Transcript Slides - Mason Institute

When I was young….
• This is the first page
“Gentlemen {sic}, we can rebuild him
we have the technology…(yeah but
how did it feel to be Steve Austen….!)”
Gill Haddow
Human, Animal and Mechanical
Implants – some early thoughts
• In some way, if our body parts represent who we are then do
changes or additions to the interiors of the body alter our
sense of self? (human, animal and mechanical)
1) Specific transfers (human-human; animal-human; mechanicalhuman…)
2) Nature (organic vs inorganic; once living or inert)
3) Amount of material (difference between implanting cells,
valves or organs; mechanical implants, joints or organs)
4) Socio-cultural history & agency attached to the replacement
(Difference between shrapnel vs pacemaker; xenotransplant
vs ICD?)
To have (to own) or to be (me)….
• Cartesian Dualism = association with the medical professional and
especially organ txp.
• Construction of self often stems from manipulation of living body
(exercise, diet, cosmetic surgery…)
• Phenomenology of the body – experiential basis of the lived body suggests
that we both have and are a body
• …the assumption that we have a coherent body or are a whole hides a lot
of work. This is work someone has to do. You do not have, you are not, a
body-that-hangs-together, naturally all by itself. Keeping yourself whole is
one of the tasks of life. It is not a given but must be achieved, both
beneath the skin and beyond, in practice (Hoeyer 2013 quoting Mol &
Law)
1st Heart Transplant
• 1967 conducted by Christiaan Barnard
• Female car-crash victim: 25-year-old Denise
Darvall.
• Louis Washansky who survived for 18 days.
• ….for the first time one of the most important
metaphors for personhood had been cut out,
handled and cleaned, and then placed inside the
body of another individual. In a few historic
moments, the borders of one human body had
been breached by the symbolic core of another”
(Helman, C. (1991). Body Myths. London, Chatto and
Windus.)
….and recipient apprehension
It started with “The Man With The Golden Hands,” which is
how Louis Washkansky, chatting in Yiddish to his wife,
describes Christiaan Barnard who performed the world's
first heart transplant on Louis. He died a couple of weeks
later ... At first Louis seemed to be doing wonderfully well.
She was not allowed to see him until three days after the
operation ... “I was very apprehensive because I thought
his personality might have changed, not realising that it is
the brain that makes the person. I was happy to see he
was the same Louis”
“A Knife To The Heart,” BBC1; 31. 4. 96 emphasis added.
Symbolism continues…
Organ Txp as a Transformative
Experience
• Interviews with 26 recipients
• Most celebrated a re-birthday (with cake)
• Mentioned acquiring (imaginary?) donor’s emotional, moral or physical
characteristics.
…”You might start peeing sitting down now that lady’s kidney!...So every day I
assure them, nope, I’m still peeing standing up” (kidney recipient in Sharp
1995: 372)
Sharp, L. (1995). Organ Transplantation as a Transformative Experience:
Anthropological Insights into the Restructuring of the Self. Medical
Anthropology Quarterly, 9(3), 372 and Sharp, L. (2006). Strange Harvest:
Organ Transplants, Denatured Bodies, and the Transformed Self California:
University of California Press
Organ Restriction/Retention
• A third refused to donate the eyes.
• “Windows of the soul.”
• Eyes give sight, but also in-sight.
GH: And you didn’t place any restrictions?
MR Johns: No.
GH: Why not?
MR Johns: Well what’s the use to her [mother]? That’s basically the idea
behind it, as they say, “they can’t take it with you” so you might as well
use them. I mean, it’s a body. It’s not really a person that you grew up
with or anything like that.
• Haddow, G. (2005). The Phenomenology of Death,
Embodiment and Organ Transplantation. Sociol Health &
Illness, 27(1), 92-113.
Impact on Recipients : Clint Hallam’s Hand
‘Removing a face transplant?’
Isabelle Dinoire
Xeno – ‘rejected’ then and now….
Identity Issues Interviews Study:
Parkinson Disease patients who had received fetal cells
Diabetic patients who had received porcine islets
“It feels like something big and meaty. And I am wondering what way it can
change me as a person. Yes, not that I’ll develop a tail or anything like
that—but that something will happen to me all the same” (Lundin 2002:
337).
“Like small piglets …tiny pig cells that I have no control over and that can
pump something animal like into my body.” (Eva in Lundin 2002: 337)
“You have surely urinated out the cells a long time ago, and if not, we
certainly don’t transplant souls in this hospital” (Eva’s doctor in Lundin
2002: 337 emphasis added).
Lundin, S. (2002). Creating identity with biotechnology: The xenotransplanted body
as the norm. Public Understanding of Science, 11(4), 333-345.
Problems with human-animal transfers
1)“The Ham Sandwich”
Michael, M., & Brown, N. (2004). The meat of the matter: grasping
and judging xenotransplantation. Public Understanding of Science,
13, 379-397.
2) “Pollution behaviour is the reaction which condemns any object
or idea likely to confuse or contradict cherished classifications”
(Mary Douglas, Purity and Danger, 1966: 36).
3) The ‘wisdom of repugnance’ or the ‘YUK’ factor….
Freudian ideas of the Heimlich and Unheimlich (familiar and
unfamiliar) where an entity can be both familiar yet strange –
resulting in the paradox of the ‘uncanny’ so it can seem ‘strangely
familiar’ yet still the familiar is strange.
Implantable Cardiac Defibrillators
An ICD – “stand clear”
• Prophylactic technology – disease onset or
occurrence.
• Unpredictable - “Kicked in the chest by a horse”
• Anxiety, depression and avoidance of physical or
sexual contact as well as effecting family
relationships (Ahmad M., Bloomstein L., Roelke
M., Bernstein A.D., & Parsonnet V., 2000; Dunbar
S.B., Warner C.D., & Purcell J.A., 1993; Heller,
Ormont, Lidagoster, Sciacca, & Steinberg, 1998;
Luderitz B., Jung W., Deister A., & M., 1994);
• Affects quality of life, relationships with others, but
identity (cf Mrs Washansky)??
Some quotes and random questions…
• The contemporary need for naturalness can be better
understood as a response to the fact that technology makes
reality more and more makeable and, consequently, more
contingent. Advancing technology changes everything that is,
into our object of choice…[I]f human nature itself becomes
makeable, it can no longer naively be laid down as the norm
(Swierstra, Van Est, & Boenink, 2009).
• Is what is natural the equivalence of what is normal? And what
is normal (minus “ ….”).
• Normalisation of natural – getting over the “yuk” to the “used
to”?
To have, to be, to do….
• Not just boundaries of the body (although it is) dependent on
what, where and why but acclimatisation to new boundaries
of embodiment incorporating the new additions (inside and
out)….by individuals and others…
• What part will regulatory, economic and political decisions
shape the redrawing of the parameters of embodiment?
• Heads up to Shawn, Leah, Duncan McLaren,
Astrid, Emma King, Alan Murray, Joyce, Laura
Downey, Carrie Purcell for the mechanical….
• You!
• …and Steve Austen..