Rowman & Littlefield Publishing Group

Where Autism and Music Meet

By F. James Rybka

Bohuslav Martinů (1890-1959) has been called “the Mozart of the 20th Century.” His extraordinary catalog of 417 diverse and well-crafted scores includes 16 operas, 15 ballets, six symphonies, seven string quartets and a host of chamber, instrumental, and choral scores. At the height of his career in the United States, he composed one symphony a year between 1943 through 1947, each premiered by the leading ensembles. Yet today, Martinů, who once flamed so brightly, is performed infrequently at best. His name is not even listed in the six-volume Oxford History of Western Music. He is notably absent from other dictionaries of 20th century music. Why?

Surprisingly, Martinů’s reputation suffered from his abundant output and prolific creativity, stupefying an early biographer who, unable to explain it, judged his music as “flawed” and slipshod. This, in brief, was his answer to the question he simply refused to answer: “How else could he have done it?”

As a physician and author who personally knew Martinů, I saw from my research of the composer’s unpublished correspondence the workings of an unusual and elusive personality, one that deserved a better answer than Martinů earlier chronicler. In short, there is compelling evidence that Martinů had Asperger syndrome (AS), making him the first composer to offer strong documentation of an autistic spectrum disorder. This caused right-brain associated activities, like music, to become heightened, an unquestioned benefit to him. Blessed with absolute pitch, he developed a phenomenal, phonographic memory so he could recall, sketch, and refine compositions in his head, and then write them out directly onto manuscript paper without any preliminary paper draft, sometimes even without having to test the chords on a piano. Yet these AS- related talents went unrecognized by elite critics who held his great output against him. Fortunately, his reputation has started to rebound and I am hopeful that my research will spark further interest not only in his music but also in the neuroscience behind it.

As a medical condition, autism exists along a spectrum, with Asperger syndrome sitting at the “high-functioning” end of it. Tracing the trajectory those with Asperger generally follow, one can see Martinů in a deeper context and properly assess the downsides of the disorder. In 1946, for example, his condition nearly killed him one night when, in a trance contemplating music, he grew entirely oblivious to his environment and ambled off a roof, fracturing his skull and falling into a brief coma. For music lovers, Martinů was perhaps the finest ethnomusicologist of the 20th century. He was brilliant at incorporating Czech folk motifs and rhythms into classical traditions, even into major symphonic scores. Although a confirmed tonalist, he incorporated dissonance and the inventions of the 20th-century music into his work. He knew his instruments well and became one of that period’s most gifted orchestrators, skillfully bringing the piano on to the symphonic stage. The renowned music critic, Olin Downes who knew Martinů, asserted in 1950: “He is incapable of an unthorough or conscienceless job. He produces so much music because, in the first place, his nature necessitates this. He has to write music. In the second place, he knows his business and loves it.” And, in that sense, Martinů was much like Mozart, a “compulsive” composer who dearly loved his work. Creating music was play and pleasure.

F. James Rybka,author of Bohuslav Martinu: The Compulsion to Compose , graduated from Cornell Medical School and became a plastic surgeon. Bohuslav Martinu was a close family friend.

There Be Dragons: Science as the Realization of Fantasy

By Timothy McGettigan

Currently, scientists argue that over 90% of the universe is made up of dark substances. Yet, though they remain undetectable, scientists are convinced that dark matter and energy do exist. In large part, this is because, at present, there is simply no other way to account for the anomalous behavior of the cosmos: if not for dark energy, then how can one make sense of the accelerating expansion of the universe? Nevertheless, the problem with such fanciful speculations is that they threaten to transgress the boundary between fantasy and reality. By way of comparison, let’s say that I am convinced that fire-breathing dragons exist. Although most rational thinkers would dismiss such a claim, I might insist that my belief is at least as legitimate as the scientific faith in dark matter and energy. While it is true that I cannot produce direct evidence of fire-breathing dragons, a similar lack of direct evidence has not dissuaded scientists from embracing the concepts of dark matter and energy. In addition, as is the case with dark physical phenomena, there is an abundance of indirect evidence which supports the contention that fire-breathing dragons actually walk the earth. Indeed, if anything, mythical dragon spoor is substantially more tangible than the residues of dark matter and energy.

