Currently in the United States, the human body defines a profitable site of “reusable” parts, which range from whole organs down to microscopic tissues. Although the medical practices that facilitate the transfer of parts from one human body to another reduce suffering and extend lives, these practices have also altered perceptions of the values assigned to the body. The practices shaping American biomedicine are seen as pervasive, and sometimes destructive, compelling scientific inquiry and social critique.
http://www.king5.com/news/Death-row-inmate-wants-to-donate-organs-117762369.html
This video (and the related article) raises ethical, legal, medical, and social issues. Should “one of Oregon’s most notorious killers” be allowed to end appeals to his death sentence in order to donate his organs? Christian Longo, the “notorious killer”, thinks so, he wants to alter his protocol for lethal injection to fulfill his wish. Longo was convicted of killing his wife and three children in 2003, in which he stated he did so “in order to live an uninhibited lifestyle”. Longo’s issue to donate his organs was recently brought to recent news with submission of his Op-Ed piece, “Giving Life After Death Row”, in the New York Times. Longo writes, “I spend 22 hours a day locked in a 6 foot by 8 foot box on Oregon’s death row. There is no way to atone for my crimes, but I believe that a profound benefit to society can come from my circumstances. I have asked to end my remaining appeals, and then donate my organs after my execution to those who need them. But my request has been rejected by the prison authorities”. In addition to Longo admitting his guilt, he has founded a group called “Gifts of Anatomical Value From Everyone, or G.A.V.E.”. This is an organization set up to “make a difference in the organ shortage in the U.S. with the help of willing and healthy volunteer prisoners. Prisoners frequently ask to help whether through living kidney donations or multiple donations after execution to anyone in need. But they are just as frequently denied unnecessarily by prison administration and transplant authorities”. In his Op-Ed piece, Longo argues, “According to the United Network for Organ Sharing, there are more than 110,000 Americans on organ waiting lists. Around 19 of them die each day. There are more than 3,000 prisoners on death row in the United States, and just one inmate could save up to eight lives by donating a healthy heart, lungs, kidneys, liver and other transplantable tissues”. Furthermore, Longo claims, “If I donated all of my organs today, I could clear nearly 1 percent of my state’s organ waiting list. I am 37 years old and healthy; throwing my organs away after I am executed is nothing but a waste”. The current procedure for those on death row in Oregon, along with other states, requires death by three lethal drugs injected, which destruct organs and make them unfit for transplants. In the video, Longo suggests an appeal to switch to one lethal drug that would kill him, and simultaneously allow his organs to be saved and donated. However, the state has denied his request, claiming his requests to change his death row appeal and change the lethal injection protocol are mutually exclusive. His requests raise many issues of concern, such as logistical and health concerns. A common concern involves the prevalence of disease, such as increased rates of H.I.V. and hepatitis in the prison population, which can effect the prisoner’s organs. However, tests can be administered to determine whether the prisoner’s organs are healthy. Another concern is on fears about security; the donation of organs by prisoners can be seen as an “elaborate escape scheme”. However, it is argued that prisoners do receive other medical care at outside hospitals and are executed on prison grounds, meaning that donating does not produce the risk of escape. Additionally, there is public apprehension towards prisoners donating organs due to the previously publicized case of “Gov. Haley Barbour of Mississippi released two sisters who had been sentenced to life in prison”. By donating organs, in this previous case, a kidney of one sister to the other, provides an expectation that prisoners can receive privileges and reductions in their sentences, and might be given the option to leave prison alive. Lastly, there is the concern of abuse. The acceptance of voluntary donations provides the opportunity to abuse these choices, which has been demonstrated by past history of medical experiments on prison inmates. However, it is argued that prisoners should be allowed to initiate a request to donate their organs without any “enticements”. Longo claims that many other men on death row express the wish to donate their organs, as well. Does the public, especially those in need of organ transplants, disagree with the prison authority’s response in denying Longo’s request? Or do they express the many concerns surrounding organ donations by prisoners? Who is to decide if a prisoner on death row can or cannot donate their organs?
