Organ Transplantation from a Organ Transplantation from a Theravada Buddhist Theravada Buddhist

PerspectivePerspective

Soraj HongladaromSoraj HongladaromDepartment of Philosophy,Department of Philosophy,Chulalongkorn UniversityChulalongkorn University

Outline of TalkOutline of Talk

Current situation in Thailand on organ Current situation in Thailand on organ transplantation.transplantation.

Main question: How one finds a Main question: How one finds a Buddhist solution to the ethical problem Buddhist solution to the ethical problem arising from it.arising from it.

A step beyond ‘secular’ and ‘traditional’ A step beyond ‘secular’ and ‘traditional’ ethics.ethics.

This means Buddhism is re-interpreted This means Buddhism is re-interpreted under the new light.under the new light.

Current Situation in ThailandCurrent Situation in Thailand

The Thai Medical Council has a rather The Thai Medical Council has a rather strict rule for pronouncing brain-death, strict rule for pronouncing brain-death, which is similar to that found in the which is similar to that found in the West.West.

However, the people in general do not However, the people in general do not disapprove of brain death criteria. But disapprove of brain death criteria. But when the person is their own close when the person is their own close relative, then they do not seem to be relative, then they do not seem to be that consistent.that consistent.

A Current AffairA Current Affair A famous teenage singer had a road A famous teenage singer had a road

accident and fell into a ditch full of dirty accident and fell into a ditch full of dirty water. At first he recovered well from his water. At first he recovered well from his external injuries, but later suffered from a external injuries, but later suffered from a severe headache.severe headache.

It was found that his brain was infected by It was found that his brain was infected by a rare form of fungus and fell into coma.a rare form of fungus and fell into coma.

The doctors tried to save his life through The doctors tried to save his life through repeated (5 times at the latest count) brain repeated (5 times at the latest count) brain surgery.surgery.

Current Affair (contd.)Current Affair (contd.)

His situation resulted in a flood of His situation resulted in a flood of teeagers from all over the nation to the teeagers from all over the nation to the hospital where he stayed. A ‘fan club’ hospital where he stayed. A ‘fan club’ spontaneously emerged aiming to give spontaneously emerged aiming to give moral support to the singer.moral support to the singer.

The doctors; however, said that the The doctors; however, said that the singer’s brain was eaten away so much singer’s brain was eaten away so much by the fungus that at best he would be a by the fungus that at best he would be a ‘sleeping prince’ if he survived.‘sleeping prince’ if he survived.

The Singer Affair (contd.)The Singer Affair (contd.) Nonetheless, this seemed to give Nonetheless, this seemed to give

reassurance to the singer’s fans in that reassurance to the singer’s fans in that they believed that he was still ‘alive.’they believed that he was still ‘alive.’

Right now he was in a stable condition. Right now he was in a stable condition. Latest news was that he was out of the Latest news was that he was out of the ICU, was able to breathe by himself ICU, was able to breathe by himself sometimes.sometimes.

The doctors said they might be able to put The doctors said they might be able to put his skull back to him some time soon.his skull back to him some time soon.

The doctors and the singer’s parents had a slim hope (I don’t know if they were realistic or not) that the singer might one day be able to get up and sing for the Thai teenagers again.

What does this tell us?What does this tell us? When asked about a person in abstract, an When asked about a person in abstract, an

average Thai may not object to the brain average Thai may not object to the brain death criteria.death criteria.

But when the person is a well known But when the person is a well known personality, such as a teenage singer, or personality, such as a teenage singer, or most importantly their own loved ones, then most importantly their own loved ones, then he or she starts to think otherwise.he or she starts to think otherwise.

However, when the person lies in the However, when the person lies in the comatose stage for a long period of time, then comatose stage for a long period of time, then the people start to change their minds.the people start to change their minds.

Attitudes toward TransplantationAttitudes toward Transplantation

Thai attitudes toward transplantation Thai attitudes toward transplantation also are interesting.also are interesting.

In the past, the Red Cross Society had In the past, the Red Cross Society had to convince people that donating their to convince people that donating their cornea after their death would not mean cornea after their death would not mean that they’d be born blind in the next life.that they’d be born blind in the next life.

Recently a novel in Thailand was Recently a novel in Thailand was published dealing with the negative published dealing with the negative effects of cloning and transplantation.effects of cloning and transplantation.

Attitudes (contd.)Attitudes (contd.)

The Vajiraprakarn Hospital case:The Vajiraprakarn Hospital case: Doctors harvesting a kidney from a patient Doctors harvesting a kidney from a patient

suffering from road accident without his suffering from road accident without his consent or knowledge. The patient later died consent or knowledge. The patient later died from the injuries suffered from the accident, from the injuries suffered from the accident, but his relatives found out later that his kidney but his relatives found out later that his kidney was missing. The Medical Council found the was missing. The Medical Council found the doctors guilty and revoked their license. The doctors guilty and revoked their license. The head of the team had a lot of business head of the team had a lot of business investment in the hospital.investment in the hospital.

AttitudesAttitudes

It seems that for Thai people, harvesting It seems that for Thai people, harvesting organs would be generally all right if the organs would be generally all right if the person has clearly indicated his or her person has clearly indicated his or her wish through wills or consent forms.wish through wills or consent forms.

But the issue becomes very serious But the issue becomes very serious when there are business motives when there are business motives involved.involved.

Toward an Asian Element in Toward an Asian Element in BioethicsBioethics Since Asia is a very large continent, it is Since Asia is a very large continent, it is

very difficult to find some elements that are very difficult to find some elements that are common to all parts.common to all parts.

As for Thailand, I would propose that one As for Thailand, I would propose that one looks at Buddhism, since most people are looks at Buddhism, since most people are Buddhists. The idea is that people of other Buddhists. The idea is that people of other religions can find their own elements from religions can find their own elements from their respective religions. Only that the their respective religions. Only that the norms should come out more or less norms should come out more or less congruent.congruent.

Buddhism and TransplantationBuddhism and Transplantation According to Theravada Buddhism, the According to Theravada Buddhism, the

body is just matter. It needs to be washed body is just matter. It needs to be washed regularly otherwise it becomes very smelly regularly otherwise it becomes very smelly - “a bag of shit.”- “a bag of shit.”

The aim is to transcend the body through The aim is to transcend the body through meditation and understanding of the meditation and understanding of the Dhamma.Dhamma.

Thus at first sight there does not seem to Thus at first sight there does not seem to be a serious objection to brain death or be a serious objection to brain death or organ transplantation.organ transplantation.

Buddhism and TransplantationBuddhism and Transplantation

However, as the singer’s case However, as the singer’s case illustrates, people are not detached from illustrates, people are not detached from the belief that the body is the person too the belief that the body is the person too easily.easily.

And one might see the other side of the And one might see the other side of the issue: Why should the potential organ issue: Why should the potential organ recipients want it so much, since it’s all recipients want it so much, since it’s all bags of shit any way?bags of shit any way?

Is it a selfish act to get organs from somebody so that one can live longer, only to enjoy the material elements of life?

In the end this decides whether organ transplantation is unethical according to Theravada Buddhism.