Ties That Bind Summary

Martyring of the Family
In the essay, “The Tyranny of the Gift: Sacrificial Violence in Living Donor Transplants”, Medical Anthropologist Nancy Scheper-Hughes argues that “paid kidney donors and related donors are often responding to family pressures and to a call to ‘sacrifice’” (Scheper-Hughes, 2007, p.507). She argues that donors are burdened by the very act and live a lifetime with the repercussions. She generalizes that all aspects of living-organ donation are wrought with abuse. She uses many examples to support her viewpoint of donor exploitation. Scheper-Hughes presents a compelling argument on the sociological and anthropological ramifications of a living-donor on the social and familial structures. However, despite its many strengths, there are a number of small, but important, weaknesses.
The Ties That Bind
Scheper-Hughes summary of David Biro’s essay lays the foundation for her argument against living-organ donation. When presenting Biro’s sister, who willingly donated her bone marrow, Scheper-Hughes makes her into a martyr. This stance weakens her case about family responsibility. Scheper-Hughes argues that

Biro’s essay doesn’t represent his sister’s gift as that, but as an obligation as a family member; familial bondage. “That is what families are supposed to do” (Biros, 1998). Scheper-Hughes turns what Biro said about donor organs into an ancient act of cannibalism. The author ends her argument of the essay with the question: Would he have done the same for her? She starts with saying no, but then gives evidence to that he would.
Family Violence
Scheper-Hughes argues that organs received from family members come at a high cost. She makes a generalized reference stating that all anthropologists agree that families can be violent and predatory; they can abuse and exploit as often as they nurture and protect. Scheper-Hughes doesn’t offer supporting evidence for both sides to her argument. The statement that an altruistic gift might be given with strings-attached is factual but weak. Humans are multifaceted and family dynamics are never simple. The author lumps all families into one category that is represented by only those that need to give a counter-gift for any gift given. Such a valuable gift, even given with strings attached, shouldn’t be devalued due to family obligations.
Compulsion to Give
Scheper-Hughes claims that many family members are forced or pressured into being a donor.

Altruism is a complex principle and is defined as an unselfish regard for or devotion to the welfare of others (Altruism, n.d.). She claims that medical professionals were once cautious about living-donation between relatives due to the interdependence but does not give supporting evidence. The fact that it could be a reality in some cases shouldn’t negate all others. Knowing that you alone could save a family member holds great power and respect. Scheper-Hughes does not argue in this article that the receiving a living organ will not benefit the recipient. “In two-haplotype matched living-related donor kidneys, transplants have a 50% chance of achieving 24 years of functioning” (Kaserman, 2007). Life expectancy post-transplant has lengthened

extensively.
Too Old?
The author argues that the United States has too many elderly on the waiting list for a transplant. Her viewpoint that anyone over 65 should be excluded is biased and extreme. Being over 65 doesn’t meant that you’re near death. Life expectancy is getting longer every decade, not even factoring in transplants. Life expectancy in the USA rose in 2012 to 78.8 years – a record high (Copeland, 2014). Health should be the determining factor whether 45, 65, or 75. Who has the best chance at donor compatibility and life quality should receive the transplant. Scheper-Hughes continues this argument with how generations of immigrants escaped Europe to get away from tyranny and being devoted to their parents, but here in the US, many children now are being recruited into sacrificing an organ to keep their elderly parents alive. “The elderly want to have living-donor organs for the best results because they have the knowledge of success rates and their physicians agree” (Scheper-Hughes, 2007). The author argues that it unethical to use organs from the young for the elderly and calls for a halt to all living-organ transplants. Scheper-Hughes’ negative views of the elderly weakens her argument as does her call to halt all living-organ transplants until better medical options come to fruition.
Conclusion
Living-organ donation is intricate process with many multifaceted dimensions. When tied to family dynamics and social structures it becomes even more complex. Living-organ donation has a significant impact on the recipient with the potential of prolonged life. The gift should not be trivialized. The reality of abuse is evident in many cases but should not overshadow the good that does happen. Scheper-Hughes findings of exploitation should be acknowledged and not minimized. Her emotional stance weakens her claims of social injustices and familial slaves. The generalizations aren’t backed by facts and her attempts to alter perceptions break down upon review. The author demonstrated that she had her own social agenda writing this paper as opposed to being more academic in her analysis of the issue. To essentially end the lives of thousands due to the possibility of abuse is unethical. Abuse is not palatable and is morally reprehensible is not in question. The act of giving altruistically is as multifaceted as families are. There is good in all; Scheper-Hughes just doesn’t see it.