the revised Organ Transplant Law enforced on July 17

A　 hospital in Kurashiki City asked  me an explanation of the revised  Organ Transplant Law enforced on July 17. My explanation was the following.

①Tachibana Takashi insisted as follows.
"The present brain death standard is a standard 'Not survived any longer', and not true criterion for brain death. "Not survived any longer" is quite different from " the person is already dead". The doctor must treat the patient in "Not survived any longer" state. For instance, if the patient is getting a stomach cancer, this is natural. It is wrong that the traumatic brain injury is an exception. Therefore, it is equal to the vivisection to remove internal organs by the present brain death standard. " This criticism has not been denied yet.

②Still, the standpoint  of Takashi Tachibana is "The brain death is the person's death". There is an insistence that denies "the brain death is the person's death" more plainly,. There are people who insist that "President of the United States bioethics council" mistaked .

③Moreover, the diagnosis "Only the organ transplant is an effective remedy" is also often uncertain. When the organ transplant is not done,  according to a certain investigation, the patient's passage is not too bad compared with the case to transplant . In addition, there is a person who has the doubt of organ transplant. A patient hoped his priority level went up as the colleague patient died. He got wounded deeply by that. l it was a testimony in the Diet.

④Nevertheless, the self-decision of the donor himself became unnecessary by revising this Organ Transplant Law, and less than 15-year-old infant came to be able to become a donor along with it. However, brain death criteria in less than six-year-old child do not exist.

⑤Moreover, the previous law had been decided, "The brain death = person's death" only in case of the organ transplant. It unconditionally put it away as "The brain death = person's death" in a new law. Therefore, treating the brain death person became equal to the treatment of the dead. Therefore, "The health insurance is applied to treatment to the brain death person for the time being" was decided. When the relative refuses the organ donation to final  after patient's declaration of brain death, treatment is not discontinued.

However, people's doubts grow.
When the doctor does the declaration of brain death besides the organ transplant purpose, and  diagnosed the brain death, is treatment done?

In the press report on May 21, the Democratic Party started the preparation for legalizing breaking off of the treatment of a clinical brain death to the patient.

Only this report might be the answer. The legalization of the right to die and euthanasia starts here.

Self-deciding the death at that time becomes a reason why the death is compelled. Moreover, Engelhardt's "Person theory" might play the role. It is  ranking of the  characters. ① free character,② subordination character , ③ imperfect character  that  can  only suffer pains ,④existence that should be protected within the range where load doesn't rest upon and and  societies .Such a rash insistencemight be performed as Global standard ,because  in Japan   it becomes  a reason  that   atheory is powerful in the United States .

⑥The WHO general meeting was decided to limit the making a passage organ transplant in May, 2010. Only the making a passage organ transplant  from  the poor country  to the advanced country is permitted.

We should  think about the Organ Transplant Law revision from the standpoint where the equality of the life is esteemed.

We should examine the right of health. It is necessary to examine the right of health from many fields, with the standpoint of medical ethics ,the standpoint of the human rights ,and  the standpoint of a social epidemiology.

Conclusion:As the issue of  right of health,
① social epidemiology must show  no existence of the self-responsibility of health,② human rights method　must  show  that self-decide of the patient  should be supported by the maximum level of the human rights esteem obligation of the nation , ③medical ethics　must show no permission for  ranking the characters.

Enforcement of the Organ Transplant Law revision

I noticed an important issue about the Organ Transplant Law revision enforced in this July.

What does it mean that the nation unconditionally decides that the brain death is the person's death?
It might be an enactment of "Right-to-die bill" that comes afterwards. The nation doesn't permit   living with an artificial respirator without expectation of recovering .
The execution is extremely easy if payment by the medical treatment fee is stopped, and it makes it to the  full self-load.

Then ,the treatment of the person of the vegetative state patient and the person in the state of the end is discontinued there if coming.

Grounds are the self-decisions.

We should not believe the fair name such as the self-decision. It is compulsion of the death by the nation  on the name of self-decision.

Grounds of the insistence of the nation  are "  being  healthy is people's obligation " that exists in "Health regime", that is, the self-responsibility theory of health. The nation  makes  the  people who became not healthy  voluntarily choose dying as a transgressor of their obligations.