Organs are rapidly becoming commodities, in which American attitudes towards life and death are modified. In the article, “Aged bodies and kinship matters: The ethical field of kidney transplant”, the authors discuss how modern medicine defines “death within a framework of ethical decision making that emphasizes the fight against specific moral diseases and conditions” (Kaufman et al. 81).The authors argue that the ultimate decision of morality is "a sacrifice of the wholeness of the body and a nonreciprocal bargain”, in which “the possibility of receiving the body part of another- the always already quality of this social fact- becomes part of the calculus by which the potential risk to another life and the sacrifice of another’s bodily integrity are weighed in relation to the value of extending one’s own life and improving one’s own well being” (Kaufman et al. 83-85). As a result, “the availability of interventions as therapeutic possibilities elicits hopes for and expectations of cure, restoration, enhancement and improved quality of life” (Kaufman et al. 83). The article discusses how effective procedures “become routine and thus expected and desired by clinicians, patients, and families”, additionally, ”when techniques become less invasive and associated with lower mortality risk, consumer demand for them and ethical pressure to make them available both increase" (Kaufman et al. 82). As time has evolved, new ways of seeing medicine have been established, as the authors state, “Just as the sonogram opened ways of seeing the fetus, its malformations, and the idea of pre-birth intervention, just as surrogacy opened up the idea of motherhood and family, and just as cardiac surgery, the mechanical ventilator, and emergency CPR changed ways of thinking about the risk of death, so, too, the idea of organs moving from children to parents, between spouses, or between friends or strangers opens up the old issue of social and familial obligation to emerging biotechnical means of expression”(Kaufman et al. 95). Medical and technological advances, in particular organ donation, have created new alternatives to defeating death and viewing life, which in turn, have produced ethical and moral issues concerning obligation and choice.
Nancy Scheper-Hughes' article, “The Last Commodity: Post-Human Ethics and the Global Traffic in ‘Fresh’ Organs”, discusses the ethics of organ transplants and the “moral and ethical gray zone- the lengths to which it is permissible to go in the interests of saving or prolonging one’s own life at the expense of diminishing another person’s life or sacrificing the cherished cultural and political values” (147). Our sense of “body holism, integrity, and human dignity” are restricted by “free market medicine” which “requires a divisible body with detachable and demystified organs seen as simple materials for medical consumption” (Scheper-Hughes 155). Additionally, “the transformation of a person into a life that must be prolonged or saved at any cost has made life into the ultimate commodity fetish. The belief in the absolute value of a single human life saved or prolonged at any cost ends all ethical inquiry and erases any possibility of a global social ethic” (Scheper-Hughes 158). As these medical transactions take place “from black and brown bodies to white ones, and from females to males”, there is “little empathy for the donors, living and brain dead. Their suffering is hidden from the general public. Few organ recipients know anything about the impact of the transplant procedure on the donor’s body” (Scheper-Hughes 150,161). “Social kinship” produced by the supply of organs is created to “link strangers, even at times political enemies from distant locations who are described by the operating surgeons as 'a perfect match--like brothers'” (Scheper-Hughes 150). The obligation to prolong and save the life of another person outweighs the medical risks of surgery or later impacts that may affect the donor’s life later on. It has become a choice to become an organ donor and help save the lives of others, thus moral and ethical issues accompany the choices and/or obligations of organ transplant patients and organ donors.
Our limitations concerning the notions of life and death have changed with the advancement of medicine and technology. Our values of the body are modified through time, as health becomes one of the main concerns of our society. We have become bounded within the framework of biomedicine and the surrounding issues of choice as one seeks to defer death and prolong life. Such ethical and moral concerns concerning organ transplants promote the progress and promise of extending human life. Has the hope to maximize human life extended far beyond what nature has intended? Medicine, science, and technology have already increased the human life span, so what’s next?
