A transplant is not just a spare part

According to Professor Margrit Shildrick, organ transplantation has far-reaching implications for how the recipients understand themselves.

Margrit Shildrick

Heart transplant surgery is a risky procedure, and not only in the sense of mere survival. According to Professor Shildrick, what is at stake is nothing less than our whole understanding of ourselves as embodied beings.

– Fully informed consent is seen as the major bedrock of any biomedical procedure, but I am not convinced that transplant recipients are fully informed, says Shildrick, who recently gave a keynote lecture at a symposium organized by the Helsinki Collegium for Advanced Studies.

Shildrick, who is a Professor of Gender and Knowledge Production at the Swedish University of Linköping, has been involved in a research project in which people who had undergone heart transplantation were interviewed.

According to Shildrick, the experiences of persons entering the transplantation clinic differ drastically from what is expected in the medical discourse.

– The narrative that the recipients and their families will meet in the clinic is very much a Cartesian one. It emphasizes the split between the mind and the body and views the operation as spare-part surgery having no existential implications to the recipient.

However, according to Shildrick, both the donor families and the recipients tend to see the operation as something substantially different from a simple swapping of one organ for another. Whereas some donor families hope that the deceased donor will continue to live on in the donated heart, some recipients experience a change in their sense of the self.

– What tends to happen after a few years is a sort of ontological crisis. When the initial euphoria of sheer survival starts to gradually wane, people start to question if it’s just a spare part.

Professor Shildrick’s project, by listening to the personal stories of the recipients, has revealed that approximately 75 per cent of heart transplant recipients are feeling distressed for many years after the operation. This is something that biomedicine, having concern for improving the continued recovery rate in heart transplantation, should take into account.

Shildrick says that the issue of what a normal body should be like has such deep roots in our cultural imaginary, that the psychological aftereffects of transplant surgery can have a negative influence on the patient’s drug compliance and clinical stability.

She believes that although the will to live may ultimately override all other factors, it is not wise to let anyone undergo such a major intervention into their bodies without explaining in far more detail the potential psychological consequences of doing so.

Professor Shildrick’s full interview »»

Helsinki Collegium for Advanced Studies »»

Linköping University »»

Text: Antti Sadinmaa
Photo: Outi Hakola
5.12.2011
University of Helsinki, digital communications


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