Gift Of Life Research Articles

Disasters that Matter: Gifts of Life in the Arena of International Diplomacy

This article examines the bodily donations made by Greeks, Turks and Cypriots to the victims of two devastating earthquakes in Turkey and Greece (1999), as well as to a Greek and a Turkish Cypriot boy, both suffering from leukemia (2000). Considering the age old discourse of amity and enmity shared by the citizens of the three nation states, I ask what made them see these hardly rare events as exceptionally important, and rush to offer each other their blood and body organs. Politicians and journalists of the time presented these corporeal responses as "civil society's demand for brotherly rapprochement," thus underscoring the anthropological insight that contemporary identity politics is increasingly "medicalized". Taking into consideration both the medical regimes of truth that made these donations possible, and the painful political experiences lived and remembered by Greeks, Turks and Cypriots to this day, I argue that the conciliation these donors performed revealed the suspense of their faith in the reconciliatory future rather than their acceptance of restorative notions such as brotherhood and rapprochement. Stated otherwise, these donors, being familiar with the euphemistic and the conditional hence pending nature of such political conciliations, dared the Derridian impossible: without endangering the principle of sharing, they opened their bodies to alterity, to their foe's bodies, and hence entertained the possibility of non-predetermined, thus unexpected even incongruous events of memory.

Early Integration of a Pediatric Supportive Care Program in Pediatric Oncology (749)

contents. This was done in a series of lectures in April 2008. II. Aims. To identify when and how the newly created palliative extubation protocol was used in the ICU and to identify deficits in its use. III. Method/Session Description. For the period of September 2008 to March 2009 we conducted a survey after each palliative extubation. Data was reported that identified the treatment team’s knowledge of the existence of a palliative extubation protocol, whether the protocol was reviewed prior to the intervention, whether the policy was used for medication management, whether Gift of Life was notified prior to extubation, and whether chaplain services were made available. We also have comparison data for the same outcomes for patients not seen by the palliative care service. IV. Conclusion. As the study progressed, the treatment teams became less aware of the palliative extubation protocol. The biggest deficits and areas for improvement were notifying Gift of Life prior to extubation and providing Chaplain services for patients and their families. We plan to continue ongoing educational interventions to improve the use of the protocol based on these data.

The Gift of Life: Death As Teacher in the Aghori Sect

This article utilizes the example of the Aghori, with their radical and unique perspective on death, as a challenge to the Western world to live an authentic, present life by maintaining awareness of mortality. Specifically, three main themes are explored: first, a theoretical engagement of the concept of death based on the (Western) philosophy of existentialism, second, a review of the historical origins and philosophy of the Aghori sect, and third, a depiction of the Aghoris as a living example of vigorously accepting death as an inevitability of life. On this basis a brief comparison of Western and Eastern attitudes towards life and death will be offered.

Lung transplant recipients' views on the integration of their new organs

Aim. Although donorship issues and the integration of the new organs are the most distinguishing aspects of lung transplantation (LTx) compared to other kinds of ‘high-tech’ medicine, there is a paucity of papers on that matter. Therefore, we aimed to evaluate these aspects in young adult LTx recipients with at least 1-year survival.Methods. Semi-structured interviews; content analysis of specific parts of the interviews; frequency distributions of resulting categories.Sample. Forty-five adults aged 18–42 years (mean: 32 ± 5.5 years). Post-transplant survival ranged from 1 to 11 years.Results. The majority of recipients (60%) fulfilled criteria of denial towards the foreign organ and/or the donor. However, they were rather sensitive towards the ethical and psychological impact of the upcoming option of living donorship in LTx. Also, the majority of recipients (79%) understood that there might as well be good reason not to opt for a LTx.Conclusions. LTx recipients appeared at first sight ‘pragmatic’ towards the gift of life, but they remained sensitive to its ethical and psychological challenges.

