Wednesday, June 5, 2013

Organ transplanting-ethics and morality.




Organ transplanting-ethics and morality.
By Laurie Smith
The first successful kidney transplant occurred in Boston in 1954, identical twins Richard and Ronald Herrick were the first participants. Richard was dying of kidney disease and his brother’s was used, saving his life. I well remember 1967 when Doctor Christiaan Barnard performed the world’s first heart transplant and could only imagine the feelings of relief for those with ailing and diseased hearts. The patient, 55-year-old Louis Washkansky received a heart from a young woman killed in a traffic accident, he survived for 18 days. There were many arguments both moral and ethical, for and against and the views are still argued today. Now we have heart-lung transplants, cornea, liver, kidney, pancreas and the small intestine. Of course there are the advances in skin grafts, one of the first types of organ transplant, the use of artificial heart valves, stents, and valves from the hearts of pigs. Remarkably these valves work as well as human ones and last 10-15 years. The use of animal valves caused a barrage of controversy from various religious leaders and animal rights groups. Most kidneys and some livers are from live donors. With the liver the lobe is taken from the donor and transplanted, the donor’s liver regrows within a couple of months. Though there are reports of donors having trouble with pain, digestive problems and depression up to three years later.
For the other major organs somebody’s loved one, child or spouse has died. Their death can impact on ten other lives. Either saving them or at the very least improving their quality of life. Who hasn’t been moved by the imagery of people lying in hospital beds, in need of a donor organ? Especially when that patient is a small child, it tears at us to see the suffering. The parents sit by them agonising, waiting for someone to die so their child may live. Many patients miss out due to financial restraints, lack of health insurance, others being deemed a better match or more viable. Organ donors are few in comparison to population size, here in Australia we are number 17 in the world though we have the best outcome rate for patients. Those needing far outweigh those willing to give. Here your driver’s licence is marked if you wish to donate, you would think it was binding, it isn’t and family members can veto it. Having it in your will is a little too late for anything other than corneas and various tissues. The prime minister has put forward the idea of a scheme to pay workers $3,000.00 and their medical expenses if they donate a kidney. Workers only it seems, otherwise God forbid we would have the great unwashed making a dollar from an organ. On average 1700 Australians are waiting and about 245 receive a transplant. The problem is that only one percent of people die in hospitals and organs need to be fresh.
How much is a life worth? To those who take them indiscriminately, nothing. To a parent watching their child die it is priceless. To those in the illegal kidney trade located in China, India and Pakistan its worth up to $250,000.00. Would you accept say a kidney, one in ten of which comes from the illegal trade of human organs worldwide, and deal with a criminal organisation that preys on the impoverished? Does the grieving parent/spouse really care where it originates, as long as it works? Taking this a step further would you accept an organ from an executed criminal? I’m not saying that because the donor is a criminal that something is inherently wrong, rather that they have no choice in the matter. Most executions in China are by lethal injection and take place in mobile execution chambers parked next to major hospitals. They have used the organs from executed prisoners for decades; this is sanctioned by the government. Ten thousand transplants occur there annually and on average four thousand prisoners are executed, with seven thousand organs used. They have the highest execution rate in the world. Five years ago the government ruled that the organs could only be given to family members, and they will be phasing out the use of prisoner’s organs in 2015. This is irony at work, members of a criminal gang dealing in organs were sentenced to death in 2009. I wonder if they used their organs?
It must be the writer in me but I feel that a system where the State can trade your parts (who gets the money, a kidney sells for $15,000.00?) is nothing short of horrific. There are 68 crimes that draw the death penalty in China and many include non-violent offences i.e., monetary crimes. This brings to mind some Dystopian future where the downtrodden are chosen for execution by the State for their ability to match some wealthy individual in need of organs. I haven’t written this by plucking facts and figures out of fresh air. I’ve scoured several newspaper articles and came across the below site and believe me the more I read the sicker I became. Children are often the forgotten victims of organ trafficking. People aren’t content with using them in the sex trade, enlisting 10 year old boys to fight in war, or working them into an early grave in substandard conditions, now they are also unwilling donors. In Africa parents have sold their children’s organs, in Haiti and Mongolia orphans and street children are vulnerable to this trade. Follow this link for the full article: http://worldpulse.com/node/62193 So where do this leave us? We have a readily available product for sale: a huge market, profiteers, criminal gangs, uncaring Governments, vulnerable donors, unwilling donors, moralists and ethicists.
