著者

西河内 靖泰

出版者

図書館問題研究会

雑誌

みんなの図書館 (ISSN:03860914)

巻号頁・発行日

no.268, pp.31-43, 1999-08

著者

西河内 靖泰

出版者

日本医学哲学・倫理学会

雑誌

医学哲学 医学倫理 (ISSN:02896427)

巻号頁・発行日

vol.18, pp.66-77, 2000-12-15 (Released:2018-02-01)

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In 1999, the multiple organ transplantation from a heart-beating-donor was reported from Kochi Red Cross Hospital. This was the first case in Japan after the "Organ Gift Act (1997) ". The patient was transported by ambulance to the hospital on Feb. 22, 1999. The Japanese mass media should have been prudent enough not to violate the donor's privacy, such as exact age, address, family, and occupation. But they set their feet on the quiet donor's home town, and took photos and movies. Afterwards, the MHW (Ministry of Health and Welfare) and JOTNW (Japan Organ Transplant Network) forbade the direct access of the media reporters to the hospital and family members, and limited not only the streams of the non-medical information of the patient but also the medical information needed to check the correctness of the transplantation. The immediate disclosure of the medical information is essential to protect the recepients rights. Without this information, patients and families can't check the official announcements of the hospital. Their medical report might be changed by the hosptital to make it consistent with other data or reports. If so, they can know neither the accuracy of the donor's diagnosis nor the accuracy of information used to make the informed consent of the family. The Japanese mass media must make the rational guidelines to distinguish the essential medical information, needed to assess the adequacy of the choice, from non-essential information. I stress the peculiar situation of the case. This transplantation was the first heart-beating donation case in Japan except the very doubtful heart transplantation case by Wada in 1968. I think first that the donor's family must have a very strong will for the correct donation and transplantation. It is their honorable obligation to disclose enough medical data to make the medical staff protect the donor's patient rights.

著者

池谷 健 本田 勝紀 西河内 靖泰

出版者

日本医学哲学・倫理学会

雑誌

医学哲学 医学倫理 (ISSN:02896427)

巻号頁・発行日

vol.17, pp.106-117, 1999-10-01 (Released:2018-02-01)

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A 62 year old man died of SAH at an Okinawan hospital in Dec. 1996, and his kidneys were transplanted after his death by consent of one daughter. Afterwards other members of his family, i. e. his wife, his son and his three other daughters, went to court over the inappropriate therapy and donation. We were asked to check a copy of his clinical chart tendered by the hospital, the letter of complaint of his family members, and the questionnaire to the hospital and answers from the director of the hospital. We pointed out 3 major issues : (1) Did he receive reasonable treatment? Was his brain death diagnosed correctly?, (2) Was the informed-consent of his family members for his organ transplantation stated clearly?, and (3) Did the co-ordinators give adequate information and make valid agreement? Did they confirm the donor's will? Did they confirm consensus of the family for donation? We cannot find out rational answers to the questions above. The patient was a mentally handicapped person, and the doctors abandoned his treatment soon after his arrival to the hospital. Once the opinion of his organ donation was made by one daughter 3 days after his admission, the doctors ignored any wish against donation by other family members. We believe that the happiness of the donor family is one of the most essential factor for organ transplantation to plant its roots in Japan. In this case, the family got no happiness but serious confusion. This case could be an extraordinary case, but because we have only a few means to check up the adequacy of organ donation in this country, this might not be an exceptional case. The difficulty to access medical data by the family must be dissolved immediately.

著者

西河内 靖泰

出版者

出版ニュース社

雑誌

出版ニュース (ISSN:03862003)

巻号頁・発行日

no.2050, pp.30-31, 2005-09