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  • Organ Donation and Transplantation: Body Organs as an Exchangeable Socio-cultural Resource
  • Ribhi Hazin
Orit Brawer Ben-David. Organ Donation and Transplantation: Body Organs as an Exchangeable Socio-cultural Resource. Westport, Connecticut, Greenwood Publishing, 2005. 300 pp., figs. $119.95.

The discovery of the immunosuppressive agent cyclosporine transformed solid organ transplantation from a figment in the imagination of research scientists into a commonplace, lifesaving reality. Since then, organ transplants have been heralded by some as a harbinger of future immortality. In Organ Donation and Transplantation, author Orit Brawer Ben-David dissects the underlying principles governing the distribution and recruitment of human organs for medical purposes. Ben-David fastens on an oft-ignored facet of organ transplantation, namely, the sociological and emotional aspects governing the distribution of organs as "exchangeable" commodities (xv). While members of the medical establishment have been accustomed to discussing the distribution and transplantation of organs along "impersonal," "mechanical" (135) lines, Ben-David offers citizens affected by organ transplantation a platform to express their sentiments on an issue that has been studied and discussed largely from the perspective of physicians and transplant doctors. Ben-David also uses this book as an opportunity to express her own views on the subject.

Ben-David's background in anthropology becomes apparent, as she grapples with the anthropological doctrine of "hero versus villain." Although the organ transplant establishment would have us label transplant doctors as heroes, Ben-David reaches different conclusions. Her view is clearly expressed in the sections devoted to patients affected by transplantation surgeries, whom she depicts as victims of "impersonal" (124), megomaniacal transplant surgeons who "play God" (xiii) by offering patients false promises of "immortality" (125) and, in so doing, satisfy their desire to "congratulate themselves on their achievements" (19). The author heaps invective upon transplant surgeons, accusing them of assuming "dominion over" (33) the body of the patient, whom they view "only as organs" (122) or, even worse, as a "machine composed of exchangeable parts" (xvii) that exist for doctors—whom she likens to "incompetent mechanics" (96)—to cut, sew up, and alter to their liking in order to "add to their own social esteem" (30). According to Ben-David, it is only through such self-serving "enhancement" of their respective transplant "department's reputation" (27) that various organ transplant hospitals can satisfy their appetite for research stipends (xvi). Furthermore, the author suggests that Israeli and "western" physicians deliberately "play games" (124) in an effort to manipulate and coerce unsuspecting family members to donate the organs of their loved ones. [End Page 120]

Ben-David depicts the doctors' quest to attain the many "profits" (xvi) of "social prestige" (136) as coming at the expense of their patients. Patients involved in organ transplantation are described by the author as victims manipulated by doctors, nurses, and medical coordinators who converge upon them in a manner "reminiscent of a military action" (xii) in order to impose "heavy pressure" (24) to persuade families to donate organs from their deceased loved ones. According to the author, these victims have no recourse for their grievances and no ability to participate in decisions related to their treatment, since all decisions made by transplant teams are "carried out behind closed doors" (73) and leave potential organ donors and recipients helplessly abandoned "like a child who needs a babysitter" (43).

In addition to noting that "doctors relate to the body of a patient as if it were their territory" (33), the author accuses physicians worldwide of charlatanry that should be addressed and checked by conscientious citizens everywhere. How, she asks, can citizens allow physicians to appear in "the role of scientists" when "medicine only exists on the edge of the frontier of science" (14)? Furthermore, the author expresses concern about the monopoly she accuses transplant physicians of maintaining over the transplantation procedure. To Ben-David, a physician operates both as "arbiter of death" (19) and as executor of transplant operations. Allowing physicians to operate dually as "the healer" and "the definer of death" (13) represents a conflict of interest, in the author's estimation.

Given an opportunity to shed light on a largely misunderstood issue, Ben-David's research undoubtedly represents groundbreaking insight into the emotional and...

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