Faculty of Theology and Religion, Harris Manchester College, University of Oxford, Oxford, UK
Med Humanit. 2020 Dec;46(4):362-371. doi: 10.1136/medhum-2020-011870. Epub 2020 Aug 3.
This enquiry examines problems which haunt the 'heart' and its donation. It begins by examining the heart's enduring significance for culturally mediated self-understanding, its vulnerability to misunderstanding and abuse and its relevance to challenging the determination of death by neurological criteria. Despite turns to brain-centred self-conceptions, the heart remains haunted by the hybrid experiences of identity accompanying organ transplant, the relational significance attached to dead hearts witnessed in the Alder Hey scandal and claims that heart transplants commonly constitute the legitimate killing of a person. To explore these phenomena, traditions are retrieved in which the heart-as-organ was construed in terms of a person's core identity. Influential Abrahamic beliefs about 'the heart' are considered in order to explore explanations for why the heart remains culturally pre-eminent, to make intelligible our haunted hearts and to examine possible violations of solidarity in organ donation practice. Jewish and Christian Scriptures are exegeted to illumine the sources of our haunting and address the desire for holistic bodily life. In these sources, the heart is the seat of affections, intelligence and agency but requires healing, conceived via the surgical metaphors of heart transplant and circumcision, if people are to join the insightful, solidary path of pilgrimage. Absent healing, the heart experiences a judgement of the whole person-organ-and-core-at the moment of death. Through such exegesis, the doctrine of the Holy Ghost emerges as a way to make intelligible, though not dispel, the heart's haunting. The doctrine's practical significance concerns the possibility of social unity among hearts, 'intercordiality', which construes people within a covenantal life of pilgrimage which encourages heart donation in certain circumstances, makes intelligible the Alder Hey parents' experience of social misunderstanding and rejects ascribing any legitimacy in medical culture to the consensual killing of patients for the sake of retrieving their organs.
本研究探讨了困扰“心脏”及其捐赠的问题。它首先考察了心脏在文化中介的自我理解中的持久意义，以及它易受误解和滥用的脆弱性，以及它对挑战通过神经标准确定死亡的相关性。尽管转向以大脑为中心的自我概念，但心脏仍然被器官移植伴随的身份混合体验、在奥尔德姆希伊丑闻中见证的死心的关系意义以及心脏移植通常构成合法杀人的说法所困扰。为了探索这些现象，我们检索了传统观念，即心脏作为器官是根据一个人的核心身份来构建的。考虑到关于“心脏”的有影响力的亚伯拉罕信仰，以探索为什么心脏在文化上仍然占据主导地位的解释，使我们的困扰心脏变得可以理解，并检查在器官捐赠实践中可能违反团结的情况。对犹太教和基督教的经文进行注释，以阐明我们困扰的根源，并探讨对整体身体生命的渴望。在这些来源中，心脏是情感、智力和能动性的所在地，但需要通过心脏移植和割礼的手术隐喻来治疗，如果人们要加入有洞察力的、团结一致的朝圣之路。如果没有治疗，心脏会在死亡时刻对整个人-器官-核心进行评判。通过这种注释，圣灵学说成为一种使心脏困扰变得可以理解的方式，尽管不能消除它。该学说的实际意义涉及到心脏之间的社会团结的可能性，即“intercordiality”，它在圣约朝圣的生活中构建人们，鼓励在某些情况下进行心脏捐赠，使奥尔德姆希伊父母的社会误解经历变得可以理解，并拒绝在医学文化中赋予为了取回器官而一致同意杀死患者的任何合法性。
