A
Comparative
Study
ofNews
Coverage
ofOrgan
Transplantation
in
the
U.S.
andJapanD
Eiko
KAWAGOE
Kobe
City
College
ofNursing
Abstraet
Thispaperreviews news coverage of organ transplantation as itappears innewspapers inthe U.S.and Japan.
Thereisa greatdifferenceinsuch eoverage betweenthe two nations with regard to Japan'sfirstorgan t,ransplant
and transplantations performed thereafter inthiscountry.
With regard toJapan'sfirstorgan transplantation, the loealpress givesextensive detailsof the transplautation it-self, while inAmerica the focus ison the factthat in Japan the event was nothing lessthan epoch-making.
Inthe news coverage of organ transplants performed in 2000,one year after the firstorgan transplanL in Japan,
the Japanese.pressdiseussessueh matters as `cases of organ transplants from brain-deaddonors,'`the
patients'
pro-gressafter organ transplants from brain-deaddonors,'`cases
of ether organ transplanLs,' `organs donated by
brain-dead ehildren,'
`incidents,'
'measures
to improve organ transp]ants,' `maLpractice'and so. On the other hand,
American papers report on `politics,' 'cases of organ transplants performed on celebrities,' 'unusual caf,es,' 'researeh
cases,'
`the
lackof organs,''medicine,'
`organ
transplant networks,''ethics;
`ineidents' and so on.This differencedemonstratesthat while brain-deadorgan transplantation has
just
begun inJapan it,has alreadytaken root in Arnerican soeiety and now presents the problemef a lackof organs. The discrepancyliesin differences inJapaneseand American views of lifeancl death,religion, cukure, medical ethics, politics,eeonomics and so on. Key words1ergan transplant, news coverage, newspaper, the U.S., Japan
1.
Introduction
The Organ Transplant Law was enforced in
Japan
onOct.
16,
1997.
0ne
year andfour
months later,on Feb, 28, 1999,the firstorgan
transp}ant
from
abrain-dead
donor
wasper-formed, sinee which time there have
been
only 21brain-dead
donors(as
ofOct.
31st,2002), Atthis turning point
in
Japan's
history,
I
wantedto study the present state of organ transplants
in
thiseountry and the U.S.,a veritable organtransplant powerhouse, and compare the two
countries, with a view to examining the
future
state of organ transplantation in
Japan.
Though
a great number of researchersfrom
various fieldshave studied organ transplantation,
few
have
investigated
how
the mass media havereported on the subject. First,Icompare articles
from newspapers inthe
U,S,
andJapan
thatre-ported on the
first
case of organ transplantationperformed m
Japan.
Seeondly,
I
look
at articlesreporting thereafter
in
both
countries andexam-ine the differencesbetween the two. I then
at-tempt to explore the
differences
between
thestate of organ transplantation and the
back-ground to such transplantation
in
the twona-tlons.
2,
Reports
of thefirst
legal
organ transplantin
Japan
from
abrain-dead
patient onthe
basis
of theOrgan
Transplant
Law
The
headlines
of Japanese newspapers read,`Brain-dead
organ transplantation
begins:
heart and liver,Osaka UniversityandShinshu
University,
the
first
casein
Japarf
(Mltinichi,
Feb. 28, 1999);`The
first brain-dead transplantation,
Kochi,
Brain
death
wasdetermined'
(Sanhei,
Feb. 28,1999};and `The firstlegal
judgment
isbrain
2
"mpPfiEffJI<Vke?
voLz 2oo3providedconcrete details.Meanwhile, the American
media ran articles on the
first
casein
Japan
onMar. 1.
-The
headline of The Washington Post was, `Japan Enters,New
Organ-Transplant
EraJThe
Neu;
Yorh
Tinzes
reported the event with theheadline,`Death Taboo Weakening. Japan Sees
lst
Transplant.'
