This enquiry examines problems which haunt the ‘heart’ and its donation. It begins by examining the heart’s enduring significance for culturally mediated self-understanding, its vulnerability to misunderstanding and abuse and its relevance to challenging the determination of death by neurological criteria. Despite turns to brain-centred self-conceptions, the heart remains haunted by the hybrid experiences of identity accompanying organ transplant, the relational significance attached to dead hearts witnessed in the Alder Hey scandal and claims that heart transplants commonly constitute the legitimate killing of a person. To explore these phenomena, traditions are retrieved in which the heart-as-organ was construed in terms of a person’s core identity. Influential Abrahamic beliefs about ‘the heart’ are considered in order to explore explanations for why the heart remains culturally pre-eminent, to make intelligible our haunted hearts and to examine possible violations of solidarity in organ donation practice. Jewish and Christian Scriptures are exegeted to illumine the sources of our haunting and address the desire for holistic bodily life. In these sources, the heart is the seat of affections, intelligence and agency but requires healing, conceived via the surgical metaphors of heart transplant and circumcision, if people are to join the insightful, solidary path of pilgrimage. Absent healing, the heart experiences a judgement of the whole person—organ-and-core—at the moment of death. Through such exegesis, the doctrine of the Holy Ghost emerges as a way to make intelligible, though not dispel, the heart’s haunting. The doctrine’s practical significance concerns the possibility of social unity among hearts, ‘intercordiality’, which construes people within a covenantal life of pilgrimage which encourages heart donation in certain circumstances, makes intelligible the Alder Hey parents’ experience of social misunderstanding and rejects ascribing any legitimacy in medical culture to the consensual killing of patients for the sake of retrieving their organs.
- philosophy of medicine/health care
- cultural history
- medical humanities
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Presented at This article is part of 'The Heart in Medicine, History and Culture'.
Correction notice This article has been corrected since it was published Online First. The Hebrew in the PDF was inverted and has been amended accordingly.
Funding This study was funded by the Sir Halley Stewart Trust (http://dx.doi.org/10.13039/501100000862). The views expressed are those of the author and not necessarily those of the Sir Halley Stewart Trust.
Competing interests None declared.
Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data sharing not applicable as no datasets generated and/or analysed for this study.