In 1997, after long social debates, the Japanese government enacted a law on organ transplantation from brain-dead bodies. Since 1993, on gene therapy, administrative agencies have issued a series of guidelines. This study seeks to elucidate when people became aware of the issues and when they formed their opinions on organ transplant and gene therapy. At the same time, it aims to examine at which point in time experts, those in university ethical committees and in academic societies, consider these technologies (...) became accepted among the public. A self-administered questionnaire was sent by mail to a stratified random sampling of 3000 people nationwide in Japan. Another questionnaire was sent both to the member societies of the Japanese Association of Medical Sciences and to the ethical committees of all the medical schools in Japan. Results of the surveys indicated that many of the public remained undecided on the desirability of organ transplant or gene therapy at the time of enactment of official guidelines. A substantial part of them formed their opinions in subsequent periods, especially around the time of first implementation and thereafter. Experts of the academic societies and of the university ethical committees regarded the time of implementation as an important factor in the acceptance of the technologies in society. Since many people formed their opinion during the period of technological implementation, communications efforts to facilitate public understanding of science and technology, as well as to advance practical discussion on policy alternatives in this period can play a key role in determining the fate of technological innovation and ethical debates in medicine. (shrink)

Interest in the retrieval of organs from non-heart-beating cadaver donors has been rekindled by the success of transplantation of solid organs and the insufficient supply of donor organs currently obtained from heart-beating cadaver donors. There are currently two retrieval techniques being evaluated, the in situ cold perfusion approach and the controlled death approach. Both, however, raise ethical concerns. Reanimation is a new method which has been used successfully in animals. We believe this new approach overcomes the ethical objections raised to (...) these other methods. (shrink)

I investigate Thomas Aquinas's metaphysical account of human death, which is defined in terms of a rational soul separating from its material body. The question at hand concerns what criterion best determines when this separation occurs. Aquinas argues that a body has a rational soul only insofar as it is properly organised to support the soul's vegetative, sensitive, and rational capacities. According to the ‘higher‐brain’ concept of death, when a body can no longer provide the biological foundation necessary for the (...) operation of conscious rational thought and volition, a substantial change occurs in which the rational soul departs and the body left behind is a ‘humanoid animal’ or a mere ‘vegetable.’I argue that the separation of soul and body does not occur until the body ceases to function as a unified, integrated organism. A rational soul is not only the seat of a human being's rational capacities; it is also the principle of the body's sensitive and vegetative capacities. Since Aquinas defines a human being as a composite of soul and body, and not with merely the exercise of rational capacities, the determination of death requires incontrovertible evidence that the body has ceased all the operations that correspond to the soul's proper capacities. The evidence of this is the body's loss of its integrative organic unity and the criterion for determining when this loss occurs is the irreversible cessation of whole‐brain functioning. (shrink)