The
headlines
of theBoston
Globe
and theChicago
Tribune were similar.In the body of the articles in Japanese
news-papers,
further
details
were provided such as thefact
that aninpatient
ofKochi
Red
Cross
Hospital was determined brain-dead,the patient's
history,
the proeedurefor
diagnosing
'
death,the patients donor card, the Japan Organ
Transplant
Network's
organ transplantselectionprocess,that the heartwas transplantedtoa pa-tient in Osaka University, the liverto one in
Shinshu
University,
thekidneys
to patients inthe National Nagasaki Central Hospital and
Tohoku
University,
and thelungs
to onein
Osaka
University,
Details of thedoetors'
pressconference were also given.Inaddition to all this
inforrnatien,
thebasis
ofbrain-death
diagnosis,
the number of organ transplants in the world, an organ transplant performed by Prof.Wada 31
years ago, and so on were referred to
in
passing.The significance of organ transplants, however,
was not mentioned
in
the reports of thefirst
legal
organ transplantin
theJapanese
news-papers.
Meanwhile, in the American media,
details
ofthe
first
organ transplantin
Japan
receivedlittle
attention; rather, the fact that Japan
had
reached an epoch-making moment was the main focus. The key words used repeatedly were`mile-stone,'
`debate,'
`taboo'and
`mistrust'.
The
pa-pers also said that
before
arriving at this`mile-stone,' the Japanese
had
had
a`fiery
debate'or
`years
of
debate'and
that behind all thislay thefactthat organ transplants
from
brain-dead
do-nors had been regarded as`taboo'
anddoctors
had
also given rise to public`mistrust'in Japan.
They
further
said that such`taboo'
was based onthe Japanese view of lifeand death
--
that as theJapanese
have
long
regardedheart
death
as`death',
thereha's
been
a greatdeal
of resistanceto organ transplantation from brain dead
do-nors, and many
Japanese
have
traditionallybe-lievedthat the donor's spirit isalso transplanted
with an organ.
Thus,
it
has
taken theJapanese
along
time to come round to theidea
ofper-forming organ
transplants
frombrain
dead
do-nors. This type of reporting in America, whichde]ves
into
theJapanese
view oflife
anddeath,
is
interestinglyquitedifferentfrom the kind of
de-tailsthe
Japanese
press gave of thefirst
trans-plant.
Doctors
tonight performed thefirst
legal
organ transplantsin
Japan
from
a dead patient,a milestone for Japanesecine and an event that
has
transfixed thenation,
(washingtonpost.com,
1999,March 1)
(Author's
underlininghere
andbelow).
The
operation was an ethical and emotionalmilestone ina country that has
long
believed
that death comes only after the heart stops
beating
and thebody
turns cold.(nytimes.
com,1999, March 1)
Nearly
two years ago,Japan
was locked ina
pmtier
debate over transplantsand ponderingthe
definition
efdeath.
Many
Japanese
feel
uneasy about
defining
brain death as the endof
life.
(nytimes.
com,1999,
March
1)
The
1997
organ transplantlaw,
passed after
Mga:s...o.wfrd.eTbate
on the subject of brain deathand organs transplants..,(latimes.com,
1999,
February
28)For the firsttime in Japan, doctors
formed a legal heart transplant today, a
striking at a taboo on taking organs
from
consider
dead.
(nytimes.
eom,1999,
Mareh
1)
Japan welcomed the success today of
four,
weekend organ transplants,
heralding
a newera in medicine in a nation where a gdeep
mistrust of
doctors
has
for
decades
kept
suehoperations unavailable.
(boston.
com/globe/1999,
March 2)3.
Reports
on organtransplants
in
theU.S.
and
Japan
in
2000
I
will now review news coverage of organtransplants reported inboth the U.S. and Japan
inthe year 2000,one year after the
first
organtransplant
in
thiscountry,Iwill
compareJapanese
news coverage of organ transplants as it
ap-peared
in
The
Mainichi
Shimbun
andAmerican
news coverage appearing in The AJbw YOrh Times
and The Wdshington
Post,
and examine theeir-cumstanees surrounding organ transplants and ways of reporting on the subjeet
in
both
coun-tries.
I
entered thekey
words `organ transplant; searched the archives of each newspaper andse-lected
and reviewed all sueh artieles.Though
I
searched only one Japanese and two Arnerican papers, I
found
about the same nurnber ofarti-cles:
Japan-58,
U.S,-57.
3.1
News
Coverage
in
Japan
The
fifth
to thetenth case of organtransplan-tationinJapan were reported one after another.
Table1 MeinichiShimbun
(Jan.
--
Dec.2000)Organ Transplantationinthe U.S,and Japan
3
This
represents thelargest
number of reports, amounting to some 43% of the total. Theypro-vide
details
of each casejust
asin
theflrst
case.Additionally,the patients'progress after
brain-dead organ transplantation and eas+L,s of other organ transplants were also reported.
