アジア渡航移植患者の人権(医療政策と法-医療を取り巻く諸政策を中心として-,【連続シンポジウム】岡山発「わが国の政策課題への処方箋」)

抄録

Recently, visiting foreign countries, especially Asian countries to undergo organ transplantation has become a target of international criticism as "transplant tourism". Is it right to blame foreign patients who go to China or other parts of Asia, including Japanese patients, in order to undergo organ transplant? Is it right for them to be refused medical care after returning home? This phenomenon has been widely observed, especially in Japan. The Japanese medical establishment has adopted a kind of policy substantially forbidding patients to go to China or other parts of Asia for transplants, and also forbidding doctors to give transplant-related care to such patients. Even if the patients who go to China or elsewhere for organ transplants can be ethically blamed, is it justifiable for medical doctors to refuse to give them medical care? These issues are related but different, and should be discussed separately. For example, in the case of China, even though it's transplant policy has human rights problems with respect to death-row prisoners and Falun Gong practitioners, it does not seem right to indirectly put pressure from behind, so to speak, on patients who are in a weak position, in order to affirm the Japanese and WHO positions against Chinese transplant policy. The issue is whether it is good or not for patients in trouble to be sacrificed in order to realize a certain policy. Of course, in Japan, legally speaking, the issue may be subject to the so-called concept of "refusal of medical care". Article 19 of the Japanese Medical Practitioners Act prescribes that a doctor engaging in medical care must not refuse medical diagnosis and treatment without "a justifiable reason". It is, however, extremely doubtful whether the receipt of organ transplantation in China, or other parts of Asia constitutes "a justifiable reason". It seems that refusal of medical care to the patients who underwent organ transplants in China or other parts of Asia and returned to their countries presents a big problem of infringement of patients' human rights. The patients' human rights are an important interest of bioethics. Just as Chinese death-row prisoners, Falun Gong practitioners, etc. whose organs are extracted, and Southeast Asian donors who donate their organs for money due to poverty, have human rights, patients who go to foreign countries because they are not able to undergo organ transplants in their own countries also have human rights. If the former are weak under the power of the state, the latter are weak in the face of the power of the medical establishment. If the concept of "humanity" applies here, it also applies there. If ethics is used as a weapon for attacks, it may also be turned to the user of the weapon. Can we tell the patients to sit and wait for death? Leaving the patients in the lurch is not true ethics.