While there are numerous doubts, controversies and lack of consensus on alternative definitions of human death, it is argued that it is more ethical to allow people to choose either cessation of cardio-respiratory function or loss of entire brain function as the definition of death based on their own views. This paper presents the law of organ transplantation in Japan, which allows people to decide whether brain death can be used to determine their death in agreement with their family. Arguably, (...) Japan could become a unique example of individual choice in the definition of death if the law is revised to allow individuals choose definition of death independently of their family. It suggests that such an approach is one of the reasonable policy options a country can adopt for legislation on issues related to the definition of death. (shrink)

: Iran has had a program of compensated kidney donation from living unrelated (LUR) donors since 1997. The aim of the program was to address the increasing demand for kidney transplantation in a morally sound manner. The program was successful in terms of increasing the number of kidneys available for transplantation. This paper presents a critical review of the program and its ethical status. Denying organ donors legitimate compensation because of the understandable fear of an organ trade is not morally (...) justifiable, and the Iranian model of compensated LUR kidney donation offers substantial benefits that overcome these concerns. Despite its benefits, the program lacks secure measures to prevent the risk of a direct monetary relationship between donors and recipients, and it must be revised in order to be morally justifiable. (shrink)

The increasing gap between organ supply and demand has opened the door for illegal organ sale, trafficking of human organs, tissues and cells, as well as transplant tourism. Currently, underprivileged and vulnerable populations in resource-poor countries are a major source of organs for rich patient-tourists who can afford to purchase organs at home or abroad. This paper presents a summary of international initiatives, such as World Health Organization’s Principle Guidelines, The Declaration of Istanbul, Asian Task Force Recommendations, as well as (...) UNESCO’s and the United Nation’s initiatives against trafficking of human organs, tissues, cells, and transplant tourism. Beyond the summary, it calls for more practical measures to be taken to implement the existing guidelines and recommendations, in order to prevent exploitation of the poor as organ providers. The paper suggests that an international legally binding agreement in criminalizing organ trafficking would be a step forward to bring a change in the global picture of organ trafficking and transplant tourism. (shrink)

Iran is the only Muslim country that has legislation on embryo donation, adopted in 2003. With an estimated 10–15% of couples in the country that are infertile, there are not any legal or religious barriers that prohibit an infertile couple from taking advantage of Assisted Reproductive Technologies (ARTs). Although all forms of ARTs available in Iran have been legitimized by religious authorities, there is a lack of legislation in all ARTs except embryo donation. By highlighting ethical issues in embryo donation, (...) the paper presents a critical review of the Act of Embryo Donation in Iran. The paper argues that the Act does not provide enough safeguards for the future child and assurance for the safety of the donated embryos. It also does not restrict embryo donation to surplus embryos from infertile couples and is silent about the number of embryos that could be donated by each couple as well as the number of recipients for donated embryos by a couple. The Act is also silent about the issues of genetic linkage (nasab) and heritage which are challenging issues, especially in a conservative Islamic society. As a result, the future child may not inherit from their birth parents, as it is not required by the Act, or from the genetically related parents under the anonymity policy. Finally there is no standard national protocol or guidelines to evaluate the safety of the donated embryos. The paper concludes that despite its benefits, the Act lacks clarity, and it is subject to misunderstanding and confusion. (shrink)

: The 1997 Japanese organ transplantation law is the fruit of a long debate on "brain death" and organ transplantation, which involved the general public and experts in the relevant fields. The aim of this paper is to trace the history of the implementation of the law and to critique the law in terms of its consistency and fairness. The paper argues that the legislation adopts a double standard regarding the role of the family. On the one hand, the legislation (...) overemphasizes the family's authority by granting the family a veto on the matter of organ transplantation, while, on the other hand, not allowing the family to make surrogate decisions. In addition, the role of the law in cases involving minor or incompetent patients is shown to be similarly misguided. The paper argues that accepting a decisive role for the family in current law is compatible with Japanese culture. (shrink)

Islamic Bioethics presents a wide variety of perspectives and debates on how Islamic societies deal with the ethical dilemmas raised by biomedicine and new technologies. The book is a "constructive dialogue" between contributors selected from a multidisciplinary group of Muslim and non-Muslim scholars from different Islamic countries. The 11 chapters illuminate the diversity and complexity of the issues discussed in Islamic bioethics and pave the way to a better understanding of Islamic bioethics and dialogue in the global bioethics community. The (...) chapters take both theoretical and practical approaches to the topic, and each covers an emerging issue in Islamic bioethics. This book will be useful for academics and professional institutions in both Islamic and non-Islamic countries, and will be instrumental in providing researchers, scholars, students, policymakers and medical professionals with access to the latest issues and debates related to Islamic bioethics. Contributors include: Tariq Ramadan, Abdallah Daar, Ali Albar, Mohsin Ebrahim, Baharouddin Azizan Alastair Campbel, Bagher Larijani, Carol Taylor, Gamal Serour, James Rusthoven, Ilhan Ilkilic, Ingrid Mattson, Hassan Chamsi-Pasha, Jonathan Crane, Hakan Ertin, Mehunisha Suleman. (shrink)