The
total percentage of cases of organ transplant amountsto 57%,the
largest
percentageof all.The
issue
of organ
donation
by
brain-dead
inlantdonors
was also raised, as organ transplant]aw only
al-lows persons older than
15
years of age to do-nate theirorgans and a revision in the law isnecessary, Under the heading `incident,'
the press
reported on
Japanese
touristsassault,edby
local
natives inthe Republic of Guatemala. This came about as thelocals
were under thefalse
assump-tionthat
Japanese
touristskidnapped
nativechil-dren
for
the purpose of organ transplants.Measures toimprove organ transplants
include
the need to increase the nurnber of institutions
to perform organ transplantation,the
lnaugura-tion of the
Japan
Transplant RecipientsOrganization
and the SupportCenLer
for
Recip-ients'
Families,
and the expansion ot'insurance
coverage
for
organ transplantanddonoT'
cards. As seen above, articles on cases of organtrans-plantsaeeount
for
57%
of the total,and together with problems of infantchild organtransplanta-tion and measures
for
future
organtran.splanta-tion,constitute themajority of articles c/nergan
transplants in Japan, This fact demonstrates
that
Japan
is
at thedawn
ofbrain-dead
organSubjeetmatter Nurnber
yo6
Casesoforgantransplantfromabrain-deaddonor
25
43e/o
Patient'sprogressafterorgantransplantfromabrain-deaddonor 3t.t.t.t.5o%t-tLt...t. Casesofotherorgantransplants5
tttttttttt9%579tt
Organdonationbyabrain-deadchilddonor 7 12.U/oIncidents
6
1OP/,
Measurestoimproveorgantransplant6
1Ollfo
Other
6
1O%o
Total 58 1OO%,4
pmpmEas]kl*seg
voLz 2oo3 transplants.3.2News Coverage inthe U.S.
As
seenin
Table
2
below,
in
theU.S.
thepoliti-cal aspects of organ transplants accounts for25% of the total number of articles, while `cases of organ transplantperformed on celebrities,'
`unusual
cases,' 'research
cases,' and `Iack of organs'
follow
`politics.'
Organ transplantations are performed
on a
daily
basis
in
theU.S.
In
the year2000,
22,854cases were performed, with the number of
liver
andheart
transplantationsfrom
brain deaddonors
standing at4,934
and2,197,
respectively,Z'which means that fourteen cases of
liver
trans-plantationand six cases of' heart transplantationare performed every
day
somewherein
theU.S.
Organ transplanLation perse istoo common inthe
U.S.
tomake thenews(Sato,
1999)
and thisis
fun-damental}y differentfrom
Japan,
where we are nowwitnessing the
dawn
of organ transplantation.been
responsiblefor
distributing
organs.This
means that there are two points at issue. Thefirst
point iswhether organs should bedistrib-uted loeallyas
before,
or nationally.The
secondiswhether organs should be
distributed
by
theprivate sector as before or the federal govern-ment.
At
issue
are whetherdonated
organs, whenthey
become
availabie, shouldbe
distributed
lg,.c.pl!y-g!-ug!t!gpaU}{ll
and whetherdecisions
about thesescarce resources should be madeprimarilyd
tth
tte
thfd1 gglce!lggleg!t,(nytimes.com,
April 13,2000)The
House
distributed Last assedpassedlecally,
week, a bill abill
to allow maintaining theby
nearly2
that would organs tobe
status quo. to1,have
thetheHouse
effect of 3. 2, 1)PoliticalaspectsThe leading articles in the U.S. in the year
2000 were `political'. When organs are offered
for
transplant, the problemis
how
to distribute them.The
number ofpatients
who are currently waiting fororgan transplantation inthe U.S. isabout
79,OOO,
but
some5,OOO
peopledie
without achance toreeeive transplants,
Under
such severecircumstances, itiserucial to decide how donor organs should
be
distributed,
(Craven,
1992)
The whole nation was divided into 62 areas, and
in
each area a privatenonprofitorganiza-tion,the
United
Network
for
Organ
Sharing,
has
Table2 TheAlbvvYbrk Times The
Itugiglai!gpg-this-st th stemand tional2000)
The
Senate
distributed
aeross the Theyearsthrou distribution.(nytimes.eom,shared the
idea
that nationally, with thenation given priority.
preventmg
Aprilna-13,
organs should be
sickest patients
administration has been arguing for
thatp
hldbhdbdl
mhout the countr with the siekest
a-valhshingtonPost
(Jan.--Dec,,
tie/I!it!s-ggue!a!!>Lgiy{11enpr.Lo.!}IJI
ltll!Lwggld-mg
ll
ld
ktht
bl
2000).