Mr and Mrs Brown are at the end of their tether, their daughter, Olivia is 12 and has polycystic kidney disease, and the only cure now is a donor kidney. Neither of the Browns are a match. Olivia came into the world via donor egg and sperm and she is their only child. They have watched their once healthy girl grow weaker and she is weeks away from death. One earlier kidney transplant failed, their health fund is having problems with a changeover to a new fund and time and ready money is running out. They search the internet and find a clinic in mainland China that can perform the operation for $150,000.00. After mortgaging their home, selling everything else of value and borrowing from family members they fly to Beijing with an ailing Olivia, and then on to their final destination further inland.
Temujin is an eleven year old Mongolian girl, orphaned after her parents died the previous year. She has lived a vicarious life since then, being put in and running away from state run orphanages. Now she lives at the rear of a horse stable in a provincial town, healthy but hungry the only currency she has is her body. When a man in a suit approaches her late one night with the promise of hot food and a warm bed she eagerly goes with him, willing to do anything to get out of the cold. Led into a tiny room in the town’s only hotel she sees the bed and begins undressing. A woman appears dressed in a long white gown with a syringe in her hand, a tiny prick to Temujin’s arm and darkness overtakes her. She never wakes up again; the removal of her kidneys and other organs that will survive the flight is done swiftly, professionally and her body is left in a shallow grave.
Bai Gau is a 30 year old prisoner in a Chinese jail, a member of a large religious sect outlawed there. He is due for execution and his organs have already been allocated, except for one kidney. This has been set aside for Olivia.
Let us go to India into a major city, we’ll meet Aadi he’s a Dalit one of India’s Untouchables. He lives with his wife and six children in an alley behind a warehouse; their home is probably the size of one of our bedrooms. They have little money or food and being Dalit are open to abuse and hounding from the authorities. Enter a man with $1,000.00/Rupees 55,000.00 the average wage per capita is around R 33,000.00 and you have a tangible incentive for Aadi to donate.
On the morning of the operation Bai Gau is put to death by lethal injection in the mobile execution chamber parked behind the hospital. All of his organs are harvested and at the last minute an appeal by his family has seen the kidney intended for Olivia being used for one of Bai’s cousins. Aadi’s kidney has arrived by air, destined for ninety year old Otto Schmidt, a German man who acquired his wealth during WW2 as a factory owner using forced labour from concentration camps. The organ has deteriorated in transit due to poor handling and is no longer viable.
Wang Li who is managing the Browns transplant informs them of the unfolding events and inadvertently lets slip the origin of the remaining kidney. They’re horrified, even more so when they hear that Schmidt has now promised to pay double the amount to claim Temujin’s organ. Enraged, Mr Brown storms into Schmidt’s room, the man lays there feeble, suffering. Brown explains his daughter’s situation and the origin of the kidney. Schmidt laughs at him, crowing that he’ll triple the price to gain an extra year or so of life. Snatching up an empty syringe from a tray, Brown pulls back the plunger filling it with air, sticks it into a tube going into Schmidt’s arm and injects an air bubble into it. Walking slowly away he drops the syringe in a rubbish bin and returns to his wife and daughter. Later that day Temujin’s kidney is successfully transplanted into Olivia Brown who makes a full recovery.
There are a few moral questions here:
1. Does any government have the right to dispose of executed criminals organs?
2. Once they knew the origin of the kidney should the Browns have allowed the operation to go on?
3. Knowing the circumstances of Bai Gau’s involuntary donation was it right for them to have gone ahead if the donation hadn’t been stopped?
4. Otto Schmidt was at the end of his long life. Did he deserve Temujin’s kidney?
5. Did his wealth make him more deserving?
6. Did Olivia’s condition and impending death make the murder of Schmidt right?
7. Knowing the method of donation should Temujin’s kidney have been used even after Schmidt’s death?
8. Does saving the life of your child mean that you should set aside all moral and ethical considerations that have served you up to now?
Now for a hypothetical viewpoint, probably stemming from my love of the Twilight Zone, so here goes. Schmidt although having a past steeped in greed and suffering, upon receiving his new kidney experiences a new paradigm in his life. The wealth he has accrued over time is put to use in helping build orphanages in underdeveloped countries, giving thousands of children a new start in life. Moral questions,
  1. If Temujin’s kidney wasn’t used would her death have all been for nothing?
  2. Does a better existence for a thousand children make up for one child’s murder?
  3. Does it matter where the money comes from as long as it is being put to a good cause?
  4. Can a person whose life had been steeped in evil and greed, truly rehabilitate?
The Browns return home and spend years repaying their debts, Olivia, happy to be alive at first, becomes depressed and withdrawn at not being able to attend college. She begins drinking at 16 and taking party drugs, all to the detriment of her kidney. After drinking half a bottle of Tequila she drives her boyfriend’s car through a red light, smashing into another car, taking the life of a young heart transplant surgeon. She survives, only to end up on dialysis and dying two years later. Mr and Mrs Brown are already in conflict since the operation and separate, suffering deep depression over the murder of Schmidt and the death of his daughter, Mr Brown suicides.
Moral question,
  1. Does the end justify the means?