Sources:
Sharon R. Kaufman, Ann J. Russ, and Janet K. Shim. 2006. “Aged Bodies and Kinship Matters: The Ethical Field of Kidney Transplant.” American Ethnologist 33(1): 81-99.
Nancy Scheper-Hughes. 2005. “The Last Commodity: Post-Human Ethics and the Global Traffic in ‘Fresh’ Organs.” Pp. 145-167. In Global Assemblages: Technology, Politics and Ethics as Anthropological Problems. Malden, MA: Blackwell Publishers.
http://www.nytimes.com/2011/03/06/opinion/06longo.html?_r=1&scp=1&sq=%22christian%20longo%22&st=cse?kgw
http://www.gavelife.org/
Thursday, March 10, 2011
Friday, March 4, 2011
The Meaning of Life and Death
While death is a natural event, meaning that cells die and body systems fail, our experiences with death continue to be shaped and influenced by medical and cultural practices and trends. We are surrounded with many questions concerning the “meaning” of death, as our experiences and perceptions of death include many issues of morality. With more of us living longer and dying from chronic conditions rather than acute diseases, new medical technologies have been created to prolong life. Dying bodies are kept alive with medications and machines; however, these technologies raise questions about the quality of life and challenges are made against these life-prolonging measures. While the traditional view of death is seen as the “enemy”, systems have been created in order to “defeat” death and make it less “feared”, such as organ “harvesting” and transplantation. To make the process of dying easier and more comfortable, we have institutionalized hospice and palliative care. Through time, death has become a process that is less hidden, talked about, and individualized.
In my Comparative Study of Death class, we have talked about the differences between dying, (being) dead, and death. All three are connected with the experience of death, where death is defined as a process, (being) dead is defined a condition or state that the body is in, and lastly, death is defined as the transition from being alive to being dead and is what intervenes between dying and (being) dead. Our experiences of death are seen as a process and end as a state. “Acceptance” or “denial” of death depends on a variety of factors—social, circumstances of the case, cultural responses, and individual needs. Kubler-Ross wrote about the stages of death: denial and isolation, resentment and anger, bargaining, depression and hopelessness, and acceptance. In addition, each person will travel through these stages in their own way.
This YouTube video is a dark satire portraying our conceptions of what death really is and what it means to us as individuals. Once death arrives, decisions are made, and the choices vary. Contrary to our American dominant ideologies, the video portrays death as an event, rather than a process. The people in the video come to terms with death, and come up with strategies to defend themselves from death. Their fluctuating reactions project what Kubler-Rose describes as the stages of death. The individuals go from denial to acceptance, which all the stages are expressed through their reactions. When they are told they are dead by the grim reaper, they feel an experiential blank, where the phenomenon of anticipatory grief has occurred because they have been forewarned. In addition to these reactions, the video brings up the issue of what awaits for the newly deceased. Conceptions of the afterlife question what souls are, where they reside within us, and where do they go once we are dead. At the end of one’s life, feelings are evoked out of loss of agency in the world and moral personhood. The subjectivity of the body becomes objectified. All of these issues are open to question and subject to personal beliefs. Despite spirituality and achievement of a meaningful death that is “dignified”, death can be painful, full of contradictions, and fearful.