The
Senate
(nytimes.com,
Subjectmatter
Number
%
PoLitiealaspeetsoforgantransplantation
14 25%...Casesoforgantransplantsperformedoncelebrities
122ttt1%
Unusualcases 9.t...t16%
Researchcasestt-tt.tt...
7
12foo
Laekofttorgans
tttttt
ttt
6 11%Other
ttttttttttttttttttttt
9 16% Total 571oO'/e
AprLl
13,2000)
The
gapbetween
theHouse
and theSenate
is
ex-pressed inan interestingway.
We
(the
members of theHouse
and of the
Senate)
are stills
ut
d
fth
u
trndCant
th(nytimes.com,April
13,20eO),(parentheses
addedby
thisauthor).The reason why there isa differenceof opinion
between
theHouse
and theSenate
is
that rr)anyRepresentatives are elected by localpeople. As
mentioned above, organ transplantation
in
theU.S.
is
performed
on adaily
basis,
and suchsur-gery,which can
be
done
onlyin
leading
hospita]s
in Japan, can be performed even in relatively
small
hospitals
in
theU.S.
The
Representatives
try to proteet small hospitalsin their own con-stituencies and maintain a system
in
whichor-gans are distributedlocally,
As
for
the second point,the governmentde-cided, as a compromise, to allow the
United
Network
for
Organ
Sharing
tocontinue tobe in-volvedin
thedistribution
of organs,but
con-eluded a contract with another organization, theUniversity
Renal Research and EducationAssocia-tion of Ann Arbor, to look for a betterway of
doing
so.But federalhealth
.o.uf.f.i.qlails
seleeted anothero!ga,.nizatkiggL!!!g-I,!uiyg!glbLBe!!a!-BgsealgbtiontheUniersitRenalReseah
and Edueation
Association
ofAnn
Arbor,
Mich.,to run the scientific registry thatamines
how
transplant patientsfare
andhow
ehanges in organ distributionpolicy affect
them.
(nytimes.com,
September
29,2000)
To
dernonstrate
how
large
the number ofarti-cles on the politicalaspects of organ transplants
is,I searched all the articles with Word
Smith
Ver.
3,
whichis
a very effective tool incorpus research. Ifound that 73,412words are used inOrgan Transplantationinthe U.S.and Japan 5
the
57
American
articles, with a nurnber ofwords being used repeatedly, and that
8,811
terms are used, one term being used 8 times on
average,
However,
`Gore'
is
used118
tirrLes, `pre-sident' 55times,
`government'41
times, 'vote'41
times,
`guidelines'35
times,`contract'34times,
`Clinton'
32
times,`Congress '32
times,legislation'
17 times and so on. Thus, such politicalterms
are used extensively and
dernonstrates
that theissue
of organ transplantationsis
close}y relatedto politics in
the
U.S.
Political
termsin
Japanese news coverage, on the othei' hand, are
rarely seen.
Within
this news of a rriore politica]nature, weean
find
a variety ofissues
related toeconomics.In
theU,S.,
where no lessthan 22,OOOcases oforgan transplantation are performed a year,the
issue
ofdistributing
organsis
an economic aswell as a politicalone.
p
thdbtt
t1ltcLl-butalsoeconomic.
Small
transplant eenters t'earedthat the new rules would
put
them out of business by steering organs to larger,city
hospitals.
(nytimes.com,
September
29,2000)After fiercedebate, both in the House and the
Senate,
the government concluded a contractwith The United Network for
Organ
Sharing andsigned a
$100
million deal for 5 years,The United Network for Organ Sharing of
Richmond
won what couldbecome
ayear,
$100
million contractfrom
theHealth
and
Human
Services
Department toter the national system
for
organ matchingand distribution.