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36 comments:

  1. Thank you for hosting my bog post Marta, I appreciate it.
    Cheers
    Laurie.

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  2. You certainly have raised a lot of moral questions here but you are not at all off the mark. This is the world we live in, for better or worse. I believe each of us must make these decisions for ourselves but how or what criteria to use is the thorny part. And it’s not just a cerebral question but also a decision which must include the heart. That is the problem—how to quantify feelings in a fair way. I just don’t think it can be done.
    Great article, Laurie, although I’m not going to get to sleep now, you’ve given me so much to think about!

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    1. Thank you Elaine, it is indeed a thorny subject and it isn't ever going to go away. I imagine that people will always make the choice that suits them at the time, irrespective of the morality or lack of it. I apologize for disturbing your sleep though.
      Cheers
      Laurie.

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  3. Horrifying implications raised here Laurie - like many things these days one must needs dig a little deeper beneath the surface. Thank you for this most insightful informative piece.

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    1. Thanks for reading and commenting PJ, exactly, you have to investigate a subject to gain a clearer perspective.
      Cheers
      Laurie.

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  4. This comment has been removed by the author.

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    1. This was Pat Yaeger's comment, which I keep trying to post and the engine deletes. Will keep on trying. Sorry, Pat.

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  5. Excellent questions. I don't believe the girl should have been murdered for her organs that was totally immoral. The prisoner, yes I believe that his organs are harvestable, he was a prisoner his life had been under control by the prison, he couldn't make decisions in there why after his death. The rich guy, that's wrong, they should have a waiting list like they do in this country and give it to the most deserving. There is a lot of hope in harvesting organs in other countries where the death rate is high, but I feel the families should get the money and not any inbetween person. And definitely murdering someone for their organs is a big NO, but then again if you start going to these countries to buy organs they will start killing to get the money for these organs, so it's a vicious cycle. One that needs a lot more research. Thanks for the brain teaser.

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    1. Hi Lori, thanks for responding. The prisoner, Bai Gau's only reason for being incarcerated was because of his religious beliefs. A whole other kettle of fish in the morality stakes. As to the rich guy, he was there because of his wealth, remember criminal enterprises don't work to the same system of 'fairness.' Money has always spoken much louder when it comes to getting what we want. Organs are like any other marketable product in the criminal underworld, they go to the highest bidder. No sentiment, no thought of who will get that kidney or organ of your choice. Only the need for profit. It can be a sad world indeed.
      Thanks once again for dropping by,
      Cheers
      Laurie.

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  6. So many tough questions here, Laurie. I wish I had the answers. I think many of us in the world live day to day never knowing any of this goes on to this extent.

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    1. G'day Eli, thank you for dropping in here as well as my homepage. I wish I had the answers too, yet there seem to be more questions than there are solutions. There are so many parts of the world where people will do anything to survive: sell an organ, sell your child's organs, sell yourself, your dignity, your pride and your freedom. All into the hands of those who prey on the weak and helpless, the sick, young children. Unfortunately the list on, in reality nothing has changed in humankind, except our technology. Those who have power and no morality will always grind their boot into the weak, and sadly those being oppressed see it as normal.
      Laurie.

