Ethics of Organ Donation and the Problem of the Sacred

Cover Page

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

The purpose of this article is to analyze the interaction between relatives of potential donors and transplant professionals within the framework of a cultural sociological approach in order to develop valid bioethical recommendations. The key thesis of this article is the assertion that principalist ethical conflicts regarding the problems of organ donation, as well as the tools of narrative ethics, are not sufficient to reveal the motivation of agents. As part of the search for the origins of this, it is proposed to reconstruct the situation of moral choice of family members within the framework of E. Durkheim’s theory of the sacred. The concept of the sacred is revealed with the orientation on the given by P. Smith and D. Alexander. The concept of sacred is revealed with the orientation on the autonomous role of culture given by F. Smith and D. Alexander, oriented to the study of the emotional dimension of social life and the study of cultural structures as a social text. Based on the analysis of the category of the sacred in the context of social circumstances of organ donation in Spain, it is shown that the successful experience of the latter in the field of transplantology is connected with the desacralization of the body undertaken by the Catholic Church in Spain and the subsequent sacralization of the gift of life. The analysis of the narratives of donor relatives and medical professionals shows that the driving force behind the relatives’ motivation is often the sacralization of the deceased’s will, which implies the possibility of a posthumous gift and reinforces the solidarity of the deceased with the society experiencing a shortage of donor organs. Obstacles to successful transplantation are perceived by donor relatives as a possible desecration of the gift of a loved one’s life. Thus, on the way to creating valid bioethical recommendations for interacting with relatives of potential donors, it is recommended to focus on the study of pre-individual cultural and social constructs of the sacred that relate to situations of donation and death. In this case, the sacred is considered as an important constant of social life, not necessarily related directly to religion.

Full Text

Restricted Access

About the authors

Sofya V. Lavrentyeva

RAS Institute of Philosophy

Author for correspondence.
Email: sonnig89@gmail.com
ORCID iD: 0000-0002-3082-2975

