Study of the withdrawal of life-sustaining treatment and related problems in emergency medicine in Japan

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The question of whether to withdraw mechanical ventilation and other treatment from dying patients remains nearly unexplored in Japan. In 2008-2009, an anonymous, cross-sectional questionnaire survey was conducted with 2,802 physicians, who were members of the Japanese Association for Acute Medicine. Of them, 928 completed the self-report survey (response rate : 33%). Data showed that mechanical ventilation was rarely withdrawn from brain-dead patients, while other treatment including medication was withdrawn frequently so that a "soft-landing" was created. Mixed reaction was observed to "the double standard of brain death" in Japan, in which brain-dead people are considered dead only when they are organ donor candidates. More respondents appreciated the double standard because it allows discretion regarding when to stop providing medical care to brain-dead people.