A Death Retold
Jesica Santillan, the Bungled Transplant, and Paradoxes of Medical Citizenship
Publication Year: 2006
Published by: The University of North Carolina Press
Series: Studies in Social Medicine
Title Page, Copyright
Introduction: Chronicles of an Accidental Death
In February 2003 Jesica Santillan, a seventeen-year-old Mexican immigrant living illegally in the United States, lay unconscious in a room at the Duke University Medical Center in Durham, North Carolina. She was dying because of a stunning medical oversight. ...
Part I. Medical Error and the American Transplant Theater
America’s Angel or Thieving Immigrant?: Media Coverage, the Santillan Story, and Publicized Ambivalence toward Donation and Transplantation
Organ donation has always faced a difficult battle in vying for positive media coverage. At the center of key tensions over how we tend to think about the goals of modern medicine and how we think about the human body, organ donation has often produced a profound ambivalence. ...
Hobson’s Choices: Matching and Mismatching in Transplantation Work Processes
The February 7, 2003, event at the Duke University Medical Center in North Carolina made clear the potential for donor-recipient mismatch during organ transplantation. This ‘‘celebrated case’’ changed the public perception of risk and hazard in health care. Like other celebrated cases, it played into a wide range of stakeholder concerns that includes U.S. immigration policies, ...
The Transplant Surgeon’s Perspective on the Bungled Transplant
On the evening of February 6, 2003, Dr. James Jaggers received a telephone call from Carolina Donor Services, the local organ procurement organization (opo) that services Duke University Medical Center and the surrounding area.1 Dr. Jaggers was the head of pediatric heart and heart-lung transplantation at Duke, ...
From Libby Zion to Jesica Santillan: Many Truths
At first glance, the Jesica Santillan case is a textbook example of how experts believe that medical errors occur. There was a human error, when no one at Duke University Medical Center checked that the donor heart and lungs matched Jesica’s blood type. But, in fact, this error actually masked a larger systems flaw, ...
All Things Twice, First Tragedy Then Farce: Lessons from a Transplant Error
In a recent book on capital punishment, Scott Turow reversed his long-standing support for the practice. While the reasons to oppose capital punishment are numerous, there was one in Turow’s brief that I found particularly intriguing. Celebrated cases, those that attract the public’s attention because the crimes in question stand out as particularly loathsome instances of a hanging offense, ...
Part II. Justice and Second Chances Across the Border
The Politics of Second Chances: Waste, Futility, and the Debate over Jesica’s Second Transplant
In the days after the surgery, Jesica Santillan’s second heart and lung transplant on February 21, 2003, became a flashpoint of controversy that helped generate a wide range of conflicting fictions, fantasies, and moral meanings. Two weeks after Jesica had received the first transplant with mismatched blood type organs, this second operation, much more than the first, ...
Tucker’s Heart: Racial Politics and Heart Transplantation in America
Organ transplantation, especially moving the heart from one body to another, exemplifies American investment in high-tech medicine. Although the first human heart transplant was performed in a South African, rather than American, hospital, by surgeon Christiaan Barnard, the 1967 exploit was made possible only by the training he received in transplant surgery programs in the United States. ...
Justice in Organ Allocation
As a philosopher and medical educator, I teach a broad range of topics in medical ethics with medical students, house staff, and faculty. It is not surprising that issues related to transplantation frequently arise in my teaching because my home institution, Mount Sinai, is a major transplant center that has had its own share of controversy. ...
Playing with Matches without Getting Burned: Public Confidence in Organ Allocation
According to one journalist, Jesica Santillan ‘‘died after a botched heart and lung transplant that shook the nation’s confidence in the organ donation system.’’1 Even before Jesica Santillan became a household name, members of America’s transplant establishment recognized that public controversy over a range of issues could undermine confidence in the transplant enterprise. ...
Consuming Differences: Post-Human Ethics, Global (In)justice, and the Transplant Trade in Organs
Even as Jesica Santillan’s story played itself out in the American media, a powerful global crisis was unfolding—an international commerce in human organs. The globalization of organ and tissue markets turns the Santillan story on its head, and provides crucial insight into the ways in which other kinds of people—wealthy, first world, well-insured, ...
Part III. Citizens and Foreigners/Eligibility and Exclusion
Sympathy and Exclusion: Access to Health Care for Undocumented Immigrants in the United States
When the editors approached me about writing this essay, I had already been researching immigrants’ access to medical services for my book on the history of the right to health care in the United States. Initially, I expected to show how the Jesica Santillan case fits into that history. It turned out, however, that Jesica’s story does not actually fit very neatly. ...
Eligibility for Organ Transplantation to Foreign Nationals: The Relationship between Citizenship, Justice, and Philanthropy as Policy Criteria
The events and commentary surrounding Jesica Santillan’s access to multiple organ transplants raise profound questions about the criteria used to justify her receiving these organs, and whether her status as a citizen of another country should have had any bearing on whether she was eligible to receive the organs and the related care. ...
Imagining the Nation, Imagining Donor Recipients: Jesica Santillan and the Public Discourse of Belonging
Jesica Santillan’s story is simple but tragic: Jesica, seventeen years old, suffered from a birth defect that left her heart and lungs unable to function properly. Her only chance for survival was a transplant to replace the defective organs. She underwent surgery at Duke University Medical Center on February 7, 2003.1 ...
Part IV. Speaking for Jesica
Babes and Baboons: Jesica Santillan and Experimental Pediatric Transplant Research in America
Organ transplantation within the American context is regularly proclaimed as a miraculous medical procedure, and indeed for many patients with life-threatening illness it can offer a remarkable extension of life. Bearing the potential to save, and thus enhance or extend individual lives, the transplant miracle nevertheless depends on radical surgical interventions. ...
Jesica Speaks?: Adolescent Consent for Transplantation and Ethical Uncertainty
In February 2003, freelance writer Nancy Rommelmann fixated on daily news accounts of Jesica Santillan’s deteriorating health. Rommelmann had a thirteen-year-old daughter who looked strikingly like seventeen-year-old Jesica, and the resemblance had been enough to fuel a paralyzing obsession. ...
Fame and Fortune: The ‘‘Simple’’ Ethics of Organ Transplantation
As the essays in this volume show, the story of Jesica Santillan’s bungled transplant raises many questions about medical technology, bioethics, and American society. These questions appear in Jesica’s story as both new and yet familiar. ...
In mid-2004, Peter Guarnaccia, Julie Livingston, and I brought together this extraordinary group of authors (from transplant surgery and medicine, anthropology, medical sociology, history, medical ethics, philosophy, health law, and health policy) for a series of conversations about the infamous ‘‘bungled transplant’’ and its implications for health care and society. ...
Charles L. Bosk is professor of sociology and graduate group chair of sociology at the University of Pennsylvania. He is author of Forgive and Remember: Managing Medical Failure (1979); All God’s Mistakes: Genetic Counseling in a Pediatric Hospital (1992), and the forthcoming What Would You Do? The Collision of Ethics and Ethnography (2006). ...
Page Count: 392
Illustrations: 7 illus.
Publication Year: 2006
Series Title: Studies in Social Medicine
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