 303 medical institutions in Japan that openly perform organ transplants from brain dead donors aged 18 and over. Transplants from brain dead children are technically possible at all these facilities, though only 56 have declared their willingness to perform such procedures."

By Mainichi Shimbun (7/18/2011), Link to article (last visited 7/19/2011)

Monday, July 18, 2011

"Japan needs effective system for Hague child-custody treaty

"In line with Japan's decision to join the Hague Convention on child custody, work to create necessary domestic legislation is about to start at government organs like the Legislative Council of the Justice Ministry.

"The international agreement is designed to deal mainly with cross-border "abductions" by parents related to broken international marriages. If an international marriage collapses and one of the parents leaves the country with their child without consent from the other one, the treaty requires the return of the child to the country and the determination of the issue of custody according to the country's legal procedures.

"In a May Cabinet meeting, the government formally decided to sign the 1980 Hague Convention on the Civil Aspects of International Child Abduction. One key question is how to deal with cases in which the return of the child to the country of his or her habitual residence could undermine the welfare of the child.

"If, for instance, a Japanese wife returns to Japan with her child to escape from her foreign husband's violence or persecution, should the child still be returned to the country?

"At the time of the Cabinet approval of Japan's participation in the pact, the government specified several conditions that will allow it to refuse the return of the child under the law. They include: The child has suffered from the father's violence; the husband has exercised violence against the wife in a way that has seriously traumatized the child; the wife cannot go with the child due to financial and other reasons and there is no appropriate person in the country who can take care of the child.

"Some critics say these exceptional clauses would strip the teeth from the treaty. But these provisos are based on relevant court decisions made in countries that are parties to the treaty.

"The government needs to explain the intentions of these clauses carefully to prevent misunderstandings that could undermine international confidence in Japan.

"Whether specific cases meet any of the conditions that enable the government to refuse the return of the child will be determined by family courts in Japan, according to the government's plan.

"There are some important questions that need to be answered through in-depth discussions on actual cases. What kind of evidence is needed to prove the exercise of violence in a foreign country, for instance? What does the phrase "seriously traumatized" exactly mean?

"An accumulation of precedents would foster stability in court decisions on such cases and promote public understanding of the issue.

"Debate is also needed on the duties of the "Central Authority," which is supposed to play the central role in the proceedings for the return of the child.

"Under the treaty, the Central Authority is obliged to perform such functions as locating and protecting the child, providing information and advice to the parties concerned for the settlement of the dispute and securing the safe return of the child to the other country.

"None of these is an easy task. Some of the contracting countries post photos of children on the Internet to find them. But that wouldn't be acceptable in Japan.

"What kind of powers and information in the possession of public institutions should be used for carrying out these tasks? Should police also become involved?

"The Foreign Ministry, which will be designated as Japan's Central Authority for dealing with cases according to the treaty, needs to define its roles and responsibilities carefully by learning from the experiences of experts handling various cases of family disputes and listening to the views of the public.

"Japan will have to fulfill the obligations of a signatory country. But smooth enforcement of the law will be impossible unless there are clear ideas about actual implementation that are shared by all of society and enjoy broad public support.

"There will also be cases in which Japan demands the return of a child who has been taken to another country.

"There are no significant differences in parental love for children between fathers and mothers.

"Japan needs to establish a system that can deal effectively with cases under the Hague Convention. The system should not favor specific positions or viewpoints and should put the priority on the child's happiness."

By Asahi Shimbun (Editorial, 7/12/2011), Link to article (last visited 7/18/2011)