A phenomenological approach to the ethics of transplantation medicine: sociality and sharing when living-with and dying-with others

Abstract

The original publication is available at Kristin Zeiler, 2014. A phenomenological approach to the ethics of transplantation medicine: sociality and sharing when living-with and dying-with others. Theoretical Medicine and Bioethics 35(5):369-388. DOI 10.1007/s11017-014-9307-3Post-print version. Please quote only from the published version. ABSTRACTRecent years have seen a rise in the number of sociological, anthropological, and ethnological works on the gift metaphor in organ donation contexts, as well as in the number of philosophical and theological analyses of giving and generosity, which has been mirrored in the ethical debate on organ donation. In order to capture the breadth of this field, four frameworks for thinking about bodily exchanges in medicine have been distinguished: property rights, heroic gift-giving, sacrifice, and gift-giving as aporia. Unfortunately, they all run into difficulties in terms of both making sense of the relational dimensions of postmortem and live organ donations and being normatively adequate in the sense of shedding light and providing guidance on ethical concerns when body parts are donated. For this reason, this article presents a phenomenological framework of giving-through-sharing, based on Maurice Merleau-Ponty's philosophy. This framework makes sense of relational dimensions of postmortem and live organ donation. It also sheds light on three highly debated concerns in organ donation ethics: indebtedness on the part of recipients, the fact that some live donors do not experience donation as a matter of choice, and the potentially painful experience of donors' relatives, who need to make decisions about postmortem organ donation at a time of bereavement. It can indirectly support what may be called a normalization of bodily exchanges in medicine.

The Haunting Temporalities of Transplantation

“…My use of queer therefore builds on a phenomenological tradition of analysing morphologically diverse bodies, including the temporalities of biotechnologised bodies (Gunnarson, 2016; Haddow, 2005; Kaufman, 2010; Shaw, 2010; Zeiler, 2014). In particular, I work with Zeiler’s ‘temporal thickness’ (2018: 88) and Merleau-Ponty’s enfolding of body and time: ‘I am not in space and time, nor do I conceive space and time; I belong to them, my body combines with them and includes them’ (1962: 161).…”

“…I extend how we may understand the phenomenological, intertwined experiences of time and self through the lens of queer temporalities and the concept of haunting. Moreover, I build on phenomenological discussions (Gunnarson, 2016; Shildrick, 2012; Zeiler, 2014) that engage with alterity, inter-/intra-subjectivity and the ‘singular-plural nature of personhood’ (Blackman, 2010: 5) by turning to the dead. That is, I examine how the dead may live on as vital organs within another being, and therefore how materiality, rather than presence of a whole person, constitutes life of both self and other.…”