Lin Ya-Ping, Chen Huei-Ya
Department of Medical Humanities and Education, School of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan.
Institute of Public Health, National Yang Ming Chiao Tung University, Taipei City, Taiwan.
Med Health Care Philos. 2025 Sep;28(3):517-531. doi: 10.1007/s11019-025-10275-6. Epub 2025 Jun 5.
This article explores the lived experiences and ethical complexities of the decision- and meaning-making journey involved in living donor liver transplantation (LDLT) through a case study of a young adult who donated part of his liver to his father. Utilising embodied phenomenology and narrative analysis, we present an in-depth exploration of personal stories and interconnected narratives that reveal the intricate layers and nuances inherent in child-to-parent LDLT within the Taiwanese sociocultural milieu. This study examines the embodied, relational, temporal and normative dimensions through a dynamic, iterative process of careful reading and analysis, from which four plotlines emerged [(1) indebtedness, (2) thrownness, (3) struggle for selfhood and (4) family seniority] along with a postscript. The findings illuminate the complex interplay of body, self, family, intergenerational dynamics and sociocultural norms throughout the decision-making process. The analysis aims to lay the groundwork for a refined framework for understanding concepts such as giving, relationality, agency, temporality and normativity within bioethical discourses on organ transplantation. Furthermore, the study offers insights for healthcare professionals to develop culturally sensitive approaches in LDLT care ethics and practice, with particular attention to vulnerability, relational autonomy and embodied intersubjectivity as normative foundations.
本文通过一个年轻成年人将自己部分肝脏捐献给父亲的案例研究,探讨了活体肝移植(LDLT)决策与意义构建过程中的生活经历和伦理复杂性。运用身体现象学和叙事分析方法,我们深入探究了个人故事及相互关联的叙事,揭示了台湾社会文化背景下亲体肝移植中固有的复杂层面和细微差别。本研究通过仔细阅读和分析这一动态、反复的过程,审视了身体、关系、时间和规范维度,从中浮现出四条情节线[(1)感恩之情,(2)被抛状态,(3)自我身份的挣扎,(4)家庭辈分]以及一个后记。研究结果揭示了整个决策过程中身体、自我、家庭、代际动态和社会文化规范之间的复杂相互作用。该分析旨在为完善一个框架奠定基础,以便在器官移植的生物伦理话语中理解诸如给予、关系性、能动性、时间性和规范性等概念。此外,本研究为医疗保健专业人员在活体肝移植护理伦理与实践中制定具有文化敏感性的方法提供了见解,特别关注将脆弱性、关系自主性和身体主体间性作为规范基础。