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  7. I am posting for Pat Yaeger, who cannot access this section:

    Laurie,

    This is absolutely the deepest, intellectual, thought provoking blog I have ever read. You are an incredible man, Sir.

    I would like to read this post a couple of times before I reply, as I want to be clear with my opinion.

    Thanks for sharing with us,

    Blessings,
    Pat

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    1. Thanks for that Marta.
      Pat, I am humbled by your response and also a little overawed. Firstly, being invited by Marta to post here, then having people dropping in and writing positive responses. My Wordpress blog has been a sounding board for my life experiences and lately photography, since its inception in June 2011. As you know I've put my two cents worth in on LinkedIn over time but this, well it is a first for me. Being showcased like this can open a writer up to the brickbats and bouquets of the reading audience. Receiving that response from you has made me feel ten feet tall and a tad bullet proof. (leave ego outside Laurie)I value your opinion Pat and thank you once more for responding.
      Cheers
      Laurie.

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  8. Laurie, you wrote a wonderful exposition on a problem that has no simple black and white answers. This past week a 10 yr-old girl had about a week to live, needing a new lung for end stage cerebral palsey, I think it was. There were many adult lungs but no children's. The transplant list organizer refused the girl an adult lung--even though her body could handle it--because it would "mess up the transplants scheduling list too much". Luckily, a Judge over-ruled this and the girl will get her adult kidney, but so many die over stupid decisions like this.

    I likd all the examples you listed, ech different and all a matter of ethics VS morality. When the government gets involved, it only complicates things. We will be seeing a lot of deaths that could have neen saved when the gov't run Obamacare is thrust upon us. All medical decisons like organ transplants will be decided by a panel of gov't officials, rather than doctors and as you poised the question--should the old be rejected and the young saved?--well they will be in 2014. Thanks for an eye-opening , fascinating aricle.

    Micki

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  9. Hi Micki, Thanks so much for reading and replying to my blog. That is a terrible ordeal for that girl and her family to go through. Putting people's lives in the hands of beaurecrats is never a healthy thing to do. All they see is the bottom line, whether or not the ledger is in the black. The next year or so will be nothing if not interesting for the people of the US as far as healthcare is concerned. At the end of the day it will be those with the least who get nothing.
    Cheers
    Laurie.

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  10. Great post. I certainly think the donor market has been made much less efficient by numerous restrictions, most well intended. The system is caught up in a bureaucratic back log. Case in point, a young preteen girl is currently on a respirator in the US and unable to get a lung transplant because of previous age restrictions for donor age that are no longer relevant because now, only a portion of the lung needs to be translated, and no one seems to know who can actually cut through the red tape in time to make the change, if anyone. I know that restricting remuneration for organs, blood, and other bio products is intended to prevent abuse and trafficking. Funny thing is though, it seems to be having the opposite effect. More importantly, those who need the organs may die before they get a chance to get them. It's unfortunate. Here's a suggestion, have a trial case study in a region allowing for medical companies to pay for legal organs from a select group of people in a select area. Test it, study it, and let the science show how effective it is.

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    1. Hi Roy, Thanks for coming by and commenting. It is a wonder that anything gets done with the amount of bureaucracy involved in medicine in general and transplants in particular. I feel so sorry for that girl, suffering while faceless number crunchers tap away at their calculators. If she dies it will be just another 'bed' to be filled. The system certainly needs to be overhauled, yet I doubt that anyone in the industry will have the fortitude to stand up and do it. What seems so easy to us apparently becomes a legal/monetary minefield to the sickness industry and as long as nothing is done to fix it, those peddling organs will thrive.
      Laurie.

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  11. Fantastic post...but not what I expected. I have worked in open heart surgery for 28 years, 10 of which I did heart, lung, liver, kidney and pancreas transplants. I was involved in both the insertion of the organ as well as donor procurement.

    In truth, I never really thought about the aspects you mention. I had my own conundrum to deal with. It is not a pretty sight...the procurement that is. The person (patient) is laid out as though having a normal procedure. They are then pounced upon by a pack of wolves...in my humble opinion.