For a majority, the representation of factors such as cultural practices or rituals, religious beliefs or ideation, societal norms or laws, deeply influence individual choices and medical concerns. Margaret Lock’s article, “Living Cadavers and the Calculation of Death” discusses aging, dying, and the difference between health care systems and cultures. Lock states, “In North America, a brain dead body is biologically alive in the minds of those who work closely with it, but is no longer a person, whereas in Japan…such an entity is both living and remains a person, at least for several days after the brain death has been diagnosed” (150). The article examines intensive care units (ICU) and the use of medical technology, such as artificial ventilators. The use of these apparatus’ is created for human entities whose brains are diagnosed as irreversibly damaged, but whose bodies are kept alive by technological support. Lock describes “brain dead” patients as “betwixt and between, both alive and dead, breathing with technological assistance but irreversibly unconscious” (136). There is a gray area between what is considered alive and what is considered dead. Amongst these ailments, the management of dying people is what palliative medicine and care are for. In addition, Lock discusses the value of such brain-dead bodies, as they provide potential value towards the supply of donors for human organs to transplant. This dominant ideology is widely disputed and has different effects across cultures. Furthermore, Eric L. Krakauer’s article, “To Be Freed from the Infirmity of (the) Age”, also discusses the use of medical technology and its quest to control death. The use of medicine and technology can be used to free us of our “infirmity of age”. Krakauer states, “Deferring death becomes more important than attending to the soul or preparation for the afterlife or the next” (390). This reflects the dilemma between the conflicting values of medicine and morals and gives insight on bioethical concerns. By affirming one’s goals at life’s end, a person can die a “dignified death”. Additionally, in the midst of suffering at the end of one’s life, comfort and meaning can be provided. These articles allow us to rethink a medical death in larger, more humanistic terms.
In order to consider the meaning of death, we must look at the meaning of life and the relationship between life and death. One may believe that where there is life there is hope. Through the stories of suffering, hope begins with the decision to survive. The metaphorical “fight” against illness is taking on all of life’s aspects, for better or for worse. Life is not only about surviving, it is about engaging in the life we have and embracing it. It is one thing to be alive physically, it is another thing to be alive emotionally and spiritually. James W. Green’s book, “Beyond the Good Death”, examines the ways in which Americans react to death not only for themselves, but also, for those they care about. On the back of the book, Green states, “A compassionate physician once remarked that in his neonatal intensive care unit ‘no one dies in pain and no one dies alone.’ That was his policy: humane, honest, straightforward. But it is not that simple, as he knew. Like birth and marriage, death is ritually dense in all cultures, creating occasions when belief and ritual are as present and as important as the physician’s ministrations. In no society do people simply leave the dead as they are and unceremoniously walk away…Despite the routine disclaimers on death certificates, no on dies a ‘natural death.’ As culture-baring primates we do not have that option”. Each person, each culture is complex, as well as the experiences and practices surrounding death. If one can have a “lifestyle”, can one have a “deathstyle” too?
Sources:
Green, James W. 2008. “Beyond the Good Death: The Anthropology of Modern Dying”. Philadelphia: University of Pennsylvania Press.
Krakauer, Eric L. 2007. “To Be Freed from the Infirmity of (the) Age: Subjectivity, Life-Sustaining Treatment, and Palliative Medicine.” In Subjectivity: Ethnographic Investigations. Joao Biehl, Byron Good, and Arthur Kleinman, eds. Berkeley: University of California Press. Pp. 381-397.
Lock, Margaret. 2004. “Living Cadavers and the Calculation of Death”. Body and Society 10(2-3): 135-152.
In my Comparative Study of Death class, we have talked about the differences between dying, (being) dead, and death. All three are connected with the experience of death, where death is defined as a process, (being) dead is defined a condition or state that the body is in, and lastly, death is defined as the transition from being alive to being dead and is what intervenes between dying and (being) dead. Our experiences of death are seen as a process and end as a state. “Acceptance” or “denial” of death depends on a variety of factors—social, circumstances of the case, cultural responses, and individual needs. Kubler-Ross wrote about the stages of death: denial and isolation, resentment and anger, bargaining, depression and hopelessness, and acceptance. In addition, each person will travel through these stages in their own way.
This YouTube video is a dark satire portraying our conceptions of what death really is and what it means to us as individuals. Once death arrives, decisions are made, and the choices vary. Contrary to our American dominant ideologies, the video portrays death as an event, rather than a process. The people in the video come to terms with death, and come up with strategies to defend themselves from death. Their fluctuating reactions project what Kubler-Rose describes as the stages of death. The individuals go from denial to acceptance, which all the stages are expressed through their reactions. When they are told they are dead by the grim reaper, they feel an experiential blank, where the phenomenon of anticipatory grief has occurred because they have been forewarned. In addition to these reactions, the video brings up the issue of what awaits for the newly deceased. Conceptions of the afterlife question what souls are, where they reside within us, and where do they go once we are dead. At the end of one’s life, feelings are evoked out of loss of agency in the world and moral personhood. The subjectivity of the body becomes objectified. All of these issues are open to question and subject to personal beliefs. Despite spirituality and achievement of a meaningful death that is “dignified”, death can be painful, full of contradictions, and fearful.
