Public Good, Private Protections: Competing Values in German Transplantation Law

Abstract

Organ transplantation has become almost routine practice in many industrialized countries. Policy, ethical, and legal debates tend to center on fairness of allocation rules or alternatives to promote greater numbers of donations. There are also certain beliefs about the use of bodily materials that are often presumed to be homogenous across Euro–American societies. In Germany, however, the idea of using the bodies of some for the good of others, and the right to proclaim some bodies dead for large–scale medical and political purposes is highly charged. This is due to the historical context of medical experimentation, selection, and euthanasia under National Socialism, and the former East German socialist policies which intervened in the private lives and bodies of citizens. This article is based on an ethnography of organ procurement practices during the period when German policymakers struggled with writing a transplant law. Active public resistance revealed deep concern about state intervention in private matters and amplified the growing unrest over definitions of moral community in a changing, post–reunification society. The article shows how public disputes about health policy become a way through which societies deal with other social conflicts.

‘Saying no to organ donation’: an empirical typology of reluctance and rejection

“…Thus, she pointed out how definitions of death are culturally constructed in modern medicine. For the German context, Hogle (, , ) examined the impact of two totalitarian regimes (National Socialism and German Democratic Republic) on recent national political, ethical and legal debates on organ donation. She identified how relying on Christian terminology or solidarity conflict with more recent secular and pluralistic understandings of citizenship and body concepts.…”

“…She identified how relying on Christian terminology or solidarity conflict with more recent secular and pluralistic understandings of citizenship and body concepts. Overall, the studies of Western public attitudes have revealed that the willingness to agree to post‐mortem donation is associated with the adoption of a fragmented scientific and economic concept of the body (Hogle , Lock , Schweda and Schicktanz ). These approaches form the background of our aim as they analyse organ donation in relation to concepts of the body, theories of gifting and reciprocity, and religious concerns.…”

Living Cadavers and the Calculation of Death

“…1. Germany, although it has recognized brain death as human death for a considerable time, has recently been experiencing renewed contentious debate on the subject (Hogle, 2002;Schone-Seifert, 1999). Sweden and Denmark recognized brain death as the end of human life nearly two decades after other European countries following extensive and at times vitriolic public debate on the subject (Brante and Hallberg, 1991;Rix, 1999;Machado, 1996).…”

Desire, duty and medical gifting: how it became possible to long for a useful death

“…Although it is a shared condition for all members of humanity, there is immense variation in how it is organised and the meanings it is ascribed, both historically (Bynum, 1995) and across regions (Course, 2007;Green, 2008;Seremetakis, 1991;Verdery, 1999). Care for the dead raises basic questions relating to who owes what to whom, or what Hogle (2002) in relation to organ donation has termed the enactment of a 'moral community'. Historically, the main arenas in Western societies for negotiating state access to material remains have been dissection usage and forensic science; however, from the 1970s onwards, organ and tissue needs have taken over as the prime instigators for negotiations of access to dead bodies (Timmermans, 2006).…”