Centre for Values, Ethics and the Law in Medicine, University of Sydney, Sydney, NSW, Australia.
Transplantation. 2011 Dec 15;92(11):1188-90. doi: 10.1097/TP.0b013e318235c817.
At the time that a patient is diagnosed as brain dead, a substantial proportion of families who give consent to heart and kidney donation specifically refuse eye donation. This in part may relate to the failure of those involved in transplantation medicine and public education to fully appreciate the different meanings attached to the body of a recently deceased person. Medicine and science have long understood the body as a "machine." This view has fitted with medical notions of transplantation, with donors being a source of biologic "goods." However, even a cursory glance at the rituals surrounding death makes it apparent that there is more to a dead body than simply its biologic parts; in death, bodies continue as the physical substrate of relationships. Of all the organs, it is the eyes that are identified as the site of sentience, and there is a long tradition of visual primacy and visual symbolism in virtually all aspects of culture. It therefore seems likely that of all the body parts, it is the eyes that are most central to social relationships. A request to donate the eyes therefore is unlikely to be heard simply in medical terms as a request to donate a "superfluous" body part for the benefit of another. That the eyes are not simply biologic provides one explanation for both the lower rates of corneal donation, compared with that of other organs, and the lack of adequate corneal donation to meet demand.
当患者被诊断为脑死亡时，相当一部分同意心脏和肾脏捐献的家庭特别拒绝捐献眼角膜。这在一定程度上可能与参与移植医学和公共教育的人员未能充分理解最近去世的人身体所附加的不同含义有关。医学和科学长期以来一直将身体视为“机器”。这种观点与移植医学的概念相吻合，将供体视为生物“商品”的来源。然而，即使粗略地看一下围绕死亡的仪式，也很明显，一具尸体不仅仅是其生物部分；在死亡中，尸体继续作为人际关系的物质基础。在所有器官中，眼睛被认为是感知的部位，在几乎所有文化方面都存在着视觉至上和视觉象征主义的悠久传统。因此，在所有身体部位中，眼睛似乎最能代表社会关系。因此，捐献眼睛的请求不太可能仅从医学角度被视为为了他人的利益而捐献“多余”身体部位的请求。眼睛不仅仅是生物性的，这一事实解释了为什么角膜捐献的比例低于其他器官，以及为什么没有足够的角膜捐献来满足需求。