The Cost of Maintaining My Gift of Life

The Cost of Maintaining My Gift of Life

Promotion of Altruistic Donation

Altruistic donation of organs and tissues, “the gift of life,” has been the linchpin of clinical transplantation since its inception. Grieving relatives originally introduced the concept, wanting to ensure that the sudden and tragic death of their loved one could be meaningful in saving the life of another. Healthy individuals, desirous of giving all or a part of a vital organ to a relation, a friend, or even a stranger in need reinforced this altruistic gesture. The nobility of these acts has set the field of organ transplantation uniquely apart from all other areas of medicine. But with demand for organs persisting, and despite the generosity of willing donors and donor families, rampant commercialism for organs (first noted by transplant professionals in the 1980s) has attracted increasing public notoriety and ethical objections. In direct response to such activities, the National Organ Transplant Act was drafted in the United States to prohibit specifically the commercialization of human organ donation. Strengthening an international chorus of objections, the Istanbul Declaration states plainly that transplant commercialism is inevitably associated with organ trafficking, because it targets the indigent and impoverished and leads to inequity and social injustice (1). The guiding principles of the World Health Organization object to organ sales for similar reasons. As an alternative to such untoward practices, Hippen and Matas (2) proposed a regulated trial of financial incentives to increase both the number of organs available from live donors and preserve the well being and dignity of the donors and their families. Although the idea of reimbursement of donor expenses is endorsed by most professionals in the field, the proponents of a regulated trial unfortunately provide no organizational details (3). What would be its control group? How would the impact of financially incentivized donation on “altruistic” donation be measured? The possibility of a trial of payment for organ donors in the United States could set into motion an unregulated national patchwork of schemes that could vary between individual states and regions. Will transplant programs in neighboring states be vulnerable to competitive “regulated” trials? Surely, if we wish to have such a trial, we should first measure the impact of systematically removing financial and other disincentives to donation and by defining and systematizing living donor “best practices.” It is important to note that a regulated trial of financial incentives has been attempted already and has been long underway in Iran. However, the experiment has been unsuccessful even in that most controlled society. Despite stringent regulations, the government has failed to fix the price for an organ, outlaw brokers, prevent Internet solicitation for vendors, and ensure the financial and personal integrity of the donors. Indeed, the Iranian investigators themselves have recently reported the experience and concluded that the “Iranian model” should not be considered for the rest of the world (4). Important realities concerning the wait list need to be addressed. A substantial proportion of those who die “while waiting” may not be active candidates; these ineligible or inactive individuals would not be helped by a trial of financial incentives. In addition, approximately 40% of those who are dying on the wait list would not be affected, because they are in need of extrarenal organs that cannot be purchased by a living donor. At the same time, potential support for live donors must be encouraged. Federal protections could be enacted for job security, assured donor leave, and the provision of health and life insurance for donation-related events that would provide donor care and remove obstacles for those who wish to be organ donors. The international community is calling its professional colleagues in the United States to continue to pursue the gains we have collectively achieved in combating organ trafficking through the tenets of the Declaration of Istanbul and other global statutes. It is critical that the concept of the altruistic donor be preserved and encouraged. Nicholas Tilney Joseph Murray Richard Thistlethwaite Doug Norman Francis Delmonico Douglas Hanto Alan Leichtman Gabriel Danovitch Mohamed Sayegh Ron Shapiro William Harmon Oscar Salvatierra Dan Brennan Sue McDiarmid Peter Stock Liz Pomfret William Bennett David Conti Bob Metzger Minnie Sarwal A. Benedict Cosimi Brigham and Women's Hospital Boston, MA

A Preliminary Study of the Market for Documentaries in Taiwan

Foreign guests were surprised by the long line waiting to see documentary films during the 1998 and 2000 Taiwan International Film Festival. It was obviously an indication that audiences in Taiwan yearned for documentaries, especially those from abroad. Moreover, in the years between 2004 and 2006, documentary films and videos such as Gift of Life , Viva Tonal — The Dance Age, Jump! Boys , and The Last Rice Farmer had made it into the commercial cinemas in direct competition with domestic and foreign feature films, and had outperformed most Taiwanese feature films at the box office.

Troubling dimensions of heart transplantation

Heart transplantation is now the accepted therapy for end-stage heart failure that is resistant to medical treatment. Families of deceased donors routinely are urged to view the heart as a...

