Anonymous blood donation, performed without financial gain for the donor, is typically seen as positive in international policies. This also applies to voluntary post-mortem organ donation, and these donations are commonly labelled altruistic. Altruistic organ donation from a living donor to a stranger has been questioned in some international medical debates, but it is performed in Sweden. Intrafamilial and friend-to-friend altruistic organ donation is an integrated part of Swedish health care in contrast to altruistic surrogacy, which is not allowed. This project offers a systematic analysis of altruistic bodily exchanges in medicine.
The project examines what gets to qualify as desirable altruistic bodily exchanges in medicine in international and Swedish policies and law. It explores how the desired bodily exchange often presupposes or encourages anonymity – with the exception of intrafamilial or friend-to-friend organ and tissue donation. At some Swedish clinics, egg donors who want to donate to the next of kin can be encouraged to donate to a stranger.
Self-interest versus Other-interest
Starting with an analysis of international and national policy and laws, and pro-donation campaigns, the project examines how altruistic donations as well as altruistic surrogacy tend to be understood and regulated in the light of the dichotomy between self-interest versus concern for others, and examines how this dichotomous framing helps shape understandings of altruistic bodily exchanges as both wanted and scarce. The project also demonstrates that the conception of who qualifies as an “acceptably” altruistic donor is shaped by concerns about donors being either too altruistic or not altruistic enough. Anonymity also enters the picture: donation or surrogacy between family members or friends fit particularly poorly into the dichotomy of self-interest vs. other-interest. At the same time, bodily exchange between individuals who know each other beforehand has a complexity of its own, which also needs to be investigated.
The sociality of suffering
What would happen if ethics debates did not start with concerns about altruism and anonymity as core features of ethically desirable bodily exchanges in medicine but with the sociality of suffering? Such an alternative entrance point would imply a shift in focus from the donor to the relationships between individuals. It would also imply that different ethical and philosophical questions would need to be raised, such as: how is my understanding of what I can give or share from my body shaped over time and in relationships with others? How can we understand intersubjective dimensions of suffering and pain? How can suffering and pain be shared, and how can such sharing help shape the perception of possible routes of action for the situated bodily subject? What form would the ethics of bodily exchanges in medicine take if the sociality of suffering, in all its complexity, was taken seriously?
The project examines how some ethical issues fit into and are reified via the dichotomy of self-interest versus other-interest, and when the ideal altruistic bodily exchange is assumed to be anonymous. It examines what ethical issues risk not being discussed and whether this should be seen as a problem in current medical ethics.
Project name: Beyond Altruism. This project is part of Zeiler’s Pro Futura research on bodily giving and sharing in medicine.
Financed by: Riksbankens Jubileumsfond and the Swedish Collegium for Advanced Study.