Although scientists often insist that science is a purely fact-driven endeavor, in reality, scientific progress is often generated more by the pursuit of fantasy than facts. Take, for example, the space race during the 1960s. In 1961, when President John F. Kennedy announced that the U.S. would land astronauts on the moon by 1970, JFK’s prognostications were based more upon fantasy than good science. As of 1961, the U.S. lacked the necessary technology to achieve such a remarkable goal. Thus, it is a fact that on July 20, 1969, Neil Armstrong set foot on the moon. However, Armstrong could never have left his boot prints on the lunar surface if Kennedy had not dared to propose his future-building fantasy.

Therefore, crazy as it may seem, fantasies represent the most productive means through which to generate scientific progress. The more far-fetched the fantasy, the more scientifically-productive the process of realizing the fantasy will be. For example, Martin Cooper has claimed that he was inspired to invent the cell phone after watching Captain Kirk use his wireless communicator on Star Trek.

So, dream big. The future is a fantasy, and science is a mechanism through which we transform fantasies into reality. Sure as there be dark matter, so there be dragons.

Timothy McGettigan is professor of sociology at Colorado State University - Pueblo, and author of Good Science: The Pursuit of Truth and the Evolution of Reality

Choosing the Best Sunscreen for Safe Summer Fun: New FDA Regulation for Sunscreen Labels

By Christopher M. Johnson, M.D.

With summer upon us, it is time to talk sunscreen. It is great for children to play in the sun. But, as most parents know, the ultraviolet rays of the sun can cause harm. The immediate potential harm is a painful sunburn; the long-term possible harm is premature aging of the skin and a higher risk for later skin cancer. The way for your child to enjoy the sun safely is to use sunscreen. But buying proper sunscreen is complicated because the labeling of these products can be confusing. Finally, after many years of studying the issue, the Federal Food and Drug Administration just laid down the rules of how sunscreen is to be labeled, making it easier for parents to understand the best one to buy for their children.

Ultraviolet light from the sun comes in two forms, called ultraviolet A (UVA) and ultraviolet B (UVB). Sunburn is mostly caused by UVB. UVA can contribute to sunburn, but the main concern with this form of ultraviolet light is skin damage that can lead to premature aging of the skin and an increased risk of skin cancer many years later. Of course you would want both forms of protection for your child, but reading the labeling of sunscreen products has been difficult, and not all products protect equally. The confusion has been over the use of terms like “broad spectrum protection,” “long-lasting,” and “sweat proof” or “waterproof.”

Starting next year, any sunscreen product that claims to be “broad spectrum”—that is, protect against sunburn as well as cancer or premature aging—must block both UVA and UVB. It also must have an SPF (sun protection factor) of 15 or higher. Regarding water resistance, the new FDA rules say that the label must tell you how long the protection will last after wetting the skin—40 or 80 minutes.

Until these new rules make it to products on store shelves, parents should check to make sure the sunscreen blocks both UVA and UVB and has an SPF value of 15 or higher. Parents should also reapply sunscreen to their children every two hours for the best protection. It is also safest to reapply it after your child has been in the water. And when you send your child out to play in the sun, remember to put a hat on them. Hats are easy, low-tech protection for necks and faces.

You can read much more about the new FDA sunscreen regulations at the agency’s site here (link to this: http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm258416.htm)

Christopher M. Johnson, M.D., has been practicing pediatrics and talking to the parents of sick and injured children for thirty years. He is also the author of How Your Child Heals: An Inside Look at Common Childhood Ailments .

