Introduction: The number of deceased organ donors remains very low (PMP 1.2) in Japan. The author, a neurosurgeon with extensive experience in deceased donors, has personally advocated for organ donation for eighteen years and observed the impact of official promotions on motivating emergency doctors.
Methods: The author analyzed annual data of deceased donors and investigated the relationship between official promotion policies and the responses of emergency doctors, both positive and negative, towards donation. Also, the author has given lectures to the medical university students about the issues of organ donations and observed their responses.
Results: Since fifteen years ago, a policy introducing the concept of terminal care to organ donation has been implemented by transplantation societies and the Japan Organ Transplantation Network. This policy asserted that donation was a human right, aimed at fulfilling the wishes of donors, and provided care for the grieving families. It emphasized that donation was fundamentally for the donors themselves, not the recipients. This policy was adopted by emergency medicine societies. Although there are 900 approved institutes for organ donation in Japan, only 10-20% of them actively participated, resulting in 120-150 donors annually. The remaining 80-90% showed no interest, yielding zero donors historically. Some leaders in emergency societies mentioned their lack of awareness or reluctance to engage in donation efforts, including education of medical students. The author concluded the following points:
1. Both proponents and opponents of donation failed to recognize the existence of awaiting recipients amidst emergency treatments.
2. The policy of terminal care or human rights motivated less than 20% of them, indicating its limitations.
3. Emotional responses among medical staff arose due to the policy's focus on emotional aspects of medicine.
Conversely, the author's lectures emphasizing the professional obligation of medical staff to aid waiting recipients received positive responses, suggesting the effectiveness of a dry and professional approach in the long term.
Conclusion: Motivating emergency doctors toward organ donation in Japan proves challenging. Future promotion activities should adopt dry and professional approaches rather than emotional ones.