Popularizing Organ Transplantation in Japan: Travelling Iceboxes as the ‘Relay of Life’

In Japan, the ‘relay of life’ has become a common metaphor for organ transplantation. Its prevalence has owed much to the cultural construction of a breakthrough motif vis-à-vis Japan's first legally and publicly accepted transplant case in 1999. The media coverage of this event forged a specific imagery in which the relay of life model and a hopeful breakthrough message were inscribed. This breakthrough motif then developed into the general metaphor for transplant medicine in Japan. Previous research has arguably ascribed the Japanese metaphor to the endeavour, by promoters of transplant medicine, to avoid invoking the Euro–American idea of a transplanted organ as a gift, in a culture that sees gift exchange (including organ transplantation with living donors) as a practice that takes place principally within the personalized network. However, this does not explain the relay metaphor per se, and is therefore an incomplete account. It is necessary to examine the reasons behind the choice of this specific metaphor, what the relay of life actually signifies, and how the metaphor was articulated and distributed. This enquiry illuminates the aforementioned developing process of the relay metaphor, whilst also taking account of the then Japanese public debating discourse about transplant medicine vis-à-vis its metaphoric idiom in the English language, the ‘gift of life’. It demonstrates that the relay metaphor in Japan was not established through the deliberate efforts of those promoting transplantation, but rather was constructed via media coverage of a breakthrough case in 1999.

Transfer of Western Knowledge to Turkey: Institutionalized Policy of Translation and Library Building

In 1932 the Turkish Government decided to westernize the country's higher education and library systems. But there was a substantial shortage of human resources to undertake the task. Having been informed of the flight of professional intellectuals from Nazi persecution in Germany for whom America was out of reach because of its restrictive immigration laws, state department practices, and anti-Semitic hiring bias at its universities, Turkey in 1933 invited over 190 of them to be part of its modernization efforts. Among the invitees was a team of philologists, expert librarians, archivists and bookbinders. These conservators of knowledge, gathered over generations, were ready and willing to oblige. To them this was the gift of life. They contributed greatly to the organization of a modern European system of libraries and document archives in Turkey. In addition, a monumental program was set up to translate the major works of classical (Greek and Roman) and general European literature into the Turkish language.

A Gift of Life: Ethical and Practical Problems With Conditional and Directed Donation

A Gift of Life: Ethical and Practical Problems With Conditional and Directed Donation

Når døde børn er livets gave - Unisex moderskab og organdonation i USA

Dead children as ";the gift of life";. Unisex motherhood and organ donation in America The focus of this article is how American women, especially mothers of organ donors dominate organizational support efforts for donor families, the implications this has for men, and the many new understandings of motherhood this medical context gives rise to. Based on anthropological field studies from the US, this article analyses the efforts of American organ organizations to support and comfort families in the time after the organ donation and explores the limited options for men to engage in this interaction, except by acting like ‘mothers'. By exploring how women speak about donation and engage in many different social relations to organ recipients and others, this article give rise to new perceptions of motherhood and discusses how gender is acted out in this particular field.

Why relatives do not donate organs for transplants: ‘sacrifice’ or ‘gift of life’?

This paper is a report of a study to explore the reasons family members declined organ donation from a deceased relative. In the United Kingdom family members' consent is usually sought before organ donation from their deceased relative can proceed. Knowledge of the concerns that may influence families' decision-making could be helpful to nurses supporting bereaved family members. A convenience sample of 26 family members, who declined donation of their deceased relatives' (n = 23) organs, were recruited via three media campaigns in large conurbations and from four intensive care units in the United Kingdom. Data were collected in 2005 using interviews. Donation decisions depended on a number of converging factors in a particular situation and not necessarily on the views of relatives about donation, or the reported wishes of the deceased in life, except if the person had stated that they did not wish to be an organ donor. Therefore, reported pro-donation views held by the family, or the deceased in life, did not guarantee donation. Protecting the dead body, which related to keeping the body whole and intact was the most frequently-recurring theme, being reported in 15 interviews. Families' wishes to protect the dead body may stimulate tension between the notions of 'gift of life' as supported by transplant policy and 'sacrifice' of the body, which must be made if organ donation is to proceed. This could account for the decision of participants to decline donation even if their deceased relative previously held positive views about organ donation.

