Twice Dead
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"Margaret Lock produces a superbly scholarly study from her point of view as an academic comparative anthropologist or ethnograpoher....Her approach is informative...precisely because she is exploring the cultural perceptions that are the source of public opinion."--British Medical Journal
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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 this book I show how brain death is associated with different sets of assumptions about what constitutes the end of human life in Japan and North America. Read the first page
Front Cover | Copyright | Table of Contents | Excerpt | Index | Back Cover
In this book I show how brain death is associated with different sets of assumptions about what constitutes the end of human life in Japan and North America. Read the first page
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Front Cover | Copyright | Table of Contents | Excerpt | Index | Back Cover
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17 of 17 people found the following review helpful
A masterpiece of social research
28 Dec 2001
Format:Paperback
Margaret Lock discusses how organ transplant interests fostered the notion of brain death in North America and Japan. Until recently, Japan did not accept brain death as a sufficient criterion of death, even when the Japanese had all the technology and medical skills to carry out organ transplantation. By contrasting the muted discussion about brain death in North America with the heated, well informed public debates in Japan, Lock makes readers uncomfortable. Are people declared brain dead in America really dead, or do neurologists simply assume that they are dead to allow transplantation to take place? When does death occur anyway; is it a process or an event? Should physicians determine death with technological guidelines, or should death be defined by the people who are the most implicated, like relatives? Lock does not provide easy answers to those questions but her exhaustive research indicates how a different consensus about brain death emerged in the East and the West.
This book is a masterpiece of social research that does not succumb to cheap moralizing. Lucidly written, it is solidly grounded in anthropology but widely accessible. I strongly recommend it to anyone with an interest in medicine or anthropology.
This book is a masterpiece of social research that does not succumb to cheap moralizing. Lucidly written, it is solidly grounded in anthropology but widely accessible. I strongly recommend it to anyone with an interest in medicine or anthropology.
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