Bioethics in Japan, 1980-2009: Importation, Development, and the Future

267 Bioethics in Japan, 1980–2009: Importation, Development, and the Future A K I R A A K A B AYA S H I This article introduces the history of modern bioethics1 in Japan from its emergence in the early 1980s, and follows its trajectory into the present. This article supplements a previously published brief historical review2 of the 1980–2000 period and suggests that the history of bioethics in Japan can best be understood as occurring in two phases: Importation (1980–1999) and Development (2000–2009). In a field only thirty years old, it is still too early for a purely academic study based on historical archives. This essay therefore reflects the author’s subjective views of the history as a witness to many of the debates of both periods. Looking forward, I hope to see a “Phase III”, the post-2009 future of bioethics in Japan. Phase I, 1980–1999: The Importation Phase Determining exactly when modern bioethics first emerged in Japan is difficult. Some may argue that bioethics made its entrance with the 1970s regulations on recombinant DNA technology. Other theories place its origins in the feminist movement. Regardless of precisely when bioethics in Japan began, it is fair to say that its development was greatly influenced by trends in the West, specifically the United States, and that by 1980, the pursuit of modern bioethics had begun. The initial phase saw the translation into Japanese of many books and articles originating from the English-speaking world, such as Potter’s Bioethics, Rothman’s Stranger at the Bedside, Beauchamp and Childress’s Principles of Biomedical Ethics, Engelhardt’s The Foundation of Bioethics, and Jonsen, Siegler, and Winslade’s Clinical Ethics. A group at Chiba University made extensive efforts to translate the main body of literature on bioethics in the US and the UK into Japanese, Asian Bioethics Review September 2009 Volume 1, Issue 3 267–278 R E T R O S P E C T I V E B i o e t h i c s i n J a p a n , 1 9 8 0 – 2 0 0 9 : I m p o r t a t i o n , D e v e l o p m e n t , a n d t h e F u t u r e A k i r a A k a b a y a s h i A s i a n B i o e t h i c s R e v i e w S e p t e m b e r 2 0 0 9 Vo l u m e 1 , I s s u e 3 268 and compiled a collection of these materials. During this early phase, academia in Japan had its hands full simply trying to comprehend the trends taking form in the world abroad. Brain Death and Organ Transplantation The epoch-making event in bioethics in Japan was the debate surrounding brain death and organ transplantation, which unfolded across the nation beginning in the 1980s. This lengthy and very public debate, which spanned nearly two decades, embroiled academia, the general public, religious groups and politicians until it found tentative resolution in the 1997 Organ Transplantation Law. This unique law stipulated that only when (1) an individual makes a prior declaration of intent via a donor card, and (2) the donor’s family grants consent, can a legal declaration of brain death be made, permitting the extraction and subsequent transplantation of the individual’s organs.3 Organ transplantations from children under the age of 15 were not permitted at the time. Despite the very protracted nature of the debate, it is important to note that it was not until 1999, nearly twenty years after the issue arose, that the first organ transplantation from a brain-dead donor was actually performed.4 The brain death and organ transplantation debate revolved around several interrelated issues: the definition of death, Japanese views of life and death, sentiment toward the remains of the deceased, and mistrust of medicine. Because this debate was the first of its kind and there was a lack of experience with these issues, the discussion...