Abstract
Bioethical discourse on organ donation covers a wide range of topics, from informed consent procedures and scarcity issues up to ‘transplant tourism’ and ‘organ trade’. This paper presents a ‘depth ethics’ approach, notably focussing on the tensions, conflicts and ambiguities concerning the status of the human body (as something which constitutes a whole, while at the same time being a set of replaceable elements or parts). These will be addressed from a psychoanalytical (Lacanian) angle. First, I will outline Lacan’s view on embodiment as such. Subsequently, I will argue that, for organ recipients, the donor organ becomes what Lacan refers to as an object a, the ‘partial object’ of desire, the elusive thing we are deprived of, apparently beyond our grasp. Within the recipient’s body an empty space emerges, a kind of ‘vacuole’, once occupied by a faltering organ (now removed). This space can only be filled by a ‘gift’ from the other, by an object a. Once implanted, however, this implant becomes an ‘extimate’ object: something both ‘external’ and ‘intimate’, both ‘embedded’ and ‘foreign’, and which is bound to remain an object of concern for quite some time, if not for life. A Lacanian analysis allows us, first of all, to address the question what organ transplantation has in common with other bodily practices involving bodily parts procured from others, such as cannibalism. But it also reveals the basic difference between the two, as well as the distance between the ‘fragmented body’ of Frankenstein’s ‘monster’—as an aggregate of replaceable parts—and the multiple organ recipients (the ‘puzzle people’) of today.
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Notes
“Cette déviation bouffonne que j’espère barrer, qui est déjà étalée de longues années sous le terme de psychanalyse appliquée” (2006, p. 66).
“Die Pathologie lehrt uns [Fälle] kennen, in denen uns Teile des eigenen Körpers … wie fremd und dem Ich nicht zugehörig erscheinen” (Freud 1930/1948, pp. 423/4).
Cf. Cassell (1992): “Michelangelo’s statue of David … evokes in all the essence of human form and purpose”” (p. 248). .
This register of bodily experienced was opened up by Sanctorius (1561–1636), the founding father of iatrophysics, whose notes on medical statics—De Medicina Statica Aphorismis—were published in 1614, after having spent no less than 30 years of his life in a weighing chair, carefully measuring the effects of food intake and other daily habits on body weight, and comparing it with the weight of waste products (urine and faeces). .
In the novel Gradiva, as analysed by Freud (1907/1941), desire is aroused by the singular shape and movement of the heroine’s feet that comes suddenly into view.
In an intriguing analysis Iris Marian Young (1992) juxtaposes ‘breastedness’ with mastectomy (building on the work of Luce Irigaray, a critical follower of Lacan). In Western patriarchal culture, dominated by the masculine gaze, she argues, women’s breasts easily become objectified into a fetish that can be handled, manipulated, even ‘owned’ by males as an object which is detachable (more or less) from her body, functioning as ‘object of exchange’ on the market of sexuality. This latent detachability is exemplified by breast removal in the case of malignancy, resulting in a breast-less or one-breasted (‘Amazon’) woman, who may replace her missing breast with a prosthesis, thus underscoring its apparent replaceability.
Lacan also makes a connection with perversion. The perverse subject discerns that something is missing in the body of the other (for instance: the phallus). This is represented as
, the barred Other, who falls short of the imaginary ideal. This deficiency has to be restored with the help of a certain supplement, an equivalent for the missing object a, so that the Other can be brought back to his/her level of dignity again: + a = 1 (2006, p. 19).“J’ai désigné comme la vacuole, cet interdit au centre, qui constitue, en somme, ce qui nous est le plus prochain, tout en nous étant extérieur. Il faudrait faire le mot extime pour désigner ce dont il s’agit” (2006, p. 224).
The paradoxical concept of ‘extimacy’ may been seen as comparable to Saint Augustine famous phrase envisioning God as ‘interior intimo meo’, more interior than my innermost being (Bracher et al. 1994, p. 76). The new organ is inside the recipient, but he/she remains highly aware of its presence.
Caníbales was the Spanish name for the Carib people of the West Indies, notorious for their cannibalistic practices. Cannibalism is used here not to refer to man-eating a last resort to fend off starvation, such as occurred during the infamous ‘Andes flight disaster’ in 1972, but as a ritualistic event notably practiced by warriors and priests.
In the Merchant of Venice, a similar formula is at work: the heart is set apart from the rest of the body. The question is, however, how to collect the heart without damaging the remainder of the body.
In this same vein, Voyeurism is defined by Kass as “cannibalism of the eyes”.
“The trumpet shall sound, and the dead shall be raised incorruptible, and we shall be changed” (1 Corinthians 15:52).
Indeed, the Last Supper, and the sacrament of the communion (conducted behind closed doors) which builds on it, has been regarded as a (sublimated) remnant of cannibalism by critics of Christianity notably in Roman times.
As Adler phrases it, organ inferiority gives rise to a sense of being disadvantaged: a Gefühl der Verkürztheit, which literally means ‘feeling shortened’ (1927/2009).
, the barred Other, who falls short of the imaginary ideal. This deficiency has to be restored with the help of a certain supplement, an equivalent for the missing object a, so that the Other can be brought back to his/her level of dignity again: References
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Zwart, H. The donor organ as an ‘object a’: a Lacanian perspective on organ donation and transplantation medicine. Med Health Care and Philos 17, 559–571 (2014). https://doi.org/10.1007/s11019-014-9553-1
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DOI: https://doi.org/10.1007/s11019-014-9553-1