Twice Dead: Organ Transplants and the Reinvention of Death

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University of California Press, 2002 - Social Science - 429 pages
Tales about organ transplants appear in mythology and folk stories, and surface in documents from medieval times, but only during the past twenty years has medical knowledge and technology been sufficiently advanced for surgeons to perform thousands of transplants each year. In the majority of cases individuals diagnosed as "brain dead" are the source of the organs without which transplants could not take place. In this compelling and provocative examination, Margaret Lock traces the discourse over the past thirty years that contributed to the locating of a new criterion of death in the brain, and its routinization in clinical practice in North America. She compares this situation with that in Japan where, despite the availability of the necessary technology and expertise, brain death was legally recognized only in 1997, and then under limited and contested circumstances. Twice Dead explores the cultural, historical, political, and clinical reasons for the ready acceptance of the new criterion of death in North America and its rejection, until recently, in Japan, with the result that organ transplantation has been severely restricted in that country. This incisive and timely discussion demonstrates that death is not self-evident, that the space between life and death is historically and culturally constructed, fluid, multiple, and open to dispute.

In addition to an analysis of that professional literature on and popular representations of the subject, Lock draws on extensive interviews conducted over ten years with physicians working in intensive care units, transplant surgeons, organ recipients, donor families, members of the general public in both Japan and North America, and political activists in Japan opposed to the recognition of brain death. By showing that death can never be understood merely as a biological event, and that cultural, medical, legal, and political dimensions are inevitably implicated in the invention of brain death, Twice Dead confronts one of the most troubling questions of our era.
 

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In Twice Dead: Organ Transplants and the Reinvention of Death, Margaret Lock “explores the way in which developments in medical technology have forced a reconsideration of the recognized boundaries ... Read full review

Contents

Accidental Death
1
Trauma
14
The Procurement
17
The Gift
23
Deaths Shadow
27
Boundary Transgressions and Moral Uncertainty
32
Reanimation
54
Technology in Extremis
57
Social Death and Situated Departures
191
Disconcerting Movements
208
Imagined Continuities On Becoming an Ancestor
209
Memory Work
232
When Bodies Outlive Persons
235
Procurement Anxiety
259
When Persons Linger in Bodies
263
Transcendence through Music
288

Narrow Escapes
76
Locating the Moment of Death
78
Jumping the Gun
101
Making the New Death Uniform
103
Tragedy
127
Japan and the BrainDeath Problem
130
Aggressive Harvesting
147
Technology as Other Japanese Modernity and Technology Born of a BrainDead Mother
149
Born of a BrainDead Mother
165
Prevailing against Inertia An Interim Resolution to the BrainDeath Debate
167
Becoming a Good Angel
190
The Body Transcendent
291
A Court Order
310
The Social Life of Human Organs
315
A Reliable Man
341
An Unsatisfactory Intelligence
345
Revisiting Vivisection in a World Short of Organs
347
A Dubious Definitions of Death
363
Reflections
365
Bibliography
379
Index
417
Copyright

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About the author (2002)

Margaret Lock is Professor of Anthropology at McGill University and author of the award-winning Encounters with Aging: Mythologies of Menopause in Japan and North America (1993) and East Asian Medicine in Urban Japan: Varieties of Medical Experience(1980), both from California. Among the books she has coedited are Remaking a World (2001), Social Suffering (1997), and Knowledge, Power, and Practice(1993), all from California. In December 2003, she was awarded the Robert B. Textor and Family Prize for Excellence in Anticipatory Anthropology, of the American Anthropology Association.

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