School of Health and Social Care Seminar Series 2010-11 Prof. Margrit Shildrick

This presentation looked at heart transplantation as an exemplary process that potentially disturbs all aspects of modernist bioethics as well as raising concerns about prostheses and human hybridity in general (Shildrick, 2010). .

The paper offered an insight into the way human heart recipients in a North American context are likely to experience psychic disruption to their sense of self as a result of their bodily transformation. Drawing on a mixed method approach of interview and visual methods (video), recipients were able to talk about their feelings about receiving a donor”s heart as well as offer more phenomenological understandings through their body language and affect. The empirical aspects offered often indicated that the emotional descriptions of their identity did not correspond with their body language and emotionality surrounding their heart transplants, which points to the existing bioethical implications of heart transplantation, in this instance, and perhaps other organ transplantation more generally. Margrit Shildrick (2010) argues that the implications have profound ethical implications on 2 levels. From a conventional perspective, results show a clear need to revamp clinic practice to enable recipients to give more open accounts of their actual bodily experiences following transplantation, and indeed to question the limits of what is seen as unproblematically therapeutic. On this level, it seems that the pressure to conform to the ‘grateful for life’ discourse, whilst grappling with, amongst other things, guilt that somebody died, which enabled them to live, obligations that come with receiving a ‘gift,’ the encouragement by clinicians to write letters of gratitude to donor’s families alongside visceral changes in their embodied self were more than the authorized narrative. The authorized  narrative situates the body as a Cartesian machine that is being restored to an originary self. However, the research confirmed that recipients are highly invested in speculating on the identity of donors precisely because they feel that some donor characteristics will carry over, and that almost 80% display distress, either in relation to the donor, to their own identities, or both (Shildrick, 2010). The authorised narrative insists that the replacement of a ‘failed’ organ restores the originary self, but the problem is that the post–transplant body is not only prostheticised, but becomes irreducibly hybrid for life: the originary self is irrecoverable (Shildrick, 2010). Throughout the seminar, Susan Stryker’s famous quotation in relation to transgender surgery kept springing to mind:

“As we rise up from the operating tables of our rebirth, we transsexuals are something more […] than the creatures our makers intended us to be. Though medical techniques for sex reassignment are capable of crafting bodies that satisfy the visual and morphological criteria that generate naturalness as their effect […] Transsexual embodiment, like the embodiment of the monster, places its subject in an unassimilable, antagonistic, queer relationship to a Nature in which it must necessarily exist” (Stryker, 2006: 248).

On the second level, Shildrick (2010) asks could a better understanding of what it means to incorporate an organic prosthesis mobilise a different approach to a range of biomedical interventions? This would require a move away from a number of ethical paradigms that insist on the Cartesian mind/body split and rethinking Utilitarianism. Both prostheses and transplants show us a destabilisation of the socio-political, legal and ethical categorisation of bodies according to normative epistemologies that create markers such as gender, sex and race (Shildrick, 2010). As the body makes novel connections and participates in assemblages of the organic and inorganic, it demands a reimagination of the ideologies of human identity, and a reconfiguration of bioethics (Shildrick, 2010).

References:

Shildrick, M. (2010). Hybrid bodies and prostheses: the bioethics of identity. Paper presented at the Intersectionality: Theory and Practice for Quality Improvement in Healthcare, School of Health and Social Care Seminar Series 2010-11, University of Lincoln.

Stryker, S. (2006). My Words to Victor Frankenstein above the Village of Chamounix: Performing Transgender Rage. In S. Stryker & S. Whittle (Eds.), The Transgender Studies Reader (pp. 244-256). New York: Routledge.