Purloined Organs

Psychoanalysis of Transplant Organs as Objects of Desire

H.A.E. Zwart, H. A. E. Zwart

• Publisher: Palgrave Pivot
• Year: 2019
• Print ISBN:
  9783030053536
• eBook ISBN:
  9783030053543
• Topic: Psicologia
• Subtopic: Mente e corpo in filosofia

This book addresses organ transplantation from a psychoanalytical  perspective. Where other authors consider topics of informed consent, scarcity and organ trade, Zwart explores the ways in which the practice fundamentally challenges our basic experience and image of the body, revolving around issues such as embodiment, ownership and bodily integrity. In organ transplantation, the body emerges as something which we simultaneously have and are—constituting a whole, as well as a set of partial objects that can be transplanted and replaced, donated and sold.

© The Author(s) 2019

H.A.E. ZwartPurloined Organshttps://doi.org/10.1007/978-3-030-05354-3_1

Begin Abstract

1. Introduction: Organ Recycling and Embodiment

H. A. E. Zwart¹

(1)

Erasmus School of Philosophy, Erasmus University Rotterdam, Rotterdam, Zuid-Holland, The Netherlands

H. A. E. Zwart

Email: [email protected]

Abstract

Bioethical discourse on organ donation covers a wide range of topics, from informed consent procedures and scarcity issues up to transplant tourism and organ trade. Over the past decades, this discourse evolved into a stream of documents of immense proportions. Beneath the manifest level of discourse, a more latent dimension can be discerned, revolving around issues of embodiment, the status of the human body and the concept of bodily integrity. Here, the body emerges as something which we have, but at the same time are, and as something which constitutes a whole, while at the same time being a set of replaceable parts. This study examines transplantation discourse from an oblique perspective, using literature and cinema as high-resolution magnifying glasses.

Keywords

Organ recyclingEmbodimentBioethicalDepth ethicsOrgan marketOblique perspective

End Abstract

Bioethical discourse on organ donation and transplantation medicine covers a wide range of topics, from informed consent procedures and scarcity issues up to transplant tourism and organ trade. Over the past decades, this discourse evolved into a stream of documents of bewildering proportions, encompassing thousands of books, papers, conferences, blogs, consensus meetings, policy reports, media debates and other outlets. Beneath the manifest level of discourse, however, a more latent dimension can be discerned, revolving around issues of embodiment, the moral status of the human body and the concept of bodily integrity. This publication aims to bring these “deeper” questions to the fore. What is envisioned is a “depth” ethics (the moral equivalent of a depth psychology) focussing on the tensions, conflicts and ambiguities at work in bioethical deliberations on organ transplantation, fuelling the viewpoints articulated on the more manifest levels of discourse. Organ donation reopens the question of the status of the body as something which we have, but at the same time are, and as something which constitutes a whole, while at the same time being a set of replaceable elements or parts.

Transplantation medicine affects the way in which we experience ourselves as embodied subjects (Blackman 2010; Shildrick 2010). Organ transplantation has “reconceptualised” (Scheper-Hughes 2000) our collective body image, notably by giving rise to a commodification of body parts, reframing the human body as a potential resource for organ recycling on behalf of suffering others and as a collection of separable, detachable, exchangeable and re-incorporable partial objects (Blackman 2010; Waldby and Mitchell 2006, p. 7; Rabinow 1996, p. 95). Seen through the eyes of transplantation medicine, the intimate interior of our bodies contains a set of valuable items which other humans (craving subjects) lack. And this tension between what potential donors have and what potential recipients desperately need, turns organs such as hearts and kidneys into valuable and procurable objects of desire. This is underscored by the fact that transplant organs (harvested either from living or from deceased donors) are currently available as merchandise on a clandestine but thriving global market: an international organ bazaar (Rheeder 2017). In his book The Red Market, Carney (2011) traces the contours of a multi-billion-dollar global organ trafficking, although the actual extent of this world-spanning body shop remains an issue of dispute (Meyer 2006; Shimazono 2007; Scheper-Hughes 2008; Greenberg 2013).