Repaying and Cherishing the Gift of Life: Gift Exchange and Living-related Kidney Transplantation in the Philippines

This paper considers living-related kidney transplantation, especially that between family members in the Philippines. Drawing on the anthropological theory of gift, it explores two aspects of the gift relationship—the relationship between the donor and the recipient and the relationship between the recipient and the object—and describes two categories of acts—'acknowledging the debt/repaying the gift of life' and 'taking care of a kidney/cherishing the gift'. This paper seeks to show that there is an internal tension in live kidney transplantation between two rival principles of gift operative in the world of Filipino family and kinship: one akin to the Maussian or 'archaic' gift and the other that places cherishing of the gift over repaying of the debt.

Laudatio in Honor of Prof. Dr. Ludger Honnefelder Twenty-First Recipient of the Franciscan Institute Medal 20 October 2007

Our celebration during this first conference has been about intersections: intersections among scholars from a variety of nations, intersections among old friends and colleagues, intersections among junior and senior scholars. This first conference in honor of Duns Scotus and Allan Wolter has sought to widen the circle of discourse and to bring many people together. During this weekend, we have been celebrating the scholarly intersection at the first session of our Scotus Quadruple Congress. And yet, we celebrate not merely the past, for we stand this evening very close to the intersection of two millennia. In our time and in each of our countries, we witness the intersection of cultures and, in our world, the unfortunately violent intersection of political, cultural and religious worldviews. Intersections open to transcendence only when a focus, a meeting point can be determined and mined. As we look at our time and place, we can affirm the power of intersections and the life that can come when we bring ideas, people and viewpoints together. The scholar whom we honor this evening is no stranger to intersections. His academic life has been the focal point for a number of important intersections. Of modern philosophy with medieval; of theology with philosophy; of Innsbruck, Bonn, Trier, Berlin; of critical editions and scientific conferences; of national and international debates and discussions; of scientific inquiry and everyday practical decision making, of the highest and noblest of human intellectual ambitions with the smallest, most precious gift we have: the gift of life. These intersections form the pattern for our celebration this evening. On behalf of the faculty of the Franciscan Institute, I am pleased to be able to give this brief tribute to our honoree, Professor Dr. Ludger Honnefelder, the 21st recipi461 Franciscan Studies 66 (2008)

Sand's La Mare Au Diable, Awakening through "Evil" and the Hero's Journey

The theme of evil implicit in Sand's title and confirmed by her quotation from Genesis found above a woodcarving of Holbein points to the hero's journey in La Mare au diable (1846). This narrative device explains the transformation of Germain in the devil's pond as the shock of awakening from depression and from a false innocence by an encounter with the Shadow. Sand's portrayal of evil as a necessary encounter in the journey to maturity shows intuitive insight. The transformation of her hero upon exiting from the woods is confirmed by his acceptance of rejection and by his subsequent realization of a Warrior's energy in the defense of Marie, a precondition to attaining the Lover's stature. His service to love and the mediation of woman's culture lead to marriage and to self-integration celebrated in a closing scene of poetic union between earth and heaven bearing witness to Germain's new consciousness of nature's beauty and the gift of life.

329 Gift of life: Young adult lung transplant recipients talk about their new lungs

329 Gift of life: Young adult lung transplant recipients talk about their new lungs

Results of Kidney Transplantation Between Spouses: A Single-Center Experience

The shortage of cadaveric kidneys is growing in Turkey despite intensive efforts to find a solution. Living related donors are the primary source of kidneys in developing countries. When a first-degree relative of the patient is not available, a second-degree relative or a genetically unrelated but emotionally related donor, such as a spouse, becomes an alternative. From November 1985 to June 2006, 81 living unrelated kidney transplantations were performed between spouses at our hospital. Seventy-one of the donors were women, and 10 were men. The mean donor age was 33.9 ± 8.5 years and the mean patient age was 38.5 ± 8.8 years. The posttransplantation patient and graft survival rates were. 1 year: 93% patient survival, 83% graft survival; 3 years: 90% patient survival, 78% graft survival; and 5 years: 83% patient survival, 76% graft survival. During the posttransplantation period (mean, 82.5 ± 61.4 months range, 6–216 months), seven patients died: three from sepsis, one from gastrointestinal hemorrhage, two from myocardial infarction, and one from pancreatitis. Three of those seven patients died with a functioning graft, and the seven other grafts were lost because of chronic rejection. To obstruct the underground trade in organs sold for transplantation, our center does not accept living unrelated organ donor candidates other than a spouse. Interspousal kidney transplantation is an important option with good clinical results. It provides the couple with a better quality of life, offers the opportunity to share the joy of giving, and enables a husband and wife to receive the “gift of life” from each other.

