Tuesday, March 1, 2011

Driver's License and Organ Donation

At the age of 15 1/2, when most of us have just learned to drive correctly we are asked to make the decision whether we want to be an organ donor. If we choose yes it is indicated on our driver's license with a red heart (refer to the license to the left). The Washington State Department of Licensing includes organ donation as a part of "Getting Your License" on their government sponsored website. This portion of the website indicates why you should donate, what it means on your license, what organs can be donated, how to register and what happens if you change your mind. In addition to this, it also indicates where to register for organ donation besides at the department of licensing, what to include in registration, as well as sites for more information and donating money to the organ donation registration. This site also provides a brochure that promotes organ donation to the fullest extent, for instance one of the headlines is "You have the power to DONATE LIFE (WA DOL)." On the first page of the brochure the benefits of donating organs, eyes, and tissue is represented through a mans survival story, through statistics and the overarching theme that with becoming an organ donor and indicating it on your license you can contribute to saving someone's life, "it provides hope to thousands of people with organ failure (WA DOL)." The second page of the brochure presents everything that can be donated to help others. One of the section caught my attention in particular, "How the donation process works":

"Your commitment to donation will not interfere with your medical care. Organ, eye, and tissue donation becomes an option only after all lifesaving efforts have been made. Consent for donation is confirmed, and your family is asked to participate in the process by providing your medical history. Surgical procedures are use to recover donated organs, eyes and tissue. The body is always treated with great care, respect and dignity."

The brochure and website information provided by the Washington Department of Licensing tends to glorify the heroism of organ donation, but does not present the very real issues that doctors, patients, and family members are faced with the reality of deciding when personhood has passed and the person is considered dead.

"To Be Freed from the Infirmity of (the) Age" by Krakauer presents the new technologies of sustaining life and what it means for defining death in modern science. Because there is the opportunity to sustain life through artificial means it has presented the issue of trying to figure when sustaining life will bring suffering, More recently "patients, surrogates, and physicians have agreed that sometimes withholding or withdrawing life-sustaining treatments is best (382)." However, laws and government policies also play a role "for allowing life-sustaining technologies to be withheld or withdrawn under certain circumstance (Krakauer 382)." Organ donation and use also indicates how an individual can conquer death or contribute someone else's desire to live longer; "the body is composed of disposable and potentially replaceable parts," this indicates the replacement of organs to promote a longer life (388). Organ transplantation is thus performed to help achieve a optimal living standard, the goal of modern science is to master the human body so when disease effects organs they can be replaced, "the Cartesian dream is manifested in the organ-replacement and life-sustaining technologies applied to gravely ill people (Krakauer 388)."

The organ donation indication on a drivers license gets much more complicated after considering that the technologies that are in place are to sustain one's life rather than announce death and harvest the organs. Furthermore, the promotion of donating organs by the department of licensing in Washington also ignores belief systems that disagree with organ transplantation and removal of body parts. In relation, Krakauer states that "the fundamental technological goal of mastery displaces traditional cultural and religious values, meanings and goals (Krakauer 390)." Modern medicine prides itself on technology that presents knowledge and answers but it also presents several problems because "all mastery displaces and thereby conceals the unmasterable (Krakauer 392)."

In the brochure on the Washington State Department of Licensing they state that, "Your commitment to donation will not interfere with your medical care." Lock's article, "Living Cadavers and the Calculation of Death" indicates the complexities of medical care and organ donation when the calculation of death is required. She states, "Brain-dead patients remain betwist and between, both alive and dead, breathing with technological assistance but irreversibly unconscious (136). The patient is surviving because of technology and the person has left the body, the trouble here is though are they really seen as dead or just brain dead; In Japan, "it is impossible to procure organs from the brain dead in Japan (136)." Culturally implications make it incredibly difficult for family members to decide if there family member is dead so that the organs can be harvested, thus "together with official and popular discourse and valued tactic knowledge, work in associations to compound medical judgement and influence the meanings that are associated with a diagnosis of brian death (Lock 138). So even though an individual might indicate they are an organ donor on their license, this symbol gets convoluted when the question of when to get the organs is presented; "If organs are to be transplanted then they must be kept alive and functioning as close to 'normal' as is possible (Lock 140)." Although the person has left that body, the biologically organism is treated as a live to maintain the value of the organs so when family members are approached it makes it difficult to differentiate dead and a life, especially if a doctor does not know their religious/spiritual beliefs (Lock 141)

The trouble with indicating organ donation on your drivers license as such an easy process at the Washington Department of Licensing indicates that it is simple to prepare for procurement. Krakuer indicates that life-sustaining practices such as receiving an organ can help a person avoid age but getting to the point, presented by Lock, is not just a matter of life or death. It is a matter of doctors, the law and family members finding a happy medium in order to decide when and if it is appropriate. The slogan sponsored by the WA DOL is, "You have the power to GIVE LIFE," I argue that once the individual is unconscious and personhood as left the power (i.e. brain dead) it is the ultimate decision of the doctor and family to decide on death for procurement.