[Organ transplantation, ethics and culture in Japan. Japanese citizens may choose between cardiac death and brain death].

The first heart transplantation in Japan was performed in 1968. However, the surgeon was prosecuted, and transplantations from cadaveric donors came to an end. A new law in 1997 offered the possibility to choose how one would be pronounced dead, and if one chose to be declared dead according to brain related criteria, then one could become a cadaveric donor, if certain conditions were fulfilled. The first donations and transplantations took place in 1999. The Japanese public has been reluctant to accept the concept of brain death. The integrity of the dead body seems to command greater respect in Japan than in Sweden, and there is a reluctance to treat body parts as exchangeable. At the same time many Japanese travel abroad to obtain organs. The act of 1997 is a very interesting way of trying to integrate a new technology in Japanese culture, and the process of obtaining informed consent from relatives relies on traditional cultural roles.