Recently, women entrepreneurship has become of particular interest to corporate social responsibility (CSR) scholarship, however, little is known about the impact of crises on women’s business activities and how they adapt to the disruptions and new market realities caused by a crisis. To design CSR initiatives that genuinely cater to the needs of women entrepreneurs, it is imperative to acquire an in-depth understanding of their unique experiences during times of crisis. This study employed a qualitative methodology to investigate the development (...) of resilience among women entrepreneurs amidst crisis. The study sample comprised Iranian women entrepreneurs who were operating health-related businesses during the COVID-19 pandemic. In addition to challenges related to money, market, management, motherhood, macro and meso level factors, women entrepreneurs were found to face crisis related challenges such as emotional exhaustion, altruism, fear of failure and uncertainty. Additionally, the findings revealed the different problem-based and emotion-based coping strategies (e.g., bootstrapping and emotional regulation) that women entrepreneurs used to build entrepreneurial resilience as well as business resilience. The resultant findings offer a comprehensive understanding of women entrepreneurs’ resilience-building process and suggest that resilience-building is a contextual as well as a gendered phenomenon. Implications for entrepreneurship research as well as women entrepreneurship and ethics literature is discussed. (shrink)

So-called futile care : the experience of the Unied States -- The reality of medical futility in Brazil -- Medical futility and end-of-lfe issues in Belgium -- The concept of medical futility in Venezuela -- Medical futility in Russian Federation -- Medical futility in Australia -- Medical futility in Japan -- Ethical issues and policy in medical futility in China -- Medical futility in Korea -- Medical futility from Swiss perspective -- Medical futility in Turkey -- Medical futility in the (...) Untited Arab Emirates -- Medical futility in Iran. (shrink)

In organ transplantation, the demand for human organs has grown far faster than the supply of organs. This has opened the door for illegal organ trade and trafficking including from children. Organized crime groups and individual organ brokers exploit the situation and, as a result, black markets are becoming more numerous and organized organ trafficking is expanding worldwide. While underprivileged and vulnerable men and women in developing countries are a major source of trafficked organs, and may themselves be trafficked for (...) the purpose of illegal organ removal and trade, children are at especial risk of exploitation. With the confirmed cases of children being trafficked for their organs, child organ trafficking, which once called a “modern urban legend”, is a sad reality in today’s world. By presenting a global picture of child organ trafficking, this paper emphasizes that child organ trafficking is no longer a myth but a reality which has to be addressed. It argues that the international efforts against organ trafficking and trafficking in human beings for organ removal have failed to address child organ trafficking adequately. This chapter suggests that more orchestrated international collaboration as well as development of preventive measure and legally binding documents are needed to fight child organ trafficking and to support its victims. (shrink)

This survey has been designed as a multinationalcollaboration to collect data from several countries focusing ondeveloping countries. The main purpose was to elaborate thefunctions of ethics committees regarding externally-sponsoredresearch . In March 2004 a total of 89 open-endedquestionnaires were sent to ethics review committees inmedical schools, medical research institutes and hospitalsaffiliated to the public and private medical universities inJapan.Twenty two ECs replied , and among them five ECshad reviewed eleven ESR proposals in 2002-3. Five of thoseESR proposals have been approved (...) and four proposals havebeen approved after some revisions. Two proposals weredeferred but not resumed. In their review, respondents weremore concerned about “individual consent” than “communityconsent”. Post-trial access to effective interventions was not areal concern. As for “Standard of care”, seven ECs replied thatthey review the ESR proposal based on the internationalstandards and four based on the local standards. WhetherESR proposal is matched with the national health prioritieswas not a great concern. Respondents expressed theirconcern about socio-cultural issues.Ethics in research especially dealing with externallysponsoredresearch is a relatively new subject and underdevelopment in Japan. Although Japan is not a developingcountry, in order to protect individual human subjects and localcommunity, capacity building in ethics review especially inresearch collaboration with other developed and developingcountries is crucial and it has to be included in ethics inresearch programs through out the country. (shrink)

The UNESCO International Bioethics Committee is an international body that sets standards in the field of bioethics. This collection represents the contributions of the IBC to global bioethics. The IBC is a body of 36 independent experts that follows progress in the life sciences and its applications in order to ensure respect for human dignity and freedom. Currently, some of the topics of the IBC contributions have been discussed in the bioethics literature, mostly journal articles. However, this is a unique (...) contribution by the scholars who developed these universal declarations and reports. The contributors have not only provided a scholarly up to date discussion of their research topics, but as members of the IBC they have also discussed specific practical challenges in the development of such international documents. This book will be suited to academics within bioethics, health care policy and international law. (shrink)

This book examines the intersections of bioethics, human rights and health equity. It does so through the contextual lenses of nation states while presenting global themes on rights, colonialism and bioethics. The book is framed by the following propositions on indigenous health: it is a human rights issue; it is located within the politics of colonization; and subjugated indigenous knowledges require restoring.

BackgroundThe current debate about medical futility is mostly driven by theoretical and personal perspectives and there is a lack of empirical data to document experts and public attitudes towards medical futility.MethodsTo examine the attitudes of the Japanese experts in the fields relevant to medical futility a questionnaire survey was conducted among the members of the Japan Association for Bioethics. A total number of 108 questionnaires returned filled in, giving a response rate of 50.9%. Among the respondents 62% were healthcare professionals (...) (HCPs) and 37% were non-healthcare professionals (Non-HCPs).ResultsThe majority of respondents (67.6 %) believed that a physician's refusal to provide or continue a treatment on the ground of futility judgment could never be morally justified but 22.2% approved such refusal with conditions. In the case of physiologically futile care, three-quarters believed that a physician should inform the patient/family of his futility judgment and it would be the patient who could decide what should be done next, based on his/her value judgment. However more than 10% said that a physician should ask about a patient's value and goals, but the final decision was left to the doctor not the patient. There was no statistically significant difference between HCPs and Non-HCPs (p = 0.676). Of respondents 67.6% believed that practical guidelines set up by the health authority would be helpful in futility judgment.ConclusionThe results show that there is no support for the physicians' unilateral decision- making on futile care. This survey highlights medical futility as an emerging issue in Japanese healthcare and emphasizes on the need for public discussion and policy development. (shrink)