Here’s this week’s Media Mix about progress in organ transplants in Japan. Generally speaking, I don’t think the media is the real reason behind the lack of public knowledge about transplants and organ donation, but by and large what tends to be reported is those instances that have a more dramatic appeal, especially when parents are desperately soliciting cash donations to send an ill child overseas to have a transplant. According to an article that appeared in Nikkei Style last February, since the revision of the transplant law in 2010, there have only been 12 cases of organ transplants for children under 15–nine of them heart transplants–and yet during that time there were also cases of parents raising money to send their children to the U.S. for organs. Since 2010, 23 Japanese children have received heart transplants in the U.S. The reason parents still have to do this is because of a paucity of donations. In 2016, 100 children in Japan were waiting for organs. The health ministry has apparently taken this issue to heart, and is now shifting the priority for donations and transplants from older adults to younger children.

It must be pointed out that the cost is vastly different. In once instance, according to Nikkei, parents raised ¥300 million to have their 1-year-old girl receive a new heart in the U.S. With national insurance in Japan, the cost of a transplant here is only a fraction of that amount, and survival rates are higher than almost any other country in the world. Another problem is that confirming brain death for a child seems to be trickier. Nikkei estimates that there are at least 70 cases of child brain death in Japanese hospitals every year, but less than ten result in donated organs either because the hospital is uneasy about asking the parent to donate, or that parents, thinking that allowing donation is akin to killing their child, refuse when they are asked. Of course, the question doctors, and the media, really should ask of parents is: “If your child needed an organ to survive, wouldn’t you be grateful for a donor?” It’s a painful question, but a valid one.