Diet Urged To Address Prospect Of Abused Kids As Organ Donors

The Japan Pediatric Society's recent disclosure of a number of cases of brain death resulting from child abuse may have implications for the planned revision of the Organ Transplant Law to enable children to be organ donors.

The current law sets the minimum age for a brain-dead person to become an organ donor at 15.

Children whose lives could be saved by transplants of small-sized organs face severe problems. Some have had to go abroad to receive needed organ transplants.

The Liberal Democratic Party's research committee has drafted a bill to revise the law to make organ transplants from brain-dead children possible, with the consent of the donor child's parents.

However, the revision will not allow organ transplants from young children unconditionally.

In June, the Japan Pediatric Society gave its approval to future organ transplants from young children with certain conditions. The group wanted to clarify the decision-making rights of donor children and prevent victims of child abuse from becoming organ donors.

House of Councillors member Hideki Miyazaki, who led work on the draft of the revision, said, "I believe that the matter will be discussed properly in the debate on the bill."

According to the society's sampling survey of pediatric medical facilities and emergency treatment centers, there were 129 children aged 15 or younger who became brain-dead or seriously disabled as a result of child abuse in the past five years.

Child abuse cases often are discovered when neighbors or doctors report them to police or child consultation centers.

Even if a child is brain-dead, experts from the pediatric society said organ donation is out of the question if there are signs of child abuse such as cigarette burns or injuries in addition to those that directly caused the brain death.

Another question is how to deal with cases in which evidence of child abuse may go undetected.

In a survey of 40 pediatricians in Osaka Prefecture, 17 of the respondents replied that they needed two weeks to a month, or even more, to confirm whether children taken hospitalized for head injuries were victims of child abuse.

Despite the key role doctors play in identifying abuse cases, they are usually too busy saving children's lives to carefully observe the parents for signs of culpability.

There have been cases involving parents who abused their children for some time before their deeds were discovered. It is possible a case of child abuse might not come to light until after the victim's organs have been donated for transplants.

Prof. Takakuni Tanizawa at the Hyogo College of Medicine said, "It is necessary to create a system in which a team of experts confirms the fact of child abuse."

In the United States, where organ transplants are far more common than in Japan, fatally abused children sometimes become organ donors.

According to the United Network for Organ Sharing (UNOS), an organization overseeing all organ transplants in the United States, even when parents are being investigated for suspected child abuse, coroners' judgments are given priority as to the question of organ donation.

If the coroner judges a donation would not obstruct the investigation, the donation is made with the consent of other relatives.

UNOS statistics show that 74 of 297 organ donors aged 5 or younger in 2001 became brain-dead because of child abuse. In 2002, 56 child abuse victims became organ donors.

From November 2000, when the Child Abuse Prevention Law was enacted, to the end of June, 127 children died of child abuse in Japan.

The number of brain-dead victims among them is not known, but 38 percent of the victims were less than 1 year old. About 90 percent of the victims were under 6.

Since the child abuse law went into effect, measures for excluding child abuse victims from organ donor lists have been devised to allow for the lowering of the minimum donation age to below 15.

Such measures may come under further consideration as lawmakers and officials discussion how to revise the Organ Transplant Law.

Copyright © 2004 The Yomiuri Shimbun.

This article posted April 17, 2004.