#Kirisaki Shidou | Explore Tumblr posts and blogs

throw-down-enjoyer · 5 months ago

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Organ donation, compassion fatigue, and Japanese perspectives on brain death

I don’t think Shidou’s sin was actually a crime (as in, it was perfectly legal) and I’m going to explain why. This is essentially a very long Kirisaki Shidou Is Not An Organ Harvester post

To start: Shidou’s sin was convincing the families of braindead patients to donate their relatives’ organs. He confirms doing this in his T2 voice drama, and the way he words it makes it clear he thinks of it as murder. (He does say that this is only half of his sin, but we’ll get to the other half later.)

You know, I… continuously tried to persuade the relatives of braindead patients who were against organ transplants.

“In order to save the life of someone you don’t know, please let me kill your family member,” I told them.

It doesn’t even take much thinking to realize how cruel that is, but… I didn’t realize that until the very end.

Translation used: https://youtu.be/9xmokVJ-6x4?si=VgcIp5LCdNnUwqUW

Brain death is the irreversible, complete loss of brain function, meaning there’s no chance for a braindead patient to ever come back. Because of this, some people may feel that removing life support from a braindead patient doesn’t constitute murder. It definitely doesn’t constitute murder from a legal perspective, but it makes sense why someone might think of it as murder— especially in Japan.

Japanese perspectives on brain death

In evaluating Shidou’s case, we have to consider the cultural context within which it was written. Many people in Japan do not consider brain death as human death, and brain death cannot be declared without consent from the family and the intention to donate organs. In fact, braindead patients are not removed from life support until their heart stops beating. Shidou isn’t being dramatic when he frames his words as basically saying, “please let me kill your family member.”

Brain death is a very contentious topic in Japan—Doctors are put under scrutiny for declaring brain death and performing organ transplants. It’s important to know that in Japan, brain death only exists in relation to organ transplants. And only certain designated hospitals will do this. Even more so, if a person writes an advance directive asking to be taken off of life support in the case of brain death, doctors are not required to follow it. And many of them don’t, out of fear of the patient’s family lashing out at them.

Only in 2010 was Japan’s Organ Transplant Law revised so that organ transplants could be performed without prior consent from the brain dead patient (now only requiring consent from the family).

Here’s a couple of scholarly articles on the topic if you’d like to read more about it.

https://doi.org/10.1186%2Fs12910-021-00626-2

https://doi.org/10.1353/nib.2022.0019

Another very important facet of this discussion is how low organ donation rates are in Japan. To give you an idea, here’s a chart showing the per million population of donations after brain death (DBD) and donations after cardiac death (DCD) in a few different countries.

Sourced from this article, which has some other interesting statistics as well: https://doi.org/10.1016/j.tpr.2023.100131

As you can see, Japan’s rates are astronomically low in comparison to other countries. This helps to contextualize why Shidou had to try so hard to persuade families to donate, and why he later became extremely desperate when his wife’s life was on the line.

I’ve seen a lot of people confused about Shidou’s crime, and many speculations about him doing heinous things such as organ harvesting or purposefully botching surgeries—but I think this is because we’re approaching the case with a western perspective. As we know, many (if not all) of the Milgram prisoners represent a controversial social issue. Brain death is not nearly as divisive in western medicine as it is in Japan, so it’s easy to overlook the idea that all Shidou actually did was take organs from braindead patients. Perspectives on brain death in Japan have changed a lot in the past couple of decades, but it’s still quite controversial; because of this, I truly believe that this is the point of contention behind Shidou’s case, and there’s nothing more sinister secretly going on.

Compassion fatigue

Compassion fatigue is commonly thought to be the manifestation of secondary traumatic stress and burnout, caused by caring for others who are in stressful situations. This commonly affects people who work in healthcare.

I believe Shidou experienced compassion fatigue from working in the hospital, as he exhibits some of the symptoms—in particular, a reduced sense of empathy and a detachment from others.

I feel that Throw Down makes a lot of sense when you view it from this angle.

Lyrical analysis on Throw Down

Shidou expresses that he no longer remembers what it feels like to take away in order to give.

