prevention and treatment of premature infants with lung diseases was paramount. Also, many inventions in technology, immunizations and drugs contributed to the increase in survival. This accomplishment attests to the special attention afforded women and children. Also, reducing the incidence of low birth weight, premature infants to 6 percent and extending viability of the fetus to 22 weeks gestation were major achievements for neonatal medicine. The Japanese Eugenic Protection Act of 1991 no doubt influenced this achievement.
If Japan begins organ transplantation on a large scale, it will not only extend lifetimes but will mean increased costs for the survivors. Standards for quality of life should be established early, along with the expectancy of increasing success. These standards must be set and accepted with consideration of the population's culture, religious preference, socio-economic levels and conditions, and personal autonomy. In Louisville we have active transplantation programs of many organs. Our Jewish Hospital is the eighth largest heart hospital in the United States, and our Kosair Children's Hospital was among the first to perform heart transplants in infants. Both institutions weigh their results not only with survival but with quality of life judgments. Criteria were established for quality of life before they initiated these programs.
As a nation Japan has demonstrated great energy, determination and excellence in its medical care and high standard of living. Japan's commitment to quality of life has been demonstrated by the many excellent reports streaming from here and by the outstanding papers on quality of life given at this conference. Japan exhibits freedom of choice to its citizens and recognizes the value of life, liberty and the pursuit of happiness for its people, young and Old. Japan has one of the most admired and cohesive family structures in the world, and is known for loyalty to family, groups and country. The