On the other hand,  there is "Right of health"  that  denies completely  the self-responsibility theory of health.
And   "Right of health"  declares  the nation's responsibility  for the people's health  and  for the recovery when people's health is lost.

Up to now, I have thought about "Right of health" only by the route from a social epidemiology. It was an extremely powerful method of indicating the origin and the road
of  achievement of the right of health in a scientific manner.

However, it is necessary to explain "Right of health" from medical ethics.

Theclue must be in thinking about Organ Transplant Law.

Especially now, when neoliberalism blows again under the Kan  Cabinet , we should be serious.

Louis Bonaparte in 1848 , Hitler in 1933 ,Kan in 2010

Aｓ Watanabe　Osamu said、the Democratic Party is composed of three parts.
1st ,the head  for neoliberalism.
2nd, the body for  pork-barrel effect.
3rd,the hands and feet for social welfare business .

When the body that Ichiro Ozawa leads moves backward , the center of the political stage has been  occupied by a neoliberalist,Kan Naoto.

Kan is only a degenerated politician , a colleague of Walesa in Poland etc.

When Japanese workers support him, History will say that the victim often supports the assailant.

I can see Louis Bonaparte in 1848 , Hitler in 1933 ,and Kan in 2010

National Art Center ,Tokyo "Orsay Museum exhibition 2010".

　I  attended a  meeting that  made the asbestos damage problem cheif theme on June 12 and the 13th at Tokyo. Hearing the story how the diseases  related to asbestos   in  hospital patients are able to be discovered , and   how  young  lawyers  work vividly  on asbestos damage lawsuits,   I had a llittle sense of incompatibility and discomfort .

Because  I had   held mini-lectures as to the asbestos damage  at all cities in Yamaguchi Prefecture for these three years.,and there were no in-hospital patient,but retired workers only.

After the meeting , I decided to go to National Art Center  Tokyo  for enjoying Sunday afternoon of the slightly cloudy cool  weather. My purpose is to see  "Orsay Museum exhibition 2010. "

It was  packed with  many spectators in exhibition space. Moreover, by  the time of the airplane, I was possible to stay only for about one and a half hours.  I couid not have   a good  appreciation.

But   Gogh's "Star-spangled night" struck  my herat. Night sky, the Great Dipper,
a river, and city lights.  I liked   to cry  ahead of his  hope and his  sense of well-being by catching Gogh who died soon .

Why has it become an aged society?: An interpretation by teleology

I had known a record  of  Kato Shuichi 's  lecture at the University of Tokyo(2006) had been uploaded to youtube since before.But it is too long for me to see during ususal days.

Recently I could see it  through the whole volume.

As a result,  I could obtain the answer to the above issue,'why did it become an aged society?'.

That is,

①For the greater  part of Japanese people, the time on their life  that can secure "Freedom" from the organization  or parents  is limited to  the only four years as  university students and after retiring old age period.

②The political reality faces the constitution deterioration, and the cooped-up feeling of the society becomes strong more and more. The necessity of  free persons  without  selfishness increases  to exceed it.

③Being able to response to  it   are only  elderly persons  and students.  The aged society  had appeared for that,i.e.  for recovering  the freedom of  Japanese society.

*The more elderly persons  increase  , the more a courageous remarks increas, and the possibility of rational development of the society rises, too. Moreover, the unity of  elderly persons and  students  is also extremely effective for freedom.

**Becoming aged ,diversity of the face and figure is lost  . However, the difference of the experience of the individual extends, and the diversity of the inner world grows by becoming aged. For younger generation there is a necessity for using  ears that catch  valuable words of elgerly persons.

Well, the preview of documentary film "However, it is not only that" intended for Mr.Kato has been uploaded to youtube,too.

Music thrown into background of movie's trailer is the song  "What a dying man left" of English version (Toru Takemitsu'scomposition and Tanikawa Shuntaro 's lyrics). MY tears do not stop  when I   see the images of aged Mr.Kato  on the song.