(washingtonpost,eom,
October
g,2oeo)
'
A large sum of money
is
consumed'by
the net-work alone.Organ
transplantation has beenre-ferred to as `luerative transplant work.'and
is
6
ptpntg#v<\*e-
vol.z 2oo3Regional networks feared losing lucrative
pt
1t
mktoout-of-towneenterssuch
as the Universityof Pittsburgh.
(washingtonpost.
com, April
5,2000)
3.2.2)Organ transplant
performed
on celebritiesThe second
largest
number of reports on organ transplants inthe U.S. press concerns thoseper-formed on celebrities,
including
the case of apro-fessional
basketball
player
returning after akidney
transplant,and the case of a governorre-ceiving a rare
heart
andliver
transplant,Medically, it'snot a miracle that Elliottis
back
la
in
for
theSan
Antonio
Surs
seven months after havin a kidne
trans-p!lag!,t
But
it's
unique.No
other athletein
any major professionalsport has played again
after an organ transplant.
(washingtonpost.
eom,
March
18,20eO)
Mr. Casey helped todraw national attention
to organ
donations
after his lifewas savedb a rare heart and ]ivertrans
lant
in
1993,when
he
was still ggyg!pgL(nytimes.com,
May
31,2000}
3.2.3)
Unusual
cases of organ transplantsThough organ transplants may not be a very
hot topic in the
U.S.
press,very unusual cases are played up: a spouse-to-spouse transplant,anArab-American
Muslim
deciding
tobe a donor-a courageous decisionas Muslims are
forbidden
from
becoming
donors
for
organ transplants,and the daughter of a eardiologist receiving a
heart
transplant,Dr.
Wayne
C.
Waltzer
removed one..of Mrs.
O'Neill'skid..aeys-audt-Ulagsp!gn!gdllLip!g-kg!
t 1tdtthhusband.
"pSpguse:!gzEpgyt
ose.rv.t.lgusp!lau!s-a!gt
lt}ggQgggg-ing!gaEiugi>Lggguu!
1cmmo-n.,."
explained.
(nytirnes,com,
JanuaryDr.Waltzer
16,2eoo)
p
m
t B
deAl{ar.amationiscontroversial.
As
an
Arab-AmericanMuslim
-....,um.Ltpart
she ef agg.nm..LIuutugit!M-!baLg!dgu!!)Lbe!ieygs-l!-is-gg!]:thatardentlbelievesitisfor
dona/tgg-g!ggusLgyggseen
to a relative, To see Heaven, they say, theirbodies
must return toGod
in
one piece,(nytimes.com,
May
20,2000)
A
loeal
cardiologistdiscovers
that "the worstheart
of anyone I'dever seen"belonged
tohis 14-year-old daughter,...Sarah's illness
seemed to
him
incurable.
His
dual
role-as ah
sieian who understood the condition andbidden
for
Muslims toi!t{Liigpli!a!ig!sltglulM-!ggt
-w.ell
and asthefathergC/-!bg-pgtignLithtt
hdhl(washington
post.com,June 20,2000)
3,2.4)
Research
casesThe fourth rnost frequent type of case, the
`research
case,t
has
a greatimpact
on alarge
number of people as they are articles run not in medical
journals
but innewspapers readby
thegeneral public. Research to create genetically
al-tered pigs whose organs can
be
transplantedinto
hurnans,
research to savediabetic
patientsby
transplanting cells from the pancreas,research to
cure a
heart
by
ereating new muscle andblood
vessels
fashioned
from
cells scavengedfrom
the patient'sown body. These stories are all good newsfor
thousands of people.
The
goal,PPL
said,is
touse thetechnology
itig-!!ga!e-gege!!gg!!y-gl!gge
t t11ltedmmpigErwghgsg-gLoseor gausp tt1tdthap.s.withTt
ggit/-beiggb u.-s>[E!tglm..,zgj!g!tlgg-py-!gg-pymag-upg]dbthehumanimmn..ne
(nytimes.com,
Mareh LT!ge-!!ggsuht 1.a.p.tgdcellsisolated 15,2000)
form the.-nepg Mcreaswerehar:.g!ttedfromdeceased
donors. The goalvide an easier andof
thesafertreatment
is
alternative to orga/pto pro- trans-pLauitgug-!ge-guu!e-pggg!'th
t'' q.s.-.(nytimes.com,
May 27,2000)Doctors
may soonbe
able to rejuvenateweakly pumping hearts by creating
brand-new rnuscle and
blood
vesselsfashioned
frorn
cells scaven ed elsewherein
atients'bodies,
new research suggests.(nytimes,com,
November 14,2000)3.2.5)
Lack
of organsThe laek of organs isa serious problem in the
U.S,
(MeCullagh,
1993)Though
thisis
men-tioned
in
many articles that are not specificallyabout a lack of organs, such articles ineludethe
lack
ofAfrican
American
donors,
an author whopublished
abook
on hissister's organtransplan-tationto increasethe number of donors, a gospel
festival
toincrease
the number ofdonors
for
mi-norities, and so on.
