Deadly Disputes: Understanding Death in Japan, North America, and Europe

Alexander Capron, Margaret Lock, Lawrence Cohen, Stephen Jamison, Charles Leslie, and Guy Micco
April 1995
Photo of a spark in darkness.

Deadly Disputes contains two symposium talks with commentary.

In "Deadly Disputes: Biotechnology and Reconceptualizing the Body in Death in Japan and North America," medical anthropologist Margaret Lock discusses the cultural impact of the iron lung and other means of sustaining life beyond what was once considered the point of death. Lock centers the discussion around the history of brain death in Japan and North America. She argues that the establishment of brain death as a criterion for determining the moment of death in the United States has made routine the harvesting and transplanting of organs from the deceased, whereas in Japan, extensive political and cultural anxiety surrounds nooshi no mondai, the “brain death problem,” and the practice of harvesting organs for transplant. Her analysis examines some of the differences between North American/European and Japanese explanations of individuality and how the individual is, or ought to be, treated by society and its institutions. Lock concludes by characterizing some current approaches to the debate of whether or not constant redefinitions of death emperil the mentally weak, the aged, or any group that could be viewed as sources of organs to supply an increasing “market” for transplant surgery.

Commentators Charles Leslie and Guy Micco respond by suggesting further areas of investigation: the political economy of organ transplants both world-wide and in U.S.-style and socialized medical institutions (Leslie); and the ethical problems surrounding definitions of body, identity, and death as medical technology makes available methods for sustaining life beyond the loss of heartbeat and breath (Micco).

In "Legalizing Physician-Assisted Death: A Skeptic's View," legal scholar Alexander Morgan Capron examines the nexus of legal problems surrounding physician-assisted dying and the procedural difficulties that have emerged both with legalization of the practice (Netherlands) and with attempts to legalize it (Oregon, Washington, California). Capron proposes a strict examination of such legislation and recommends that it should have many safeguards to protect patients and doctors. He also suggests that some advocates of right-to-die legislation do not adequately consider the benefits to be gained by more thorough studies of pain and the greater institutionalization of pain management. He concludes that any legalization of physician assistance in dying must have as many legal and ethical safeguards in order to avoid both "death-on-demand" and possible abuses of the infirm by doctors or relatives.

Commentator Stephen Jamison of Life and Death Consultations responds by suggesting that physician assistance in dying is already happening and that its legalization would be beneficial provided that safeguards are in place to prevent abuses of the law. The practice must be institutionalized in a way that insures that the responsibility of participating in an act of suicide will not fall on the conscience or reputation of any single individual.