A fetal Minamata disease in Yamaguchi prefecture

A　45-years old patient　whom I had examined yesterday seemed to have gotten a fetal Minamata disease.

This person  was born after the  mother had migrated to Kansai area. The mother had already gotten Minamata disease .

At first I could not understand  why this person  have gotten Minamata disease.

The mystery was able to be solved when the mother told that she spent the time of pregnancy and birth in her hometown by the Yatsusiro sea. She had kept eating the fish every day  at that time.

I have helped a doctor who was investigating  the mercury damage of Tokuyama bay coast residents　in my school days. When that is recalled, it is not a coincidence that this patient had visited  me on this day .

At any rate, unhappiness exists universally like this.

Ikeda Masayuki 's lecture meeting was held.

Ikeda Masayuki,professor of School of Medicine Nagasaki University is a famous doctor who is showing a preeminent talent in various areas of the general practice, neurology, and the medicine effect judgment, etc.

We held Mr.Ikeda's lecture meeting respectively in Yamaguchi City and Ube City on June 5 and the sixth,2010.

We have already held Noguchi Yosinori's lecture meeting before the last year, and Yamanaka Katuo's lecuture meeting last year.

THis program was in a series for studying diagnostic reasoning .

Mr. Ikeda advocated the axis of the diagnosis by the story , the axis on doctor - patient relaionship , and the axis of society. Most of those axes are in the area "Examine in an interview".

And, the key word of the axis of the story is "What is embarrassed in patient's daily life?" imagining one house. With the bath ? In the bedroom ? In the rest room? In the kitchen ? In the living room ? When it is recorded  merely accurately, even though there is no knowledge of the disease, the correct diagnosis can be made by almost all doctors .

On the axis of doctor- patientrelationship, the doctor should be conscious that it is the patient who teaches and help him. And, the patient may be conscious of his contribution to actually serious and social by telling the doctor his experience. The patient if it can be thought, "It is depreciation of my life (Pile up internal reserves in the society through his doctor) to be sick, and to teach his doctor. Thus, a new dimension was added to the study of the diagnostic reasoning.

However, dissatisfaction might have somewhat remained in the teacher who had requested useful knowledge at once for the diagnosis and treatment.

Mr. Ikeda said in the start of the lecture. In master's behavior at being, it might be a free coincidence and information as the message be 0. However, if something was produced in the apprentice, the education has been splendidly approved as a result. "It is not contents but thought manners to want to tell. " *The diagnosis is the practical instruction of directionality for the treatment, not the game seeking for disease's name .

Had we made a mistake in the strategy?

There are three patterns to blame former Prime Minister Hatoyama.

One is that  he thoughtlessly promised , destroyed oneself, and  left the successor a heavy load . This attacks is from the right wing. It is  merely a  lesson for the art of protecting politician's  own interests .

Another is  that he challenged a matter to do  and made everyone embrace the dream , but betrayed  everyone  for his weakness of the character at last . This attacks is from the left wing.

About these two types,  the mass communication discusses confusedly.

However, the third pattern is the most interesting. We  can know it  from representation of Mr.Yukio Okamoto on Asahi Shimbun  on June 3. The importance of the deterrent of Marine Corps was slowly but steadily acquired by Mr. Hatoyama and he  had seemed to be gradually a  good leader. But his strength was insufficient. Successor's Prime Minister should  make the best use of the one that former Prime Minister Hatoyama learnt with great pains.

I  can guess easily that Yukio Okamotowa　is the teacher who taughut former Prime Minister Hatoyama  that the deterrent of Marine Corps is important.

Let us  remember that Secretary of Defense Mr.Gates stayed in Japan from 20th to 21st October, 2009, and he threatened one after another with Foreign Minister Okada, the Prime Minister Hatoyama, and Minister of Defense Kitazawa. Gates : "The Obama Goverment reached the conclusion that the current plan was the one of the best. I also want Japanese Government to advance the construction of the replacement facility in the Futenma base etc. steadily. ". 

Okamoto was a tutorial that the United States had sent along this line. He made Mr.Hataoyama's mind broken  with occult violence  of U.S. that could contain his (political) assassination.

