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Document Details :

Title: Zorgzaam omgaan met het dode lichaam. Care for the Body of the Deceased
Subtitle: Kanttekeningen bij de ethiek rondom transplantatiegeneeskunde Ethical Reflections concerning Transplantation Medicine
Author(s): SCHOTSMANS, Paul, , VAN REUSEL, Walter
Journal: Bijdragen
Volume: 66    Issue: 2   Date: 2005   
Pages: 145-157
DOI: 10.2143/BIJ.66.2.616518

Abstract :
The mechanical view on the human body may be considered as the context in which the highly technological medicine of these days originated. Organ transplantation is certainly one of the most impressive possibilities of this new evolution in medical technology. It exists by the grace of the paradigm of the body as a “Körper” (Nietzsche): this paradigm leads to a self-evident acceptance of transplantation medicine in its most brilliant applications. Refinement of surgical techniques, better preservation of organs, the development of more effective immunosuppressives, better procedures for the establishment of brain death criteria and better criteria for the selection and matching of donors and receptors are immanent goals of this type of medicine. Meanwhile the lives of many thousands of patients are saved and these patients even receive the chance for a new life, with much more quality.
The ethical reflection on organ transplantation has followed rather rapidly this technical discourse and sounds as a kind of “moral engineering”. This is certainly connected with the upcoming success of “Principlism” (Beauchamp & Childress), whereby medical decision making is oriented by applying four major principles to medical cases (beneficence, non-maleficence, autonomy and justice). It is also connected with the ethical approach of utilitarianism, which fits almost perfectly in this technological atmosphere.
The authors question this approach and suggest that a more relational understanding of the human body as “Leib” (Nietzsche) would be a better paradigm for the promotion of solidarity in the context of organ donation and transplantation. Human beings do not only ‘have’ a body, but ‘are’ also their body. The body of the deceased refers to the life of a loved one. Technical procedures surrounding organ removals sometimes hinder the possibility for the family to bereave adequately around their loved one. The authors are convinced that the urging problem of organ shortage is not only caused by lack of solidarity or laziness, but also by the reductionist discourse of transplantation medicine itself.
They suggest that we have to find – eventually with the help of poets and writers – an adequate new language to replace the alienating discourse of current transplantation medicine. They see also in communitarianism and personalist care ethics a better ethical approach for touching the peculiar sensitivities of eventual donors and receptors.



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