Bloomberg News

Emperor’s Surgery Highlights Scarcity of Japanese Heirs

February 28, 2012

(Adds Emperor admitted to hospital in fifth paragraph.)

Feb. 17 (Bloomberg) -- Japanese Emperor Akihito undergoes heart surgery tomorrow, casting light on succession rules that limit the number of eligible heirs to the world’s oldest hereditary monarchy.

Akihito, 78, will have coronary bypass surgery at the University of Tokyo Hospital to treat the narrowing of an artery, the Imperial Household Agency said in a Feb. 12 statement. The emperor, who had prostate surgery in 2003 and was hospitalized with pneumonia in November, was on medication after experiencing arterial problems last year.

Concerns over his health have prompted the government to consider altering the 1947 law that mandates only men succeed to the throne and requires princesses to give up their titles if they marry commoners. Akihito’s grandson Hisahito in 2006 became the first male born into the family in more than four decades, increasing the number of potential heirs to three.

“By the time he assumes the throne, he will be the imperial family,” Colin Jones, a law professor at Doshisha University in Kyoto, said of the 5-year-old prince. “You’re looking at a future where the imperial family consists of a single nuclear family. That’s problematic in that, if he doesn’t have a son, then what do you do?”

Akihito was admitted to the hospital this morning, Kyodo News said, citing the Imperial Household Agency.

Crown Prince Naruhito, 51, will serve as regent during his father’s surgery and convalescence. Naruhito, who has one daughter, is next in line to the throne, followed by his 46- year-old brother, Prince Akishino, and nephew Hisahito.

‘Great Priority’

Fueling the debate is that eight of the 23 members of the imperial family are single females who will have to marry outside the bloodline, leaving fewer people to handle traditional functions such as giving speeches and attending events. Several aristocratic families were stripped of their status after World War II, limiting the number of royal matches.

Prime Minister Yoshihiko Noda on Dec. 1 said the government should study whether princesses should be allowed to keep their status after marriage and called for a national debate.

The matter is “of great priority in assuring the stability of the activities of the imperial family,” Noda told reporters. “We are currently considering how we should move forward.”

He has made no mention of altering the law to allow women to ascend the throne. A 2005 proposal backed by Prime Minister Junichiro Koizumi to determine succession by order of birth regardless of sex met with opposition from his Liberal Democratic Party. The plan was shelved after Akishino’s wife, Princess Kiko, became pregnant.

No Backup Plan

Without reforms, there may not be a backup plan if Hisahito doesn’t have a son or is incapacitated. While the emperor’s role is mostly symbolic, Japan’s constitution requires him to perform tasks including appointing the prime minister and promulgating laws passed by the Diet.

“Monarchies have extended families just so that there’s a source of spares,” Doshisha’s Jones said. “Over time there will be no other members of the imperial family to act as proxies.”

Akihito, the first Japanese emperor to serve from the outset in the strictly symbolic role under the constitution imposed by the U.S. after World War II, succeeded to the throne in 1989 after the death of his father, Emperor Hirohito.

During a typical bypass operation, a surgeon takes a blood vessel from the patient’s chest or leg and constructs a new channel to allow blood to flow to the heart, circumventing the original, clogged artery. The procedure can take three to six hours, according to the American Heart Association.

‘Common Procedure’

“Bypass surgery remains a very, very common procedure worldwide,” Dr. Richard Shemin, chief of cardiothoracic surgery at the Ronald Reagan UCLA Medical Center in Los Angeles, said in a phone interview. The mortality rate for young and healthy patients is less than 2 percent, while risks for older patients like the emperor may be “somewhat higher” depending on other medical conditions, Shemin said.

Akihito’s recent health problems prompted his younger son, Akishino, to suggest in November that Japan’s emperors be allowed to retire once they reach a certain age. Current law contains no such provision.

Lawmakers will need to resolve the succession issue soon, since it may be too late to do so by the time Hisahito becomes emperor, Jones said.

“They can’t just suddenly conjure up new imperials,” he said. “They’ve got to do something now.”

--With assistance from John Brinsley in Tokyo. Editor: John Brinsley, Brian Fowler

To contact the reporter on this story: Terje Langeland in Tokyo at

To contact the editor responsible for this story: Frank Longid at

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