DUST: the Inside Story of Its Role in the September 11th Aftermath

By Paul J. Lioy

Memorial Day 2011 has just passed, and during the Spring of 2011 another page in the fight against terrorism and the need to be prepared for the unknown. Tom Kean, who has commented widely about preparedness, is still correct because even with the death of Osama Bin Laden threats remain high against our country’s people and infrastructure, and his words should be a reminder that being prepared for terrorist events is an important part of our country’s responsibility to protect and defend. The 10th Anniversary of the deadly attacks on the WTC, United flight 93, and the Pentagon is also just around the corner. They will be solemn occasions that will provide an opportunity to educate those who were too young to remember or are part of the next generation. Since the publication of Dust: the Inside Story of Its role in Role in the September 11th Aftermath, I have talked to many individuals and groups, and recorded interviews, about the reasons for writing the book. In my discussions, it became clear that people wanted to know how the results of our analyses of the dust were used to understand exposure and health response relationships. In reviewing what has been written since publication of my book, the actual health effects experienced by the workers/volunteers remain highly correlated with the time of a person’s arrival at Ground Zero, and whether or not he or she was wearing a respirator during their completion of Ground Zero related activities over time. Based upon all my conversations with physicians and other environmental health professionals, my hypotheses remain consistent: the unknown or unquantifiable gases released during the jet fuel fires were part of the etiology of the diseases derived from the aerosol that contained the WTC Dust and inhaled by the workers/volunteers during the first days after the collapse of the towers. However, they cannot be realistically reconstructed in toxicological tests because they would have to include both the WTC Dust and combustion gases released by “uncontrolled” fires caused by the burning jet fuel.

The reader response to other important aspects of my story has come as sort of a surprise. Many were associated with the content of Chapter 12 which deals with the lessons learned and the lessons that still need to be learned from 9-11. These are linked specifically to the 5 Rs + 1: Rescue, Re-entry, Recovery, Restoration and Rehabitation. The Plus 1 is Resilience. Because of the natural events that have occurred since 9-11 (e.g. earthquake and Tsunami in Japan), and military actions overseas, I have had opportunities to describe the levels of completion or success using the 5 Rs for some of those incidents. As a member of the general public you can use my 5Rs to grade us all on the actions and the outcomes of those actions that can and do occur in natural and terrorist events.

Paul J. Lioy is a Professor and Vice Chair, Department of Environmental and Occupational Medicine at UMDNJ-Robert Wood Johnson Medical School. He is Deputy Director for Government Relations and Director of Exposure Science at the Environmental and Occupational Health Sciences Institute of Rutgers University and RWJMS-UMDNJ. Dr. Lioy is the author of Dust: The Inside Story of its Role in the September 11th Aftermath.

Relapse Prevention: It’s The “How” That Counts

By Deborah Serani

A recent study from the University of Toronto suggests how you process information determines if you’re at risk for a depressive relapse. More specifically, researchers learned via the use of fMRI technology that how the brain responded to a sad event was a predicting factor.

In this study, depressed participants were shown a series of sad clips of movies. Individuals who ruminated about the sadness they experienced fell into another depressive state as opposed to those who were able to feel and accept their emotional experience. It’s been long-known that patterns of negative thinking put a person’s mental health at risk. Like treading water, negative thinking gets you nowhere fast, leaves you fatigued and overwhelmed. Before you know it, you’re unable to problem-solve, and depression sets in. In this study, individuals who experienced the depth of their sadness and accepted the limits &/or hardships continued with their recovery intact. So, when it comes to keeping your depression from relapsing, it’s all about “how” you move through your experiences.

Taking the “how” to a scientific level, fMRI data showed that frontal brain activity resulted in ruminating behavior whereas brain activity in the rear part of the brain signaled acceptance. This is of great interest not only to researchers, but also to therapists who specialize in depression treatment. This study supports the aims of psychotherapy and medication, where interrupting a negative rumination style is the targeted goal of treatment. For those who live with depression, learning how to problem-solve, visualize and work toward acceptance of what one can change and what one cannot, can help inoculate against relapse.

“Part of what makes depression such a devastating disease is the high rate of relapse,” says Norman Farb, a PhD psychology student and lead researcher. “This study suggests that there are important differences in how formerly depressed people respond to emotional challenges that predict future well-being.”

Reference:

Farb, N.A.; Anderson, A.K.; Bloch, R.T. & Segal, Z.V. (2011). Mood-linked responses in medial prefrontal cortex predict relapse in patients with recurrent unipolar depression. Biological Psychiatry, DOI: 10.1016/j.biopsych.2011.03.009

Deborah Serani is a psychologist in private practice in New York and the author of Living with Depression: Why Biology and Biography Matter along the Path to Hope and Healing.