Junior Researcher of the Department of Humanitarian Expertise and Bioethics

Russian Federation, 12/1 Goncharnaya Str., Moscow 109240

References

  1. Александер Дж., Смит Ф. Сильная программа культурсоциологии / пер. с англ. С. Джакуповой // Социологическое обозрение. 2010. № 2. С. 11–30.
  2. Alexander J.C., Smith Ph. Sil’naya programma kul’tursotsiologii [Strong Program in Cultural Sociology], transl. from English by S. Dzhakupova. Sotsiologicheskoe obozrenie. 2010. N 2. P. 11–30.
  3. Александер Дж. Смыслы социальной жизни: Культурсоциология / пер. с англ. Г.К. Ольховикова. М.: Праксис, 2013.
  4. Aleksander J.C. Smysly sotsial’noi zhizni: Kul’tursotsiologiya [The Meanings of Social Life: A Cultural Sociology], transl. from the English by G.K. Olkhovikov. Moscow: Praksis Publ., 2013.
  5. Куракин Д. «Элементарные формы»: великая книга и великая тайна // Социологическое обозрение. 2018. № 2. С. 115–121.
  6. Kurakin D. «Elementarnyye formy»: velikaya kniga i velikaya tayna [The Elementary Forms of Religious Life: A Great Book and a Great Mystery]. Sotsiologicheskoe obozrenie. 2018. N 2. P. 115–121.
  7. Куракин Д. Ускользающее сакральное: проблема амбивалентности сакрального и ее значение для «сильной программы» культурсоциологии // Социологическое обозрение. 2011. Т. 10. № 3. С. 41–70.
  8. Kurakin D. Uskol’zayushchee sakral’noe: problema ambivalentnosti sakral’nogo i ee znachenie dlya «sil’noi programmy» kul’tursotsiologii [Eluding Sacred: Ambiguity of the Sacred and Its Importance for the “Strong Program” in Cultural Sociology]. Sotsiologicheskoe obozrenie. 2011. N 3. P. 41–70.
  9. Нагорный В.А., Медведев Е.В. Презумпция согласия на посмертный забор органов и тканей человека для трансплантации в контексте соматических прав личности // Вопросы современной юриспруденции. 2013. № 29. С. 117–127.
  10. Nagorny V. A., Medvedev E.V. Prezumptsiya soglasiya na posmertnyy zabor organov i tkaney cheloveka dlya transplantatsii v kontekste somaticheskikh prav lichnosti [Presumed Consent to Post-Mortal Removal of Organs and Tissues for Transplantation within the Paradigm of the Somatic Rights of the Individual]. Voprosy sovremennoy yurisprudentsii. 2013. N 29. P. 117–127.
  11. Azuri P., Tarabeih M. Religious Worldviews Affecting Organ Donation in Israel. Transplantation Proceedings. 2022. Vol. 54, N 8. P. 2047–2056.
  12. Becker F. et al. Optimizing Organ Donation: Expert Opinion from Austria, Germany, Spain and the UK. Annals of transplantation. 2020. N 25. P. e921727-1.
  13. Charon R. Narrative Medicine: Honoring the Stories of Illness. London: Oxford University Press, 2006.
  14. Dalal A.R. Philosophy of Organ Donation: Review of Ethical Facets. World journal of transplantation. 2015. Vol. 5, N 2. P. 44–51.
  15. Etheredge H.R. Assessing Global Organ Donation Policies: Opt-In vs Opt-Out. Risk Manag Healthc Policy. 2021. N 14. P. 1985–1998.
  16. Fernández-Alonso V. et al. Facilitators and Barriers in the Organ Donation Process: A Qualitative Study among Nurse Transplant Coordinators. International journal of environmental research and public health. 2020. Vol. 17, N 21. P. 7996.
  17. Frank A.W. Enacting Illness Stories: When, What, and Why. Stories and Their Limits Narrative Approaches to Bioethics, ed. by H.L. Nelson. London, New-York: Routledge, 1997. P. 31–49.
  18. Gironés P., Crespo M.L., Santamaria J.M.D. Impact of Organ Donation in Spanish Families: Phenomenological Approach through Relatives’ Lived Experiences. Transplantation Proceedings. 2015. Vol. 47, N 1. P. 4–6.
  19. Gracia D. Prior Consent of Deceased and Family Permission. Ethics. Access and Safety in Tissue and Organ Transplantation: Issues of Global Concern. Madrid, Spain, 6–9 October 2003. Report. Geneva: WHO, 2004. P. 10–11.
  20. Martinez-Lopez M.V. et al. Family Bereavement and Organ Donation in Spain: a Mixed Method, Prospective Cohort Study Protocol. BMJ open. 2023. Vol. 13, N 1. P. e066286.
  21. Messina E. Beyond the Officially Sacred, Donor and Believer: Religion and Organ Transplantation. Transplantation Proceedings. 2015. Vol. 47, N 7. P. 2092–2096.
  22. Mikhel D. Organ Transplantation in Russia: An Anthropological Perspective. Anthropologica. 2021. Vol. 63, N 2. P. 1–23.
  23. Prabhu P.K. Is Presumed Consent an Ethically Acceptable Way of Obtaining Organs for Transplant? Journal of the Intensive Care Society. 2019. Vol. 20, N 2. P. 92–97.
  24. Rithalia A. et al. Impact of Presumed Consent for Organ Donation on Donation Rates: a Systematic Review. BMJ. 2009. N 338. P. a3162.
  25. Sáenz R.H. An Interpretive Approach to Religious Ambiguities around Medical Innovations: The Spanish Catholic Church on Organ Donation and Transplantation (1954–2014). Qualitative Sociology. 2023. Vol. 46, N 1. P. 77–108.
  26. Smith Ph. Durkheim and After. The Durkheimian Tradition, 1893–2020. Cambridge: John Wiley & Sons, 2020.
  27. Smith Ph. Narrating the Guillotine: Punishment Technology as Myth and Symbol. Theory, Culture & Society. 2003. Vol. 20, N 5. P. 27–51.
  28. Willis B.H., Quigley M. Opt-out Organ Donation: on Evidence and Public Policy. Journal of the Royal Society of Medicine. 2014. Vol. 107, N 2. P. 56–60.
  29. Zimmermann C.J. et al. Family and Transplant Professionals’ Views of Organ Recovery before Circulatory Death for Imminently Dying Patients: A Qualitative Study Using Semistructured Interviews and Focus Groups. Am J Transplant. 2019. Vol. 19, N 8. P. 2232–2240.

Copyright (c) 2024 Russian Academy of Sciences

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies