Thursday, April 27, 2006

What do we owe?

"The single most important thing to know about Americans -- the attitude which truly distinguishes them from the British, and explains much superficially odd behavior -- is that Americans believe that death is optional."
Jane Walmsley

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Some of you may have been following the comments from this post. I made a reply, but I still had something Sailorman said on my mind (I'm not picking on you, Sailorman, I swear). He said that the dead owe nothing to the living. Which got me thinking about personal responsibility. What do we owe other people:our families, our children, strangers, other residents of our nation or the world. Do we intervene when we see someone getting beat up? Do we stop at an accident? Do we intervene if we think the neighbors are molesting their kids? Do we keep the world clean for future generations even if it means we drive less or give up something we really like(I don't know, pick something)?

I feel like I'm rambling. Do the dead owe the living anything? The thought has brought out the existentialist in me. The Talmud says, "he who saves one life, saves the world entire." When a family has to make a decision to donate, do they owe the potential recipient anything? I'm not talking about laws or presumed consent. I'm talking about morally. When it comes to donation, though, I don't think it's about what the dead owe the living, but about what the living owe the living. If given the opportunity to save someone's life, would you do so? What if it was conditionally? One commenter said she would only donate for a family memberif she could know who the recipient was, that it was her right and if the recipient didn't go for it, they didn't have to accept the organ. But when a house is on fire, do you say to the people trapped inside, well, I'll rescue you if you promise to come clean my house. They're in no position to say no. One guy I know recently found out he had received a new heart after being in a coma. He couldn't agree to anything. People waiting for organs are desperate and sometimes have only days or hours to live. So is it morally right to place a restriction on the gift of life?

This whole line of thinking led me to think about dead people. Now I have personally done post-mortem care on dozens of people. I've cleaned blood and various other body fluids from them, redressed them in clean gowns and generally made them presentable to be seen by their families. One of the big concerns families have is having their family member "cut up". But when you've actually touched a dead person, you see that this is just the shell we live in. Our bodies are just a suit of clothes that we wear and when we die, no matter what you believe happens next, we take off that suit and move on. It's fitting to act with respect and reverence, but it's still just your shell. I think everyone should do post-mortem care at least once. Like it used to be done(and still is, in some parts of the world), when a dead person was layed out in the parlor for the wake.

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6 comments:

Keith, RN said...

Hi. Did you catch the piece on NPR today by a man telling the story of his receipt of a kidney? The link is http://www.npr.org/templates/story/story.php?storyId=5369771.

All the best

keith

Keith, RN said...

Here's the full link---sorry

http://www.npr.org/templates/story/story.php?storyId=
5369771

Robin said...

Do the dead *owe* the living anything? Well, technically... no. But the living don't owe the living anything either. People, hopefully, will *want* to do things to better the world and help our fellow man.

It makes me sad to see people "looking out for number one" to the exclusion of all others. "What's in it for me?" shouldn't always be the defining question in the decision making process.

KarenM said...

Keith,

I caught the entire piece on NPR regarding the man receiving a kidney in 1996. It was a riviting segment and had me sitting in my car outside Home Depot for the conclusion. That's what NPR always does to me!

Overall, I thought the writer adequately expressed his relief that he would finally be healthy after being on the transplant list for four years. His recovery seemed miraculous. It was at the end that my heart sank and I felt such sorrow for the 14 year old donor's parents when the recipient expressed that he had tried to write a letter and couldn't seem to do it. He went on to say that he hoped this oral essay would suffice and somehow the parents would know he appreciated their gift (I'm paraphrasing, but I believe the essence is correct). Assuming this piece is rather recent, the donor's parents waited for ten years to hear his thoughts. And that's only if they happened to be listening or were made aware by someone of the piece. That's heartbreaking. He didn't necessarily have to write a letter, but he could have made an audiotape or had someone write on his behalf.

I realize I might be missing something on this, but these are my thoughts from listening to this yesterday.

KarenM in NC

sailorman said...

"I still had something Sailorman said on my mind (I'm not picking on you, Sailorman, I swear). He said that the dead owe nothing to the living. Which got me thinking about personal responsibility. What do we owe other people:our families, our children, strangers, other residents of our nation or the world. Do we intervene when we see someone getting beat up? Do we stop at an accident? Do we intervene if we think the neighbors are molesting their kids? Do we keep the world clean for future generations even if it means we drive less or give up something we really like(I don't know, pick something)?

You knew I would comment I hope :)

I think it's more accurate to say the dead don't owe anything to the living solely on the basis of their relative mortality.

This is a way of saying that if we know our decisions and goals will be respected (to some degree) after death, it governs our behavior while alive.

I save money, in part, because I love my family and want them to have the money after my death.

What happens when those goals are not respected? What happens when all my estate gets randomly added to the MA lottery pool?

Well, i become less likely to save money.

And that's only money. Organs are much MORE personal--about as personal as you can get. If you're not going to respect my right to control what happens to my body, and the reason is "because I'm dead" and you're not... why respect my other rights? It's true I won't miss my liver. But I also won't miss my house.

p.s. which thread do you want to continue this on?
pps and as to the lawyer question, what do you want to know?

liver mom said...

I am a recipient and wrote my donor family a letter several months after my transplant. I have also written a letter to my donor family every year on my transplant anniversary. The first letter was the hardest thing I've ever done. To try to convey your thanks knowing that family suffered a horrible loss. Though it was heartfelt, it still didn't seem to say enough.


I belong to a transplant support group which is for donor families and recipients. I'm shocked when I hear a donor family has never heard from a recipient. I've never heard from my donor family and know I may not ever. I was very close to death and am here because a wonderful family was incredibly generous.