Tobias Matthay: Injuries of a Forgotten Master Teacher

By Stephen Siek

In the mid-1850s, Sigismund Lebert and his colleague Ludwig Stark issued a popular series of piano method books, formidably entitled Theoretical and Practical Piano School for Systematic Instruction in all Branches of Piano-Playing from the First Elements to the Highest Perfection. True to their Germanic heritage, their approach was systematic and thorough, though their advice was confined to the mere insistence that all pieces be practiced loudly and repetitively—to obtain “a firm style of playing.”

When Lebert and Stark published their books, the piano had undergone dramatic changes from the time of Mozart. It had grown in size and power, so that by the mid-nineteenth century that “firm style” became an obsession to many. When the American pianist Amy Fay arrived in Berlin in 1869, she complained in her correspondence about the draconian methods of her teacher, Louis Ehlert:

You have no idea how hard they make Cramer’s Studies here. Ehlert makes me play them tremendously forte. … My hand gets so tired that it is ready to break, and then I say that I cannot go on. “But you must go on,” he will say.

Yet even as many clung to the old ways, some teachers in Europe began to notice how unsuitable rigorous drills with stiffly held fingers (however effectively they may have served the harpsichordist) were for extracting artistic effects from the modern piano—and could even lead to incapacitating injuries.

But in 1903 a new era dawned when Britain’s Tobias Matthay (1858-1945) published The Act of Touch. This major work emphasized a more enlightened approach to piano performance. Matthay lived at a time when many believed that science could unlock the secrets of artistry, and that even virtuosic playing could—and should—be effortless. He disavowed the age-old credo of mind-numbing drill and calisthenics. Instead he stressed that all real practice demanded analysis of the causes of technical problems—analysis that rested on a study of the piano’s mechanisms and human physiology. Between the Wars, Matthay’s influence flourished on both sides of the Atlantic, spurred on by the successes of such noted pupils and master pianists as Dame Myra Hess, Sir Clifford Curzon, and Dame Moura Lympany.

How ironic today then to observe over 100 years later, in a blog posting from September 2009, a prominent teacher echoing the hortatory advice of Lebert and Stark than the thoughtful Matthay:

First have the student play each run slow, heavy, digging in. Repeat 3 to 5 times with the right hand alone. I play along emphasizing playing loud, slowly … If the hand gets tired during the slow, heavy, digging in practice, have the student practice the left hand chords.

Such advice is not unusual for piano teachers today in light of how Matthay’s ideas have all but vanished from the mainstream. And yet…and yet… not so coincidentally, nearly every piano blog today devotes a generous amount of space to the discussion of the injuries that Matthay’s lessons on piano technique studiously sought to avoid—begging the question of whether a re-discovery of Matthay’s teachings might not well be less expensive than physical therapy sessions or even surgeries some pianists undergo.

Stephen Siek is the author of England's Piano Sage: The Life and Teachings of Tobias Matthay. A pianist and musicologist with an extensive background in Matthay teaching principles, he is a professor of music at Wittenberg University.

The Political Branding of Country Music: 10 Years Post-9/11

By Elizabeth Barfoot Christian

Some argue the sound of country music has become nearly indistinguishable from today’s pop---that it has lost in soul what it has gained in fan base over the last quarter-century. And that may be true when you listen to crossover country artists like Taylor Swift and Lady Antebellum (as well as rockers like Bret Michaels and Bon Jovi’s recent countrified-rock albums). Like many boundaries in postmodern culture, the lines between popular musical genres have been fading for quite some time.

But boundaries are a funny thing. Just when you think we’ve gotten past the need for labels… just when you think it’s OK to be a little bit country and a little bit rock ‘n roll, someone strikes a chord so offensive that lines must be drawn.

That boundary was recast in steel by country music following the world-altering events of Sept. 11, 2001.

As the molten metal of the Twin Towers melted, many hearts in the U.S. hardened. A new, angrier country was born. And from it emerged a new, angrier brand of country music as well.

Perhaps in hindsight “angry” is not a fair term to describe the artists who put to lyrics the pained, raw emotions that millions of Americans were feeling immediately after 9/11. Toby Keith, already branded a country outlaw, reportedly penned his No. 1 hit “Courtesy of the Red, White & Blue (The Angry American)” in about 20 minutes as his response to the 9/11 attacks on America. Keith’s father, a U.S. military veteran who taught him the importance of patriotism, had died unexpectedly just six months before the terrorist attack, and Keith took out his anger at both events in song. One for honor, the other, ire.