Clive
O.
Callender
said that when itcomes to organdonation,gmglg-Atg!igglLAIug!lgf
A s..th..eneedsp
/1
t
tdthd argfew.
(washingtonpost.com,
February 23,2000)The
storyis
toldin
Mr.
Marx's
newbook,
"ItGets Dark Sometimes: M Sister'sFi ht to
Live
andSave
Lives"
Most donated trafficaccidents.,
the
United
States
organs
..Mr.
(JAM
Publishing).,.
come as a result of
Marx
testifiedbefore
!gaiLgdgpg!o
awareness,..,
(nytimes.com.
March 19,2000)
More
than 1,OeOpeoplewill participatetodayin an outdoor gospel festival at First
Seventh-day Adventist Church in the District
that
is
intended
toboost
abone
marrowandgngag-dtgpallg!Lddyg-!guiggg!lllgg,t
d
f
t
(washingtonpost.eom.
July 22,2000)4.
Background
to the coverage on organtransplantation
Up to this point Ihave reviewed the coverage
Senateabout
orOrgan Transplantation inthe U.S. and Japan
7
on organ transplantation inthe U.S, and Japan,
I
would nowlike
toturn to thebackground
tosueh coverage. The articles from Japan demon-strate that this country
is
at thedawn
of organtransplantation.
The
American
coverageinclude
politics,organ transplants of celebrities, unusual cases, research cases, the Iack of organs, and so on, and thiscomes
from
abackground
in
which organ transplants have taken root in iXmericansociety, and
in
which thereis
a serious problemcaused
by
thelack
of organs.These
two points illustratethecontrast between the two countries.Iwould
like
todiseuss
thesetwo pointsin
moredetail.
4.1
Japan
at thedawn
of organ transplantationvs. the
U.S.,
where organ transplantation hasal-ready taken root insociety
Organ
transplantationbegan
in
1963
in
LheU,S,,and in 1964,
just
one year later,inJapan.Thus,
the two countriesbegan
organtransplan-tation almost at the same time. The world's
first
heart
transplantation was pe]'t'ormedin
1967.
(Fuse,
1992) The firstheart transp}antationin Japan was performed one year
later,
In
Japan,
however,
heart
andliver
transplantationshave
notbeen
performed since then. Then, forthe firsttime in 30 years,a heart
transplanta-tion was performed
in
1999.
In
the meantime, such transplantations have been perforrnedcon-tinually
in
theU.S.,
and the number ofheart
andliver
transplantationshas
increased
dramaticallysince the widespread use of the immunosuppressive
drug,
Cyclosporine.
(Trzepacz,
2000)
What created this hiatus of 30 years? When
the
first
heart
transplant was performedin
Japan
in
1968,
thepatient
died
following
thesur-gery, and suspicions about decisionsconcerning
the
donor's
point
ofbrain
death
and aeceptaneeof the organ by the recipient were pointed out.
Prof.
Wada,
whoperformed
theheart
transplant,was sued for murder. Though the doctorwas ex-empted from prosecution,the case inviteda sense
8
IrpFi'HiEk.K(\$E.M
VoL7, 2003of
distrust
in
medical care, and raised suspicionsin
Japan
about organ transplants, especiallyorgan transplants dependent on the point of
brain
death.
These
faetors
resultedin
adelay
in
organ transplantation.
Furthermore,
theJapanese
people hold the beliefthat the deceased'sbody should remain
intact
afterdeath,
and that organtransplantation also means spiritual
tion,as reported in The New Ybrk Times. The
Japanese cannot
believe
that a manis
dead
whenhis heart is still beating. They believea
dead
person can still come tolife
againif
his
or
her
heart
is
functioning,
It
is
because
of thisview of lifeand
death
and theirreligiousbeliefs
that the Japanese find itdifficultto achieve a
consensus on
brain
death
and organ tion.
