Biomedicine as Global Assemblage: The Malay Muslim Account of Total Brain Failure

Abstract

The rather rare condition of total brain failure, commonly referred to as “brain death”, has become emblematic of the possible conflicts between scientific and religious, modernising and traditional, and academic and popular views on death and dying. To capture those heterogeneous and often contradictory discourses on total brain failure in one particular context, that of Malay Muslims in Malaysia, I make use of the analytical construct “global assemblage”, a concept that grasps well the complexity of discourses and practices pertaining to biomedicine. The article delineates how the global assemblage of total brain failure has played out in Malaysia, based on ethnographic fieldwork. It reveals that representatives from the Malaysian Ministry of Health and Muslim clergy from JAKIM, the federal Department for Islamic Development, and the State Mufti Departments accepted the established, albeit disputed biomedical notion of total brain failure in order to establish death and remove “viable” organs for transplant purposes. In contrast, the rural Malay Muslim community surveyed here does not accept the notion of total brain failure, sticking rather to their hitherto held, traditional perception of death, stemming from an era before ventilation became a standard procedure at critical care units. The opinions of such communities are, I argue, excluded from the national discourse on total brain failure in Malaysia.