Unlike in Japan, the cloning issue has generated widespread protest in Korea. Credit: YUN JAI-HYOUNG/AP

The word ‘bioethics’ — seimei rinri (life ethics) — is familiar to most Japanese people, but its use tends to be different from that in the West. Issues such as ‘brain death’ and organ transplants have generated widespread concern. But there is little active public discussion of the ethical implications of techniques such as genetics and cloning.

The political difficulty in confronting the ethical dilemmas raised by new biomedical techniques was reflected in the debate over accepting ‘brain death’ as death, triggered by Japan's first and only heart transplant, performed in 1968. Still referred to as the ‘Wada transplant’ after the surgeon who carried it out, the operation ended in controversy when the patient died and the medical team was accused of murder.

One result was that organ transplantation was put on hold. Only now, nearly 30 years later and after heated debate, has Japan finally passed a bill allowing the transplant of organs from brain-dead donors (see Nature 387, 835; 1997). Meanwhile, guidelines or regulations for cloning or handling of human genes have yet to be developed by the government, reflecting low public concern on such issues.

Darryl Macer of the University of Tsukuba, who runs the Eubios Ethics Institute, says one apparent explanation is that policy makers “are more concerned with promoting public acceptance than exploring ethical issues in decision making”. Macer points out that Japan is a paternalistic society, where the views and opinions of ‘experts’ are usually followed uncritically.

A survey this year, led by Eubios Ethics Institute, revealed that the news about the cloning of the sheep Dolly had made little public impact in Japan. Indeed, the survey revealed that 30 per cent of those interviewed were not aware of research in genetic technologies, while another 30 per cent were generally supportive of such research. The rest felt unable to choose between the risk or the benefit of genetic technologies.

Norio Fujiki, emeritus professor at Fukui Medical School, says the surveyshowed that the Japanese people are generally supportive of genetic technologies and scientific research, even though many are poorly informed on the subject. “People still find genetics ‘mysterious’, and have biased and misleading ideas,” says Fujiki.

In principle, the Japanese people say that they are supportive of genetic screening — as well as of gene therapy. But screening services are not readily available, and genetic counselling is not widely practised. Indeed, under the 1948 Eugenic Protection Act, which was abolished in 1995, it was illegal to abort fetuses which had genetic diseases and chromosomal abnormalities. Fujiki, who has been providing genetic counselling in Japan for 35 years, says that people still have preconceived ideas about genetic diseases which they are reluctant to discuss. Many view the lack of debate on such topics — and the delay in reaching a consensus on the need for government action — as stemming from Japan's cultural and religious background.

Some sociologists and religious groups disagree with this interpretation, saying opposition to new biomedical technologies is based merely on a lack of understanding. But the government appears relatively unconcerned about bioethical issues.

Admittedly some efforts have been made by the government to integrate ethics into decisions about gene therapy and brain death. The Science and Technology Agency (STA), which is setting up a genome research centre in the Institute for Physical and Chemical Research (RIKEN), is planning to set up a bioethics section to investigate bioethical issues arising from the life science research programmes run by the agency.

But many are still calling for proper guidelines, and for proper education in bioethics. Even the STA's plan has only been given ¥8 million (US$65,000) funding, and some are concerned that it could end up as a technology assessment committee, rather than a body that monitors ethical issues involved in the research.