Day: October 30, 2009

more than just bare bones health care

Yesterday I was privileged to participate in a seminar on ‘brain death’ and organ donation run by a reflective clinician.

It was deeply fascinating.┬áThe content itself was tremendously stimulating — covering the historical, philosophical and medical as well as the thorny ethical and pastoral aspects of the topic. But almost more interesting were the reactions of the doctors, nursing staff and chaplains in attendance.

One particular debate really grabbed me: the issue of what to make of a family that insists on keeping their loved one on respiration — against overwhelming medical evidence of its ‘futility’ — or refuses to permit organ donation — even when the patient is a consenting donor.


I’d like to share three slightly random observations:

  1. There was a consensus on the pastoral significance of this issue. The feeling was that the assertion of ‘rights’ over the patient’s body was either part of the family’s grieving process or their attempt to wrest back some control in a largely disempowering process. This was generally seen as something to be worked with rather than as a hurdle to leap (or an irritation to endure). What a relief that today’s clinicians recognise that there’s more than just a rational calculus to be applied in situations like this!
  2. There was an acknowledgement that a patient’s personhood includes his or her body. This acknowledgement emerged from the frequently reported conflict between the stated desires of the patient (e.g., to be a donor) and the feelings of the family. The fact that this was taken seriously showed me that no-one thought our bodies can be easily detached from our personhood — even if they can’t be simply identified with or reduced to it. As a believer in the resurrection I was cheering.
  3. There was almost a glimmer of recognition that personhood is as much about embeddedness as embodiment. It’s as deeply connected to our relationships as it is to ourr corporeality (actually, the two are linked — our corporeality is the key to our corporateness; it’s through our bodies, or extensions of them, that we relate to others). Indeed, this is why the family’s wishes and sense of obligation to their loved one must be factored. The relatedness these things express is an essential part of what makes the patient a person.