Denying Culture in the Transplant Arena: Technocratic Medicine's Myth of Democratization

Abstract

In the United States, organ transfer has generated a highly selective and overly specialized approach to bioethics. A dominant assumption is the myth of medical democracy: whereas professionals involved in this highly technocratic arena publicly embrace notions of medical equality, particularized practices expose another reality. The more specific ideological tenets of medical democracy read as follows: First, all potential transplant patients are equally deserving of replacement organs. Further, all citizens are entitled to equal access to these unusual commodities, which are regularly described as precious and scarce “national resources.” Whether the premises of medical democracy are in fact played out in daily practice, however, is another matter entirely. Organ donation is driven by a universalized sense of humanity, whereby all bodies are assumed equal beneath the surgeon's knife. Yet the social worth of individuals varies radically: children, pregnant women, the unemployed, and prisoners, for example, expose a wide spectrum of responses to certain categories of bodies. So, too, do the cultural origins of organ donors. By drawing on anthropological knowledge of sociomedical practices relevant to organ transfer, this essay explores this theme of medical democracy specifically in reference to the needs of Latinos in New York City.