Heart transplantation: its risks, the expectations, and cultural negotiations in Japan

Abstract

The aim of this thesis is to facilitate an understanding of the experiences of Japanese heart transplant recipients in terms of how their identities are transformed. The thesis contributes to the discipline by providing an understanding of issues relating to the surgical procedure of heart transplants, the labelling of the recipients by the Japanese government and Japanese cultural factors. This is a qualitative study based on semi-structured interviews, which have been analysed thematically. The thesis sheds light on two major aspects of heart transplantation. One is the experiences of heart transplant recipients, from diagnosis through surgery to recovery. The other is the influence of Japanese cultural expectations about the body and the custom of reciprocal gift-exchange on recipients’ experiences. In so doing, this thesis argues that heart transplant recipients face an issue of identity crisis when making a decision to have transplant surgery, and that identity is reconstructed in the post-operational period. In this process, the recipients face social stigma as the result of having a heart transplant. Considering heart transplants as they are viewed by Japanese people in everyday life, the use of an organ for this medical purpose is in conflict with conventional attitudes towards the treatment of the dead body in Japan. In addition, it is difficult for the practice of altruistic organ donation to take root in the modern consumer culture of Japan, where gift-giving has become a quasi-commercial transaction. As a result of these phenomena, anonymous relationships between heart transplant recipients and donors are varied in terms of the gift relationship. It is key how Japanese heart transplant recipients repay their donor. The repayment strategies are impacted by cultural factors.