    Each organ is usually going to a different recipient at a different hospital. I was there to assist in procuring the heart...the first organ to be exposed in the surgery, yet the last to be taken (the heart has to stay to keep the other organs viable while they are being prepared for removal) when the others are ready.

    After assessing the viability of the heart, I would sit in the corner of the OR and watch, as doctors and nurses worked furiously to prepare organs for harvest. It was like watching a deer carcass being gutted. My first harvest disturbed me so greatly, I went to the wall in the OR and cried, my head in my hands.

    A transplant surgeon there for the kidneys, came and sat with me. He asked me if I believed in God...a higher power. I told him I did. He then proceeded to tell me his way of dealing with all of this...

    "What makes that patient a person is his soul, his mind, his cognizance...right? He has been declared brain dead, so all of that has gone wherever it is going to go...right? So, the body is just a vessel left here to house viable, working organs. The unselfish and courageous wishes of this man are being carried out. He is giving life to possibly 80 other people. I'm here for the kidneys. I'm hoping this man and his generous gift will save the life of my 13 year old patient with poly-cystic kidney disease. Remembering that...is how I can do this."

    In answer to all of the ethical questions posed...I can honestly say "I don't know." Obviously, the black market sale and procurement of organs is hideous and wrong, but like everything else in this world...if there is a need and a buyer, it will continue. As for choosing the means over the ends or the other way around..."there by the grace of God go I." Until you are faced with those circumstances, how can you truly know what you would do in the face of such suffering? I have no answers...

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    1. Hi Taylor, thank you for reading and commenting on my blog. It has been a great journey on here for me, interacting with lovely people who are caring enough to want to read about such a contentious subject. I was touched by your reaction to your first experience and I respect you for continuing to perform your job. Your experience in this field and your anecdote about the heart transplant surgeon brings a depth of knowledge to this discussion. His way of coping with what must be a traumatic experience, removing organs from a donor body, (brain dead but body still functioning)shows the depth of feeling he has for both patients. How uncanny that you talk about the young girl with polycystic kidney disease. As a policeman I attended many a post-mortem and was always awed by the intricacies of the internal workings. For those organs to go to waste is a sad thing. We are in this brave new world and organ transplanting will continue. I feel that the only way to put a dent in the illegal organ trade is for more people to become donors, and that their loved ones allow their wishes to be fulfilled. There will never be enough to go around legally though.I wholly agree with your statement, 'Until you are faced with those circumstances, how can you truly know what you would do in the face of such suffering? I have no answers...' All we can do is hope that people look inside themselves and make a decision based on some moral spark that may rest inside them.
      Laurie.

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  12. Dear Laurie,

    Dear Laurie,

    Thank you so much for your article! You not only raise questions we should ALL consider closely and not run away from but it was also a pleasure to read. Your writing style is concise and full of practical examples. I have left my personal views on this subject on LinkedIn (on the Intellectual Network Forum). Thank you again and all good wishes,

    Jelka Samsom

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    1. Hi Jelka, Thank you for stopping by and reading, I will push my way through to the INF on LinkedIn to read your views,
      Cheers
      Laurie.

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  13. Hi,
    Thank you for the intense and complex research you have done on this article. There are so many positions to take into consideration and I personally believe that it is overwhelming for any family who has to go through such circumstances hoping that their child will have the chance to live.

    Therefore I am hesitant to judge any family who does what they think is morally correct to save their child. Of course there are black markets but does that mean that we should stop using good methods to try and save people whom we can help. I don't think so. Black marketing will exist as long as mankind is greedy, envious, selfish and only thinks about self. If I were to only look at the dark side of life then everything would be hopeless. To forsake the good just because there are people misusing the system is not an answer.


    There are lots of issues here and I must confess that I don't have any answers. As Taylor has said in her words, I would like to say in mine, if you haven't worn the shoe it is pretty hard to judge what you would do.

    Ciao,
    Patti

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    1. Hi Patti,
      Great to hear from you. The questions raised on the moral/ethical subject of using trafficked organs are tough ones. I have no problem with the system that is in place for voluntary donors, or the hospitals and staff that perform miracles of medicine daily. Well there is a problem and that is lack of donors. My beef is with those who prey on the weak and vulnerable, whose circumstances are such that they have to sell parts of their bodies to survive. Or worse still those who have no choice: children, refugees, executed prisoners - being brutalised to fill a gap in the market, a very deep, dark market that is inhabited by those who themselves are without pity, love or remorse.

