Symbolic considerations might also include, as mentioned earlier, the significance in different cultural traditions of specific internal organs and their relationship to personal identity, Even the medical literature in transplantation cites numerours cases donor’s self (e.g., personality characteristics, gender-related dispositions, ethnicity) is still present in the kidney, liver, heart, or lung that now resides in their bodies. Transplant organizations, on the one hand, wish to dispel such ideas to facilitate the psychological adjustment of the recipient. On the other hand, the same organizations publicize dramatic accounts of donor families meeting recipients and describing their sense that some part of their deceased loved one survives in the transplanted organ. This is a rich area for anthropological exploration.
A related research question is how cultural definitions of death, norms for the treatment of the dead, and notions of and afterlife complicate organ transplantation. In the United States, the shift from the traditional heart-based determination of death to the current dependence on evidence of brain activity began over thirty years ago (1968), and yet next of kin and medical staff alike still voice confusion and ambivalence about “brain death” (Joralemon 1995:340). Medical anthropologyists Margaret Lock and Christina Honed (1990; Lock 2002) have documented the wide-spread resistance in Japan to the idea of brain death and the impact this has had on the development of organ transplantation in that country. The treatment of the dead and its relationship to transplantation has been investigated as well in Germany (Hogle 1996) and Mexico (Crowley Matoka nd).
For Peruvian shamanism, I suggensted many research topics related specifically to the patients. Fox and Swazey (1974, 1992) have made significant contributions to the analysis of the transplant patient’s experience by focusing on the significance of receiving a “gift of life.” They use traditional social science theory about the socio-cultural significance of gift giving (e.g., Mauss 1954) to explain the core dilemma faced by transplant recipients: The gift they receive is of inestimable value (i.e., their own survival), but in is ultimately unrepayable. Fox and Swazey coined the phrase tyanny of the gift to capture the impact on recipients of being on the receiving end of a nonreciprocal gift.