How Do Rationality and Empathy Deal with “Well-Being” and “Well-Dying” in Organ Transplant and Life-Prolonging Medication?

Weber’s typological theory of means-end rational, value-rational, affectional, and tradition has so far been taught as major sociological theory at university education. However, present behavioral economics and evolutional psychology teach us that means-end rational decision is also based on heuristics and emotion which have innately been constructed in human evolution. If we looked at various aspects of our life and death in secular and religious lives, we would know the interactive boundary between rationality and empathy.

In this paper I will first illustrate the brief history of organ transplantation and its current condition in Japan, in which most Japanese people hardly recognized the medical and legal definition of brain death and felt conflicted over donating families’ living organ and staying with dying family until they stop breathing and suffer cardiac arrest. Medical experts and mass media revealingly tried to convince the public about the means-end rationality of altruistic organ donation. However, a few Japanese religions opposed organ transplantation from their religious perspectives. The second example is life-prolonging treatment relying on artificial breathing and nutrition by gastrostomy tube and central vein infusion at hospital and nursing care home for the elderly. Increasing longevity in Japan may cause a rise in anxiety among Japanese people, as they are getting more worried about taking care of their elder parents, exhausting own living expense in their 80s and 90s, and suffering from dementia. Recently, the concept of dignified death and national death have been discussed among ordinary people who begin to prepare in advance for the directive of medication and funeral in the end of their life time. “Well-dying” could be an important topic in both private and public sphere, involving rational and empathic decision and interaction among concerned people in Japan.