      Of course we shouldn't judge others until we've walked a mile in their moccasins but I would look long and hard at a family who would choose to accept the organs of a murdered child so theirs might live. I feel that morality tends to shift towards what is judged to be the best outcome for the problem at hand, at the time. We can, when the need arises convince ourselves that something is okay as long as it suits our needs. Naturally the life/death struggle of a loved one often takes precedence over any concerns we may have as to the effect on ourselves or others.

      The dark side of life? As you well know I spent the first 17 years of my life living there, then fell into occupations that took me back on a regular basis. To appreciate light we need to know the dark and that it exists alongside us all in many guises, casting its long shadow over us. I think it is distance from an event that helps us make the decisions we do on a lot of things. When it isn't happening in front of us, when we don't want to know the origin of our organ, we can put a spin on it that is palatable to our moral barometer.

      Let's take our hypothetical Brown family. Mr Brown had no trouble ending the life of the old, greedy, arrogant Mr Schmidt, who he saw as an obstruction to his daughter's existence. It didn't take much for Brown to do what he did. Many people would, knowing they could get away with it. Now, how about we make it close and personal. Could our Mr Brown stand in that dingy hotel room in Mongolia and watch young Temajin get butchered like a deer so his Olivia could survive?
      Now that's a moccasin I wouldn't want to wear.

      Thanks for dropping in Patti, I hope to hear from you.
      Cheers,
      Laurie.

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  14. I'm posting for Sarah Mallery, who cannot access this section.

    "This is a fascinating, albeit harrowing article, Laurie. I hate to say it, but as I read this, I was reminded of families of suicide bombers who get promised payment from terrorist organizations if their children strap bombs onto themselves. Many of these situations are so ethnically dirty and I applaud you for bringing them to our attention! Best of luck with it....

    Sarah Mallery (S. R. Mallery)"

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    1. Hi Sarah, thanks for dropping by and posting. Yes it is harrowing and like most things we don't want too know about in life, it is incredibly dirty. Injustice and terror seem to go hand in hand and the only way to make some inroad is to shine a light on it. Once the injustice is shown to the world then there is no excuse for ignoring it.
      Laurie.

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  15. Thanks for bringing up this issue, Laurie. I must admit I hadn't considered some of the issues involved. Nevertheless, I'm not as pessimistic as you. I think informed debate leading to enforced regulations can improve things. It's a better solution than leaving the criminal gangs free to sell to the highest bidder. Personally, I would do a lot of unethical things to help people I love, but I don't think I should be allowed to do so. Anyway, the first step in this minefield is awareness, and you have just helped a good number of people in that direction.

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    1. Good morning Bryan,
      My pleasure, nothing is ever as we see it. This issue is akin to rolling a log to one side and seeing the goings on amongst the inhabitants beneath. Most people never see that side of the log. Bryan I've been a pessimist since watching my first newsreel at the pictures as a 6 year old child. 1956 and WW2 was still fresh in everybody's mind. A week never went by without footage of the concentration camps in Europe, the terrible scenes of bodies being bulldozed like cordwood into pits, images of gas chambers. This more than anything else created Laurie the optimist, abuse at home added to it. So I grew up looking at the world differently, coming to the conclusion that it was a harsh and often scary place.
      Informed debate is good, right here is a start and enforcing regulations is heading in the right direction. The only problem is you then come up against, what I think is one of the greatest crimes against humanity and that is official corruption. That is why the 'war on drugs' will never be won. The production and trafficking of narcotics is one of the world's biggest money makers and it only managed to get there by 1, the demand for an illegal product and 2,the collusion of some government officials in all departments and countries involved. My personal feel on this is, as long as there is a lack of any product, from human organs to chewing gum someone will step up and provide it.
      You are right, people will do unethical things for loved ones, and one would hope that their own moral code would make them think twice before doing something they shouldn't. Minefield is a great analogy for this subject, we are all in it and cannot avoid the shrapnel. Thanks again for posting.
      Laurie.