On
the otherhand,
Americans
do
notkeep
ing on" to a
dead
person'sbody,
According
to
Christian
faith,
the spirit goes to heaven and thecorpse ismerely an empty object without a soul.
There isno problem inremoving anything from
a
lifeless
body,
Moreover,
American
people thinkabout what they can
do
at the time ofdeath.
Amerieans generallythink highly of positive
tion,so they value
donating
organs to saveers people's lives,Many Americans believein
Christianity,
which tellsthem to`love
thy
bor,'
which maybe anotherimportant
factor.
(Fox,
1992)
In
theU.S.,
organdonation
is
called`the
giftof life,'which demonstrates the eoncept of
ing
with others,i whiehis
also animportant
teaching of
Christianity.
Many
donors
in
the
U.S.
are highly educated, intelligentChristians,who
have
been
brought
upin
a gooddomestic
environment, which proves the factor.
(Hosaka,
1992}This`sharing'
is
seenin
the name of thenetwork, the
United
Network for Organ Sharing
(UNOS),
while theJapanese
networkis
simplyealled the`Japan Organ Transplant Network.'
The word `gift' is repeatedly used in 7:heIVbtv
YOrh
Times,
and The Wdshington Post. Suchviews on religion and
life
anddeath
in
theU.S.,
together with
its
culture, contribute to thewide-spread of organ transplantation.
That
report affirmed the good sense of
iug-g!gagE
across wider regions and the need
for
activefederal
oversight of the sort the
IIouse
has
now voted to remove.(nytimes.
com, April
6,2000)
Itwas a memorial service and celebration
for
deceased organ donors, their families and
those who received the gif!g of new lives.
(washingtonpost.com,
April
3,2000)
4.2.
Lack
of organsin
theU.S.,
and the presentstate of organ transplants
in
Japan
As organ transplantation has developed in
American
society,it
has
resultedin
the problemof a Iackof organs, whieh
is
causedby
animbal-ance
in
the supply and demand of transplantableorgans.
As
a result, organshave
become
akind
of `social resource' in the U.S. In The IVew YbrkTimes
andThe
Washington
Post,
the expression'scarce
resources' isrepeatedly used.
The House voted yesterday to overturn new
federal
rules aimed at making sure that thesickest patients get the
first
chance to usedonated ergans, as Iawmakers debated how
best
to share the searce resources and savethe most lives.
(washingtonpost.
com, April
5,2000)
The idea of identifying organs as resources
dernonstrates
thatAmericans
regard organs asrnere objects. In the Japanese media, the word
'resources'
cannot
be
found,
as theJapanese
think their soul is in their organs.
Moreover,
highly
paid white males may have rnore chancesto obtain organs as resources,
hard-to-find
or-gans, than either
females,
minority groups orraee and the huge
discrepancy
between
rich andpoor
in
theU.S.
Iiesbeneath
theissue
of organtransplants.
The number of patientswho are waiting to re-ceive organs isabout 13,OOO
(as
ofSept,
2002)inJapan.
There
is
the problem of the scarcity oforgans inJapan, too, though itisrnore severe in
the
U.S,
due
to the sheerdemand
in
thateoun-try.
In
theJapanese
media,however,
there areno articles on the scarcity of organs. This may
indicatethat such articles are not of great sig-nificanee
in
the present situation wherebrain-dead
organ transplantationsare progressing at a snail's space, In Japan, thereis
still a greatdeal
of resistance to organ transplantation,andit
remains a eontroversial matter, sothe
Japanese are not concerned with following news coverage relating tothe scarcity of organs.
This
will be an issuefor the future,after greater dis-eussion of organ transplantationitself.
5.
ConclusionIhave reviewed news coverage on organ
trans-plantationappearing
in
newspapersin
theU.S.
and Japan. There was a greatdifferenceinsuch coveragebetween
the two countries regarding thefirstorgan transplant and organ transplanta-tionsthereafter
in
thiscountry. Thisdifference
demonstrates
thatbrain-dead
organtransplanta-tion
has
just
begun
in
Japan,
whileit
has
be-come well established in American. society where
the greatest concern
is
the problem of alack
of organs. The differenceliesin the differentviewsof
life
anddeath,
religion, culture, medical ethics,politics,economics and so on. As the issue of
organ transplantation
is
a very delicateonere-latedto human death,extensive studies covering
a variety of
fields
willbe
indispensable.