For a majority, the representation of factors such as cultural practices or rituals, religious beliefs or ideation, societal norms or laws, deeply influence individual choices and medical concerns. Margaret Lock’s article, “Living Cadavers and the Calculation of Death” discusses aging, dying, and the difference between health care systems and cultures. Lock states, “In North America, a brain dead body is biologically alive in the minds of those who work closely with it, but is no longer a person, whereas in Japan…such an entity is both living and remains a person, at least for several days after the brain death has been diagnosed” (150). The article examines intensive care units (ICU) and the use of medical technology, such as artificial ventilators. The use of these apparatus’ is created for human entities whose brains are diagnosed as irreversibly damaged, but whose bodies are kept alive by technological support. Lock describes “brain dead” patients as “betwixt and between, both alive and dead, breathing with technological assistance but irreversibly unconscious” (136). There is a gray area between what is considered alive and what is considered dead. Amongst these ailments, the management of dying people is what palliative medicine and care are for. In addition, Lock discusses the value of such brain-dead bodies, as they provide potential value towards the supply of donors for human organs to transplant. This dominant ideology is widely disputed and has different effects across cultures. Furthermore, Eric L. Krakauer’s article, “To Be Freed from the Infirmity of (the) Age”, also discusses the use of medical technology and its quest to control death. The use of medicine and technology can be used to free us of our “infirmity of age”. Krakauer states, “Deferring death becomes more important than attending to the soul or preparation for the afterlife or the next” (390). This reflects the dilemma between the conflicting values of medicine and morals and gives insight on bioethical concerns. By affirming one’s goals at life’s end, a person can die a “dignified death”. Additionally, in the midst of suffering at the end of one’s life, comfort and meaning can be provided. These articles allow us to rethink a medical death in larger, more humanistic terms.
In order to consider the meaning of death, we must look at the meaning of life and the relationship between life and death. One may believe that where there is life there is hope. Through the stories of suffering, hope begins with the decision to survive. The metaphorical “fight” against illness is taking on all of life’s aspects, for better or for worse. Life is not only about surviving, it is about engaging in the life we have and embracing it. It is one thing to be alive physically, it is another thing to be alive emotionally and spiritually. James W. Green’s book, “Beyond the Good Death”, examines the ways in which Americans react to death not only for themselves, but also, for those they care about. On the back of the book, Green states, “A compassionate physician once remarked that in his neonatal intensive care unit ‘no one dies in pain and no one dies alone.’ That was his policy: humane, honest, straightforward. But it is not that simple, as he knew. Like birth and marriage, death is ritually dense in all cultures, creating occasions when belief and ritual are as present and as important as the physician’s ministrations. In no society do people simply leave the dead as they are and unceremoniously walk away…Despite the routine disclaimers on death certificates, no on dies a ‘natural death.’ As culture-baring primates we do not have that option”. Each person, each culture is complex, as well as the experiences and practices surrounding death. If one can have a “lifestyle”, can one have a “deathstyle” too?
Sources:
Green, James W. 2008. “Beyond the Good Death: The Anthropology of Modern Dying”. Philadelphia: University of Pennsylvania Press.
Krakauer, Eric L. 2007. “To Be Freed from the Infirmity of (the) Age: Subjectivity, Life-Sustaining Treatment, and Palliative Medicine.” In Subjectivity: Ethnographic Investigations. Joao Biehl, Byron Good, and Arthur Kleinman, eds. Berkeley: University of California Press. Pp. 381-397.
Lock, Margaret. 2004. “Living Cadavers and the Calculation of Death”. Body and Society 10(2-3): 135-152.
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