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Our Bodies Belong to God

Our Bodies Belong to God: Organ Transplants, Islam, and the Struggle for Human Dignity in Egypt

Copyright Date: 2012
Edition: 1
Pages: 370
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  • Book Info
    Our Bodies Belong to God
    Book Description:

    Why has Egypt, a pioneer of organ transplantation, been reluctant to pass a national organ transplant law for more than three decades? This book analyzes the national debate over organ transplantation in Egypt as it has unfolded during a time of major social and political transformation-including mounting dissent against a brutal regime, the privatization of health care, advances in science, the growing gap between rich and poor, and the Islamic revival. Sherine Hamdy recasts bioethics as a necessarily political project as she traces the moral positions of patients in need of new tissues and organs, doctors uncertain about whether transplantation is a "good" medical or religious practice, and Islamic scholars. Her richly narrated study delves into topics including current definitions of brain death, the authority of Islamic fatwas, reports about the mismanagement of toxic waste predisposing the poor to organ failure, the Egyptian black market in organs, and more. Incorporating insights from a range of disciplines,Our Bodies Belong to Godsheds new light on contemporary Islamic thought, while challenging the presumed divide between religion and science, and between ethics and politics.

    eISBN: 978-0-520-95174-7
    Subjects: Health Sciences

Table of Contents

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  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. List of Illustrations
    (pp. ix-x)
  4. Note on Confidentiality and Photography
    (pp. xi-xii)
  5. Note on Transliteration
    (pp. xiii-xiv)
  6. Acknowledgments
    (pp. xv-xix)
  7. Preface
    (pp. xxi-xxv)
  8. Introduction: Bioethics Rebound
    (pp. 1-19)

    This book centers on why transplant medicine surfaced as a topic of much social and ethical debate in Egypt from the 1980s to the early 2010s, amidst dramatic political and economic change. The debate both reflected and shaped the sense of impending crises in medical and religious authority, in the context of mounting dissent toward an unjust and brutal regime, the privatization of health care, advances in science, the growing gap between rich and poor, and the Islamic revival. In the print news, on state television, and in religious sermons, opinions clashed over this life-saving but deathridden medical practice.¹ As...

  9. 1. Egypt’s Crises of Authority
    (pp. 21-45)

    When Egyptian doctors first experimented with kidney transplantation in the 1970s, the wider public had no idea that the number of patients in kidney failure was ominously rising or that this life-restoring surgery would soon become the object of a contentious debate. By the 1990s, investigative reporters for newspapers and local television channels fully exposed the gory and often scandalous details about the transplantation of kidneys, eyes, and other body parts. Doctors, legislators, journalists, and religious figures all argued and debated vehemently about the ethics of procuring and transplanting parts of the human body, with seemingly no resolution. During this...

  10. 2. Defining Death: When the Experts Disagree
    (pp. 47-81)

    Shortly after Egypt’s first kidney transplant, doctors sought legislation to initiate a national program for organ transplantation, like those established in other countries, to regulate the procurement of organs from both living and dead donors. But opponents to the proposed legislation insisted that the “cadaveric sources” for organ transplants were in fact dying patients, not yet cadavers. This claim formed a major obstacle to the passage of a bill. The already thorny question about the rights and ownership of deceased bodies was now further complicated as doctors and others began to ask who counted as “really” dead.

    This chapter details...

  11. 3. From Secret to Scandal: Corneas, Dead Donors, and Egypt’s Blind
    (pp. 83-113)

    In February 1996 in a public morgue in Cairo, a son discovered that the eyes of his deceased father were missing. While preparing his father’s body for burial, he found that in place of his father’s eyes, two pieces of cotton had been stuck into the emptied sockets. His complaint against Ain Shams Teaching Hospital led to a police investigation that found the medical staff guilty of procuring eye globes from the deadwithout consentfor use in cornea transplants. The prosecutor general interrogated the director of the eye bank, arrested a laboratory technician, and ordered the eye bank to...

  12. 4. Shaykh of the People: Genealogy of an Utterance
    (pp. 115-139)

    As we have seen so far, questions that we might classify as “bioethical” have been vigorously debated in Egypt by official muftis and doctors. These have included questions about whether procurement of organs from the dead is appropriate, who counts as dead, and whether (and how) to obtain consent from surviving family members. With the diversification of media outlets, these debates have entered into a larger public domain, in which nonexperts, including patients and family members, have become more familiar with a wide array of expert opinion. Meanwhile, amid the scandals of eye theft and mistreatment of the dead, a...

  13. 5. Transplanting God’s Property: The Ethics of Scale
    (pp. 141-171)

    In 1976, medical teams in Cairo and Mansoura competed to perform the first kidney transplant in Egypt. While the Mansoura team officially won the “race,” to much fanfare in the Egyptian press, Cairo surgeons followed only two months later with their own successful transplant. Dr. Abdel Kader Kotb, a vascular surgeon who was a recent medical graduate at the time, performed all the essential elements of the first Cairo surgery. As a young no-name doctor, he would be the one blamed by the “big doctors” if anything went wrong. The operation was purposely scheduled on the weekend of a...

  14. 6. Only One Kidney to Give: Ethics and Risk
    (pp. 173-207)

    There was some commotion in the transplant ward of a public Cairo teaching hospital over a young patient who had just received a kidney from his mother. Another patient in the unit explained to me what was going on:

    This poor young man—he has a younger brother who also has kidney failure. While he was in the operating room he heard that his younger brother was upset that the mother had given the older brother her kidney.

    You see, the mother had reasoned that her older son was already married and had a child. She thought to give it...

  15. 7. Principles We Can’t Afford? Ethics and Pragmatism in Kidney Sales
    (pp. 209-237)

    Although I interviewed many patients and doctors involved with kidney transplants from paid donors, I did not meet with those who sold their kidneys. The organ trade has been deemed a politically “sensitive” issue, and I already had difficulty attaining permission from the Egyptian Ministry of Security for my research. In any case, I had not originally set out to study “the organ trade” or to take up undercover reporting in Cairo; I was more interested in the ways in which people struggle with the ethics of their decisions surrounding organ transplantation in its legitimate and ordinary permutations. Through the...

  16. Conclusions: Where Cyborgs Meet God
    (pp. 239-252)

    While poor patients in organ failure were utterly vulnerable to medical mistreatment and state negligence throughout Egypt, the Mansoura Kidney Center had established a decidedly different model of care. Closing itself off from the problems emanating from Cairo, the center boasted impressive treatment outcomes and the enforcement of strict regulations, which included limiting the attending physicians to working solely in the hospital and not in private clinics. Hospital staff members were also proud to report that their poor rural patients received first-class treatment, including follow-up care and even their prescription medications at no cost to them. And although the physicians...

  17. Epilogue: The Ongoing Struggle for Human Dignity
    (pp. 253-256)

    On January, 25, 2011, a day meant to celebrate the Egyptian police force, protestors gathered at Tahrir Square in the middle of Cairo to call for justice and human dignity. Egyptians throughout the country were in no mood to honor the police. One of the calls for the demonstrations came from a Facebook group calledWe are all Khalid Sa‘id, in reference to a twenty-eight year old Egyptian from Alexandria, who had uploaded onto the internet a video of police sharing the spoils of a drug bust. In retaliation, members of the police and security apparatus dragged him out of...

  18. Notes
    (pp. 257-296)
  19. Glossary of Frequently Used Arabic Terms
    (pp. 297-300)
  20. References
    (pp. 301-318)
  21. Index
    (pp. 319-342)
  22. Back Matter
    (pp. 343-344)