Thispaper has reviewed the present circumstances of organ transplantationsinthe U.S. and Japan by examining articles innewspapers. Ihope also to
research information on
diselosure
or the privacyOrgan Transplantationinthe U.S.and Japan 9
of
donors
and recipients,(Asano,
1999)
reviewingnot only newspapers but also magazines, televi-sion, the
Internet
and so on.The
Japanese
musthave a thorough
debate
on organ transplanta-tion,learning from both the significantadvan-tagesof such surgery and theproblems
l'ound
in
the U.S.
Notes
1) This paperisbased on an oral presentation
'A
study of news coverage of organ transplantation in
the U.S.and Japan'at the 43'"annual c/onvention
of the Japan Associationfor Currenl/Eng]ish
Studiesheldat Tokoha Gakuen Universityon Oct.
14Lh,2eOl,
2) These figuresare cited from UNOS
[http:1!
www.unos.org].
References
Asano,Kenichi
(1999)
Kochino K)Jokunwa Ikasaretanoha.Sou;July1999:42-55.
Craven, J.& Gary,R,(1992).Psychiatric Aspects
of
OrganTransplantation.Oxford UniversityPress,New
York
Fox, R.C.& Swazey J.P.(l992)ESpareParLs : Organ
ReplacementinAmericanSociety.Oxford University Press,New York
Fuse,Yuko
(1999)
America niokerM ZokiisyokuHodo noGeng'o.Gekkanminpo; June 1999:20-23,
Hosaka, Masayasu
(1992)
Zohiisyohu to Nihonjin.AsahiSonorama
McCullagh, P. tJ.
(1993)
Brain Dead, Brai.nAbsent,BrainDonors.'ffuman Subjectsor Human Objects?
Wiley,New York
Sato,Ryuzo
(1999)
Zohiisyoku no Honshitsuron. Forbes;Oct.1999/76,77.
Trzepacz P. & Andrea F.
(ed.)
(2000}
The 7'ransplantPatient.'Biological,Psychiatric,and E'Lhiealfssues
in Organ Transplantation. Cambridge University Press,New York
10 神 戸 市 看 護 大 学 紀 要 Vol
.
7,
2003
Referential
Site
American Society of Transplantation[http://www
.
a−
s−
t.
org /] The Boston Globe[http://www.
boston.
com /globe/] Chicago Tribune[http://chicagotribune.
com /]Coalition on Donation [http;//www
.
shareyourlife.
org ]Department of Health and Human Services[httpl//www
.
organdonor
.
9QV]Japan Organ Transp】ant Network [http;//www
.
jotnw
.
er
.
jp
]Japan Transplant Recipients Organization[http://www
.
jtr
.
ne.
jp
/]Los Angeles Times [http://latimes
.
com /] Mainichi Shimbun [http://www,
mainichi,
cojp /]The New York Times [http://nytimes
、
com /l
Transplant Communication [http;〃www
.
medi−
neしor,
jp
]UNOS (United Network for Organ Sharing)[http:〃www
.
unOS
.
。rg ]The Washington Post [http://washingtQnpost
.
com /](受 付 2002
.
11.
14 受 理 2003.
2.
3) アメ リ カ と日本
にお ける臓 器 移 植 報 道の比 較 研 究 川 越 栄 子 神 戸 市 看 護 大 学 要 旨 目米の 新 聞 が 臓 器移 植にっ い てどのよ うに報じて いる か を概 観し た。
日本初 (1999年 )の報 道にっ い て,
日本の新 聞は,
患 者 の病 状,
脳 死 判 定の手 順,
ド ナー
カー
ド の事,
心臓は大 阪 大,
肝 臓は信 州 大,
など と事 実を細か く報 道して い た。一
方,
ア メ リ カの メ ディアは,
臓 器 移植の事 実は最 小 限に抑えられ,
視 点は,
日本が画 期 的に新 しい時 代に突 入 したことにお か れていた。
繰 り返し使 用されて い るキー
ワー
ドと して milestone,
debate,
taboo,
mistrust な どがあっ
た。
そ の後1年を経 過し た 2000年の臓 器 移 植 報 道は