Beyond the societal impact of transplantation medicine, often framed in bioethical terms, an ontological dimension can be discerned. Transplantation medicine reinforces (and at the same time builds on) a particular understanding of human embodiment, namely the view of the human body as an aggregate of replaceable, exchangeable and exploitable parts: items that should not be allowed to go waste. As Žižek (2004/2012) phrases it, due to the availability of heart, liver and other transplants, in combination with pacemakers, artificial limbs, transposable skin and similar items, a new type of body is emerging, a “body in pieces”, a composite of replaceable components (p. 108). The plasticity of our body-image becomes more pronounced as human beings increasingly see themselves as “spare parts persons” (Schweda and Schicktanz 2009) whose bodies are collections of “detachable things” (Waldby 2002, p. 239). Seen from this perspective, organ trafficking (the emergence of a global clandestine organ market) is a symptom of a more comprehensive ontological event: the advent of the body as an organ recycling resource.

As Lesley Sharp (2006, 2007) has pointed out, transplantation medicine gives rise to two incommensurable discourses concerning the human body. On the one hand, it transforms procurable body parts into “objects of intense desire” (p. 49, p. 52). Human cadavers become lucrative treasure coves from which reusable parts can be harvested. A single body may contain fifty or more transplantable items. As transplant surgery is exorbitantly expensive, donated organs are objects of great value, bearing heavy price tags. And yet, both the surgical realities involved in removing organs from the torsos of donors and their economic costliness are obfuscated and mystified, Sharp argues, by euphemistic linguistic constructions—“semantic massage”, as Richardson (1996) phrases it—which continue to revolve around vocabularies of “Samaritan” disinterested altruism and the “gift of life” (Hagen 1982). As a result, contemporary organ transplant discourse is permeated by a profound ontological tension: an “ideological disjunction” (Sharp 2006), between the commodifiable and the inviolable body, between lucrative and intrusive surgical practices on the one hand and a rhetoric of dignity and benevolence on the other.

To bring this ontological tension to the fore, a depth ethics is called for, bypassing (bracketing) the more immediate (manifest) ethical issues at hand, in order to focus on the more basic (latent) conceptual shifts that are unfolding on a different scene or stage—or “Schauplatz”, to use the Freudian term (1900/1942, p. 541).¹ In order to open them up for critical reflection, I propose to examine transplantation discourse from an oblique perspective, using literature and cinema as high-resolution magnifying glasses (Zwart 2017). Movies and novels relate to contemporary culture in a way that is similar to how dreams or day-dreams relate to everyday consciousness, providing a stage where (evolving and conflicting) understandings of human embodiment are enacted, probed and questioned; provided that mechanisms such as condensation, displacement, representability and secondary elaboration (Freud 1900/1942) are taken into account. These tensions and ambiguities will be addressed from a psychoanalytical angle. Notably, the work of Jacques Lacan (1901–1981) will be used to highlight some of the contradictions and ambivalences of bodily existence surfacing in the contemporary transplantation debate.

The attempt to approach organ donation from a Lacanian perspective may cause some raised eyebro...

Table of contents

• Cover
• Front Matter
• 1. Introduction: Organ Recycling and Embodiment
• 2. The Body As an Aggregate of Replaceable Parts
• 3. An Ontological Struggle: Integrity Versus Fragmentation
• 4. The Real, the Imaginary and the Symbolic: Lacan’s Understanding of Embodiment
• 5. Love and the Idealisation of the Body
• 6. Cannibalism and the Partial Object
• 7. Another Analogy: The Catholic Devotion to the Sacred Heart
• 8. Types of Discourse
• 9. Commodification of Organs As Objects of Desire
• 10. A Lacanian Assessment of Organ Transplantation
• 11. Alfred Adler’s Concept of Organ Inferiority
• 12. Thomas Starzl: A Case History
• 13. The Transplant Organ As an Extimate Object
• 14. Separation and Desire
• 15. Bios and Techne
• 16. Revealing Intrusions/Intruding Revelations
• 17. An Oblique Perspective: Organ Transplant Cinema
• 18. Procuring the Gift
• 19. The Toxicity of the Purloined Implant
• 20. Crank 2: High Voltage, or the Purloined Organ
• 21. Depth Ethics and the Oblique Perspective
• 22. Encore: Middlesex and the Re-makeable Body
• Back Matter