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  16. Before comments close for good I would like to take this opportunity to thank everyone who read and commented on my blog. Especially Marta for giving me the opportunity to reach a wider audience. I value the replies from each and every one of you who took the time to say what they felt on this subject, and I hope that you took something away from the experience.
    Cheers
    Laurie.

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  17. My gratitude to Laurie for an extraordinary post, and to all of you who took the time to read and leave comments that contributed to enrich the original post.
    If someone would like to state her views after the post is removed, you can do so by clicking on "Older Posts" at the bottom of the upcoming guest post :)

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  18. Laurie:

    Your article is a subject most people would rather look away from and not admit it exists. With its complicit “agents’ --- in the form of criminal organizations, governments, medical institutions, religious institutions, willing recipients, impoverished families, and the lure of money--- it’s a tangled jungle, like a Joseph Conrad “Heart of Darkness”; where the line between legitimacy and illegitimacy becomes a shadow.

    In my view, the stories of “Mr. and Mrs. Brown”; “Temujin”; and “Bai Gau”; reflect the archetypal Greek tragedies of unintended consequences, resulting from the human inability to foresee fate.

    I see two great anxieties underlying the “moral questions” and “hypothetical viewpoints” you pose. First, the over-riding question of the meaning of life; secondly, the complementary fear of death. They’re like a confluence flowing together like an underlying stream in our subconscious; a stream that breaks the surface whenever we’re reminded of death.

    It seems to me that when we are standing on the edge of that Unknown Void, all principles of morality and ethics begin to dissolve --- as do other principles. I believe it’s because, at that “moment of truth”, they become superficial human constructs that are relevant in the flow of life, but which lose their substance in the face of death.

    “How much is life worth?”, you ask. I would say that the question is tied like a Gordian Knot to that unanswerable question of the meaning of life. And, I think, that for most people, the fear or imminence of death makes them cling tenaciously to life against the Unknown, and against that unanswerable question.

    And that leads to your final question about preserving life: “Does the end justify the means?” In my opinion, for reasons given above, an answer is not an ethical or moral one.

    But, there is an alternative road; but that’s another discussion.

    Thank you for the thought-provoking article.

    Sincerely,
    J. Federico Martin
    June 21, 2013

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  19. Hi J. Federico, well it was worth the wait for your reply. I saw this post as being a forum to put out the questions,the ones that people don't want to ask or even think about. Like most questions about life and death they come from the great unknown and we as humans, fearing this unknown would rather talk about anything else. In reference to 'The Fates' with my puppets as it were I tried to show that sometimes when we go against the natural order of life/death we can set a new train of events in motion. I enjoyed reading mythology as a child, I think it stuck. Not many want to think about death, I'm lucky, in a way I've stood at that doorway twice and had a glimpse. My belief is there is something different there. It makes no matter as people need to see it for themselves. I love the Gordian Knot simile and I'm definitely no Alexander the Great to undo it. I agree, when you're hanging by a thread and all seems lost, morality, ethics, humanity all seem to take a back seat so you can survive. All Twilight Zone simile's aside, I think in the last question I was looking at 'Olivia's' life being saved by the murder of 'Temajin.' I see the question of taking of one life to save another to be well within the realms of morality. Perhaps you could enlighten me on your alternative road. I would be very interested in reading it. Once again thank you for taking the time and effort to read and comment.
    Cheers
    Laurie.

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  20. Laurie:

    Regarding trading one life for another (or others) is a philosophical question that has been brought up often through examples of various situations in classes of philosophy, and through articles. I think it’s one thing to answer it in the theoretical/hypothetical abstract, and quite another to actually come face-to-face with it in a “no-return” moment of life vs. death.

    Before we talk about an alternative road, please read the following book review of John Gray’s “The Silence of Animals”. Gray takes the opposite side of the question on the meaning of life. I think you’ll it interesting.

    BOOK REVIEW
    Simon Critchley on The Silence of Animals
    John Gray’s Godless Mysticism: On "The Silence of Animals"
    June 2nd, 2013
    LOS ANGELES REVIEW OF BOOKS
    http://lareviewofbooks.org/article.php?id=1722&fulltext=1

    A friend of mine just happened to send it to me while we were having this discussion. (He knows nothing about this discussion.)

