The interminably hospitalized or ailing characters in Air, Clannad and Kanon (both of which have two) remind me of the dying heroines in operas like La Boheme, who manage to expire while everybody's singing up a storm. "Mimi! Mimi!"

The "dying kid" theme shows up a lot in Japanese melodrama. A large part of it is dramatic convenience, but there's actually a medical reason behind it. Despite having the world's longest lifespans and some of the most modern medical technology in the world, Japan does very few cadaverous organ transplants.

Most transplants are live-donor organs such as kidneys, and weighted for population, Japan does less than a tenth as many as the U.S. Only eleven heart transplants were performed in 2008. This has led to "organ transplant tourism," such as the three yakuza lieutenants and a yakuza oyabun who received liver transplants at UCLA.

EU countries have long complained about this, and only U.S. hospitals still place Japanese nationals on heart transplant lists. Cadaverous organ transplantation was formally legalized in 1997. A bill passed the Lower House in June 2009 intended to bring Japan's medical ethics laws into line with World Health Organization guidelines.

This doesn't really "solve" the problem, as the definitions of "brain death" and the legal concept of "consent" remain far from settled in the public mind. As the Mainichi Shimbun opined about the bill:

It doesn't appear that thorough deliberation of the various proposals has taken place, nor does it seem that Diet members and the public have reached a real understanding of the issues.

What makes this all the more interesting is that abortion is legal in Japan and is little debated. Japan is one of the few developed countries besides the U.S. that has a death penalty and regularly uses it. It is also little debated.

When it comes to surveys showing how "atheistic" Japanese are, it should be remembered that a belief in a Judeo-Christian deity says little about people's beliefs when it comes to life-and-death matters such as transplantation and cancer. Japanese doctors still regularly (as high as 70 percent) hide diagnoses of cancer from patients.

They do so even in the face of studies showing that the decision to conceal the "true diagnosis was not related to the presence of psychiatric disorders in Japanese cancer patients" (informed patients had a lower rate). Doctors are acting upon religious and cultural beliefs, not science.

I believe that at the heart of the matter is the firm hold Buddhism still maintains over all aspects of funerary culture in Japan, including Obon, the second most important holiday after New Year's. (On the other hand, faux Christian marriage ceremonies have become more popular than the traditional Shinto rites.)

In fact, after I wrote the above paragraph, the aforementioned bill passed the Upper House (13 July 2009). This is a "sea change," explains Mari Yamaguchi of the AP, "because of Buddhist beliefs [that] consider the body sacred and reject its desecration."

So the languishing patient remains a very believable possibility in Japanese melodrama. Another good example is My Hime, in which Mai's little brother languishes away for the entire series before going to the U.S. for a heart transplant in the happy ending.

Labels: anime, buddhism, health care, japan, jun maeda, politics, religion, shinto, yakuza