Then, the situation could not been changed by 100,000 people's meeeting at Okinawa, after Prime Minister Hatoyama's mind had broken . 

What  was necessary to change the situation  was  an invitation Prime Minister Hatoyama to 100,000 people's meeeting  to give him encouragement to make  East Asia  safe  , before  his mind had broken.

I feel ,we could had made a mistake in the strategy for true resolution  of 'Hutenma Problem'.

I met Mr.kato Shuichi recently.

　The most famous Japanese critic  Mr.Kato Shuichi wrote the fictitious interview records frequently .

I think it is interesting when someone collects only them and makes one book.

Who becomes the object of the fictitious interview record  for Mr.Kato and  who did not become ? The clue for undestanding Mr.Kato Shuichi might be obtained from the differences  between them .

I had thought that the fictitious interview record was only one mode of  his expression.

But I came to actually think that Mr. Kato had spoken really with them,it is  due to my recent experience .

My position the chief director of a small medical Coop is fulfilled with solitude . The significant problems foy  Coop organaization are found very much , and as a clinician  standing on the front of  emergent medical treatment, I  must work every day so bewilderingly.

There is  no effective support for this special playing manager.

One day I had to leave to Tokyo for the business meeetings .Waiting  for departure  from Yamaguchi-Ube Airport,I could  not make  my facing issues clear ,while  I noticed much incompleteness of routine work left at my hospital.

At that time, Mr. Kato showed up in my mind. After that, I kept talking for a long time with Mr.Kato. Then, I felt myself not so solitary. Ah ,it was noticed that my character thus must divide, and it  help me not fall into crisis.

And  I  believd the fictitious interview records  tahat Mr.Ｋａｔｏ　ｗｒｏｔｅ　might have been subjectively non-fictitious.

Ｉ　kept talking with MrKato ａｆｔｅｒ　ａｒｒｉｖｉｎｇ　ａｔ　Haneda . "Was not it surprised for ｙｏｕ　ｔｈａｔ the skirt of the girl 　there　 is ｔｏｏ　ｓｈｏｒｔ　?" "No, if it was that extent, Ｉ　experienced many times in Vancouver. " ”Well, it might be figure skating of the recent Olympic Winter Games. Ｙｏｕ　ｍｕｓｔ　ｓａｙ　ａｂｏｕｔ　Kim Jonah．” ”No, your explanation doesn't hit ．　Ｉ　ｔａｕｇｈｔ　 Japanese ｌｉｔｅｒａｔｕｒｅ　at University of British Columbia in Vancouver to students with short skirts　ｗｈｅｎ　Vietnam war　ｗａｓ　vividly ｐｒｏｃｅｓｓｉｎｇ. ”

Mr. Kato had disappeared 　ｓｏｏｎ　ａｆｔｅｒ　I　ａｒｒｉｖｅｄ　the office of the　Ｍｉｎ―Ｉ－Ｒｅｎ　at　Ｈｏｎｇｏ，meeting  my companions who did not let  me solitarily finally.　

Ｉ　ｔｈｏｕｇｈｔ　Mr.Kato　ｈａｄ　returned 　ｔｏ　Kaminoge or somewhere.

"Change to Algeria" of Okinawa

It is a telegraph that Ambassador to Japan MacArthur ( a nephew of MacArthur who was the commander-in-chief of occupation forces) addressed to the American Department of State on February 3, 1958.

Today,it will not be understood .

Ambassador MacArthur said, "I worry deeply about Okinawa  for its close resemblance to Indo-China, Morocco, and Algeria under French rule".

Intense struggles for independence against France had happened in these regions that had been given here.

In those days,a revolutionist Frantz Omar Fanon(1925-1961)  who was also a psychiatrist was added to National Liberation Front( FLN).

It is likely to make a fifty-fifty relationship between Japan and U.S. in the formality at least  to prevent the independent struggle generation in Okinawa.

This anxiety became a cause why President Eisenhower revised Treaty of Mutual Cooperation and Security between Japan and the United States of America in 1960.

Now,does not Washington's ambassador to Tokyo telegraph the Department of State that there is a possibility of the change to Algeria  of Okinawa  under the current American- Japanese joint rule?