    Regards,
    J. Federico Martin
    Saturday, June 22, 2013

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    Replies
    1. Thanks J. Federico, not exactly a quite read before bed with a hot cup of cocoa is it? I think he's right in one way about man the great killer ape, we have done this for ever but we've also shown love and compassion to others and cared about where and how we live. It seems to me that when we are all lumped together in the herd that's when we tend to show our barbarous tendencies. Because we need to belong to something and long for meaning we follow who or what we think has all the answers. Then those who don't share our beliefs and ideals become much easier to dispose of. I'm well aware of the state of barbarism in the world, I've been to war and have seen in other careers man at his best and worst. There is something in me that wants to see mankind become more than a ravening beast, obviously this beast is part of our nature. I would like to see the other side of it win the struggle, where even if there are millions of us that we treat each other with love and respect. We have the capacity to kill, rape and murder and treat our children and those who can't fend for themselves with no regard for anything other than our basic needs. Yet we also have the means and knowledge to treat people differently, to actually care about what happens to humanity and the planet. Just because we can do something horrific doesn't mean it has to be that way.
      cheers
      Laurie.

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  21. Hello Laurie,

    This is one of those topics that leads us back to where we started -- but hopefully, with a new awareness.

    When Simon Critchley comments on John Gray’s ideas regarding the search for the meaning of life ---

    “Homo sapiens must learn to give up the destructive and pointless search for meaning and learn to see that the aim of life is the release from meaning..”;

    and,

    “It is “this sense” that Gray wants to cultivate in us, this turning of the self away from itself and its endless meaning-making and toward things in their variousness and particularity”

    --- it leads me back to your specific questions about ethics and morality, in terms of conduct; where you would like to see “love and compassionate” overcome our “barbarous tendencies”.

    It made me reconsider my question as to what effects the search for the meaning of life has on our behavior. I asked myself: Is the search for ‘meaning’ more individual than collective? If so, then wouldn’t the “release from meaning” also be more individual as well?

    At the moment of imminent death, does it become fundamentally a matter of self-preservation? Aren’t ethics and morality concepts that have to do with a collective life? After all, although we live collectively, we die individually.

    Except in war. Where soldiers die together, and sacrifice their lives for each other. As you can attest, Laurie, war is where death hovers over life; where life becomes compressed, like a deep burning flame; where soldiers become as one. But is it ethics and morality at play, or is it “love and compassion” in a crucible ?

    Outside of war, we live separate lives, however collectively. And an impersonal civil society tends to impose “rules”, rather than offer “guidance”; it puts people in a corral, rather than on an open range.

    I think that the questions you’ve brought up will continue to be asked, as long as human beings exist.

    “We shall not cease from exploration
    And the end of all our exploring
    Will be to arrive where we started
    And know the place for the first time.”
    (Little Gidding from Four Quartets / T. S. Eliot)

    All the Best,
    J. Federico Martin
    Sunday, June 23, 2013

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  22. Hi J. Federico, I think when I look at our world and my tiny place in it, then out into what I can see of the vastness of the universe, I know I would like to know what it is all about. If there is no meaning to life then what is our purpose other than being here and eventually dying? I'm not saying that I live in a constant funk over 'what is it all about.' Nor am I part of any organised religion that tells me what they think it's about. I live my life through it's trials and tribulations, and wonder is this it? Is there more than just living? No real answers come to mind and I get on with it.
    Yes we live together and die alone. Dying may bring some answers but while we are living together we need some moral/ethical constraints otherwise we might as well live as beasts on a full time basis. But who is going to release us from the need for meaning? We could stay as two year olds emotionally/mentally and live right in the moment where we are the very centre of the universe. Or, we can grow and allow our self to develop and look for individual meaning. Is 'the destructive and pointless search for meaning' referring to religion and society forcing their views of meaning on people by whatever means necessary? If so then I agree with him, if not then I feel that people should look for meaning in their own way. If we live in a collective society then we need some rules to be able to live together in safety from those who prey on others. Impersonal civil societies need to impose rules rather than guidance, otherwise they can't control the populace. There isn't any room for free thinkers in society, they stir the masses. I don't know it's all very complicated. I'd love to have a world where people, at the very least respect each other, the cynical side of me knows that it isn't happening any time soon. Thanks for your reply to my vexing questions J. Federico.
    Cheers
    Laurie.

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