Pomegranates represent death in Greek mythology, and I believe that’s what they represent here too. Shidou has become desensitized to death; the pomegranate no longer has any flavor.

If it’s not needed, I’m not interested

Shidou only thought about what was physically necessary to keep a patient alive, and remained emotionally distant.

They’re dead either way, so it doesn’t really matter to him.

Now slowly close your eye, put your regret on display

Wish for being there for someone

With the same expression no matter who comes

This is the part that most makes me think of compassion fatigue—Shidou had difficulty expressing empathy for grieving families and had to fake it.

I don’t feel scared because I don’t know

Shidou didn’t understand what it was like to be in that situation. But now that it’s happened to him… he understands. And, looking back, he understands how unkind he had been about all of it. This is why he considers himself to be a murderer, why he truly believes that he has killed many people.

Ethics is a delusion

This is a line that definitely struck me as odd for awhile, but I think it makes sense in the context of his situation. His sin was not illegal—but is it ethical? That’s what all of this—whether you forgive him or not—hinges on.

The other half of Shidou’s sin

Going back to what I said earlier, Shidou’s sin wasn’t only convincing families to donate their relatives’ organs. His sin is also transplanting his son’s organs in an attempt to save his wife.

I believe that Shidou’s family got into a car accident, which resulted in his older child experiencing brain death and his wife being left in critical condition (and the younger child presumably died immediately). Considering the views surrounding brain death in Japan, it would have been difficult to find a donor, so Shidou became desperate enough to transplant his son’s organs. Since he’s the father, there wouldn’t have been any issues with receiving consent for the transplant.

Some people believe it’s the other way around—that he transplanted his wife’s organs into his son—but I believe otherwise, for multiple reasons.

In Shidou’s T1 voice drama, he expresses relief at the fact that his judgment is being determined by Es, who is a child. This makes sense if he feels that he killed his son.

Instead of being told by the law that I won’t be forgiven, I wanted a child like you, Es, to tell me that.

I feel sorry that you had to be given this role. And, I truly apologize for being so insistent about sentencing me to death as well… But, you’re perfect. You’ll give me the ending I’m most suited for.

Translation used: https://youtu.be/C4MiQ3V3YjQ?si=hPmlUkc6BfdcacNg

Additionally, a few scenes in Triage…

As stated before, I interpret the pomegranates to represent death. Shidou brings home three pomegranates, one for each of his family members. He later hands his son a price tag from the pomegranates—a representation of Shidou sentencing him to death.

And at the end of Throw Down, an organ tag falls out of the flower person. The name seems to read “Rei Kirisaki” and has XY marked, probably indicating that the donor is male.

Not to mention, it’s much more plausible for the flower person to represent Shidou’s wife rather than his son. When the person falls apart, there’s a shot of a red rose—the flower most known for representing romantic love—falling out of them.

Final thoughts and conclusion

To summarize: Shidou used to routinely try to persuade the families of braindead patients to donate their relatives’ organs. Despite that the prevailing thought in Japan is that brain death is not human death, Shidou did not think of it this way.

Shidou’s family later got into an accident; he transplanted his braindead son’s organs in an attempt to save his wife, but it was a failure, resulting in her death. This situation made him reflect on his past actions—he did not consider it murder before to discontinue life support on a patient, but now that he did it to his son, his perspective has changed. Everything he has done is within the confines of the law, but he is now burdened with immense guilt and thinks himself a murderer. Not just in regards to his son, but to all of the patients that he had pulled the plug on.

Side note: I don’t think having low empathy is inherently a bad thing (I have naturally low empathy), but in this context it would make sense for Shidou to feel bad about lacking empathy.

Side note 2: Shidou is a surgeon, so it is entirely possible he personally performed the transplant on his wife. Operating on family members isn’t illegal or anything, but is widely considered to be unethical and not really a good idea.

Well, that’s all I had to say—Feel free to either add on to this theory or debate me on it. This post ended up quite long, so thank you for reading!

#Milgram #Kirisaki Shidou #Shidou Kirisaki #theory #analysis #long post #vi posts

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