{"id":241,"date":"2021-04-20T00:10:38","date_gmt":"2021-04-19T15:10:38","guid":{"rendered":"http:\/\/cbel.jp\/wp9835259570\/?p=241"},"modified":"2022-09-30T21:06:09","modified_gmt":"2022-09-30T12:06:09","slug":"04-01-01","status":"publish","type":"post","link":"http:\/\/cbel.jp\/en\/04-01-01\/","title":{"rendered":"Beyond the Twilight Zone: A Comparative History of Brain Death Policies in Japan and the United States"},"content":{"rendered":"<p><strong>Hiroyuki Nagai<\/strong><br \/>\nVolume 4 Issue 1 Pages 1-14<br \/>\nFirst Published: April 2, 2021<\/p>\n<p style=\"text-align: right;\"><a href=\"http:\/\/cbel.jp\/wp9835259570\/wp-content\/uploads\/2022\/03\/cbel-report_04_01_01_nagai.pdf\">PDF<\/a><\/p>\n<hr \/>\n<h4>Abstract<\/h4>\n<p>In Japan and the United States, brain death policy development has resulted in a situation where two opposing positions co-exist regarding the notion that \u201cbrain death is human death.\u201d Although discussions on this topic have only taken shape in the United States this century, similar discussions were already underway in twentieth-century Japan. This paper explores how public debates in the United States caught up with those in Japan. Comparative analysis of the processes leading to the development of brain death criteria reveals that, in Japan, the creation of medical evidence-based criteria occurred in a smooth, sequential manner\u2014first addressing cases with a short \u201calpha period\u201d (i.e., the period from brain death leading to cardiac death), with many brain death cases defined as those caused by primary lesions, unlike in the United States where lesions (i.e., multisystemic disorders) were deemed responsible for a majority of brain death cases. By clarifying the historical context, this study shows how this difference in definition has led to the co-existence of two opposing policies. In Japan, various technological developments extended the \u201calpha period\u201d by the 1990s, while controlling it with appropriate ethical considerations. This period\u2014referred to as the \u201ctwilight zone\u201d\u2014was never widely accepted in the United States, but Japanese attempts to extend the \u201calpha period\u201d were incorporated into bioethics commission reports in the 2000s.<\/p>\n<p>&nbsp;<\/p>\n<h4>Key words<\/h4>\n<p>Bioethics policymaking, Brain death, Comparative history, Harvard Criteria, Takeuchi Criteria<\/p>\n<div id=\"extensionsWeblioEjBx\" style=\"position: absolute; z-index: 2147483647; left: 162px; top: 72px;\"><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Hiroyuki Nagai<br \/>\nVolume 4 Issue 1 Pages 1-14<br \/>\nFirst Published: April 2, 2021<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[29],"tags":[54],"class_list":["post-241","post","type-post","status-publish","format-standard","hentry","category-regular-article","tag-volume-4-issue-1"],"_links":{"self":[{"href":"http:\/\/cbel.jp\/en\/wp-json\/wp\/v2\/posts\/241","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/cbel.jp\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/cbel.jp\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/cbel.jp\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/cbel.jp\/en\/wp-json\/wp\/v2\/comments?post=241"}],"version-history":[{"count":10,"href":"http:\/\/cbel.jp\/en\/wp-json\/wp\/v2\/posts\/241\/revisions"}],"predecessor-version":[{"id":662,"href":"http:\/\/cbel.jp\/en\/wp-json\/wp\/v2\/posts\/241\/revisions\/662"}],"wp:attachment":[{"href":"http:\/\/cbel.jp\/en\/wp-json\/wp\/v2\/media?parent=241"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/cbel.jp\/en\/wp-json\/wp\/v2\/categories?post=241"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/cbel.jp\/en\/wp-json\/wp\/v2\/tags?post=241"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}