"It's not a job; it's a lifestyle": the experience of being a donation coordinator

Lifesaving organ transplantations cannot be performed without the donation of organs from another human being. The donation coordinator in an organ procurement organization has the responsibility of coordinating this "gift of life"--a highly stressful, but inherently rewarding occupation. Although numerous studies have examined the medical and social implications of organ donation, little has been written about the experiences of donation coordinators. This qualitative study examines the experiences of donation coordinators at a large metropolitan organ procurement organization, to understand how they perform under stress, the ways that they cope with this stress, and the meaning that they attribute to their roles. Implications for organ procurement organizations are discussed to assist such organizations in recruiting donation coordinators and in developing supportive interventions for current employees. Suggestions to help donation coordinators maintain good mental health are also offered.

The Institute of Medicine Report: Sensible and Consequential

Dr. Dick Howard has recently written that we have a societal obligation to provide organs for transplantation after we die and that ‘good deeds are not voluntary; they are required’ (1). Further, he states that: ‘the transplant community urges individuals while they are alive and the families of appropriate brain-dead persons and others … to bestow the “gift of life” or to “donate life” to someone in need’ and ‘we place high value on the lives of others, even if we do not know them (such as people on the transplant waiting list). The transplant community should begin to frame the discussion in these terms’. Dr. Howard's moral view captures the goodness of organ donation (its altruism) and brings a call to social responsibility. This was a welcome commentary on behalf of the transplant community and in keeping with the nobility of the field: to value the dignity of human life and the dignity of the patients that we care for (donors and recipients). For Dr. Howard to have this commendable perspective on moral duty and then shortly thereafter, bring a perspective on the Institute of Medicine (IOM) report is seemingly conflicted with the ideals he has previously espoused and counter to the IOM report (2, 3). Those arguments for moral duty and social responsibility are at the core of the IOM recommendations not to support financial incentives for deceased donors or permit the buying and selling of organs from live vendors. Further, not all would agree with Dr. Howard's conclusion that the IOM ‘report adds little that is new’. What is ‘new’ is that this IOM document brings a current and independent thinking that would be influential if a Congressional hearing was to be convened for a revision of NOTA; yet the release of the IOM report makes the consideration of a NOTA revision all the more unlikely. To assert that ‘nowhere does the report state emphatically that financial or other incentives are ethically wrong’ is disputed by many pages of the IOM report. At least these 2 sentences provide an unambiguous ethical rebuttal. Every society draws lines separating things treated as commodities from things that should not be treated as things ‘for sale’ (3). ‘Despite the growing market for body parts and products, there remains a strong societal taboo not only against buying solid organs from living people but also against buying and selling dead bodies or certain parts of dead bodies, including solid organs’ (3). The IOM's reasons for rejecting a market in organs from deceased individuals also apply to a market involving organs from living people (3). ‘These reasons hold even though a few analysts argue that it would be cost effective to pay individuals as much as $90 000 to provide a kidney for transplantation and even propose changes in the laws to permit such a payment in a regulated market. These proposals have yet to gain traction in the United States because they are incompatible with the fundamental values and norms that govern transplantation and because international markets in organs from living individuals appear to involve the exploitation of relatively impoverished people…’ Dr. Howard suggests that ‘much of the report is disappointing in that the IOM seems to have lost sight of the real goal of their effort: increasing the number of organ donors.’ On the contrary, what did the IOM clearly recommend? It recommended a way to increase the number of organ donors by the following: ‘We believe that at this time the best approaches are to pursue ways to increase donations based on circulatory determination of death …’ The IOM recommended that federal agencies work with states and cities that have extensive trauma centers and emergency response systems to develop demonstration projects that can determine the feasibility of increasing rates of donation after circulatory determination of death. There is a component of Dr. Howard's commentary that would derive a consensus and it is by this statement: ‘it would be valuable if everyone could think of donation as part of end-of-life considerations’. To this recommendation, the transplant community should be supportive especially for donation after cardiac death—as proposed by the IOM.