Keith was not alone. Country music saw a huge and almost immediate economic windfall following 9 /11. County Music Television sponsored the first Freedom Concert one month after the attack and raised $5 million for victims. Keith and Alan Jackson, who wrote and recorded “Where Were You (When the World Stopped Turning”), both achieved worldwide recognition for their patriotic ballads.

Jackson and Keith, already two of the more traditional country artists, were instrumental in returning country to its more populist, working-class roots. The sound of many of today’s popular country artists may not carry the same twang it did back in the day of Haggard and Jones, but 10 years post-9/11 the message is as political and patriotic as ever—and more Americans than ever are listening.

And while the musical qualities between country and mainstream pop many have merged somewhat, the message couldn’t be more distinguishable in post-9/11 America. If you don’t believe me, just ask Natalie Maines, whose career as darling of country radio took a drastic downhill slide with one poisonous political remark. While the Dixie Chicks—whose name you dare not speak in Lubbock, Texas—will forever be outcasts to true country fans, the group has experienced a rebirth in a more mainstream market with a much more liberal-thinking fan base.

Country has definitely come to town, and people who had never listened to it are listening to and loving it on both crossover and pop radio stations in growing abundance. Country stars have swarmed the Grammys. The last two entertainers of the year have been country singers. Both top finalists in this year’s American Idol were country singers, and the quasi-partnership with Fox News, the most popular cable news channel, which continues to host annual Freedom Concerts nationwide, isn’t hurting things either. Many of Fox News’ commentary programs regularly feature country artists singing and oftentimes offering personal political opinion.

The Hollywood left entered the political arena decades ago. The “Mom and apple pie” patriotic crew is catching up through the medium of country music and conservative cable news.

Elizabeth Barfoot Christian is assistant professor of journalism at Louisiana Tech University and the editor of Rock Brands: Selling Sound in a Media Saturated Culture.

Next blog: Has MTV helped kill the music industry?

Celebrities, "Extravagant Expectations" and the Love Life of Americans

By Paul Hollander

The recent ending of Oprah Winfrey’s talk show that ran for a quarter century is a reminder of the importance and prominence of celebrities in American society. The reverence shown toward them prompt reflections about the social, psychological and cultural conditions which underlie their cult.

Celebrities differ from the famous people of the past because their prominence depends to a very large extent on publicity - on the successful projection (or marketing) of a certain image or a "trademark" by the media. They also differ from the culture heroes of the past because their accomplishments, talents, skill or moral stature are more questionable. Most celebrities are entertainers, or known for some personal quality the public considers entertaining that may include forms of misbehavior or scandalous aspects of their personal lives.

I suggest that some of the conditions which underlie and promote the rise and cult of celebrities also play a part in the difficulties large numbers of Americans experience when trying to establish and maintain long term, intimate personal relationships. "Relating" to celebrities is a fantasy relationship stimulated by the shortage of genuine, face-to-face, one-on-one relationships - a futile attempt to personalize an impersonal world. When there is a scarcity of sustaining, intimate personal relationships and a decline of closely knit, durable communities, people seek substitutes. Celebrity worship is one of them. The endless browsing of dating sites is another one.

People admire celebrities because they seem to possess everything most ordinary people do not have: wealth, fame, huge amounts of attention, excitement and physical attractiveness.

Not unlike the difficulties many young people have in distinguishing a "soulmate" from a date or a "hook-up," fans of celebrities have an impaired capacity to distinguish between what or who is truly admirable and what or who is not. Confused values cast their shadow over the search for an ideal partner as they do on the attention and affection lavished on celebrities of questionable accomplishments and often even more questionable moral character. What seems to matter is that most celebrities are an integral part of popular culture that satisfies the enormous demand for entertainment.

In my recent book (Extravagant Expectations: New Ways to Find Romantic Love in America) I reported that the majority of a large sample of people (using a popular dating website) considered the most important human quality the sense of humor. These people were looking for somebody who would make them laugh, who are entertaining. Honesty, sincerity, integrity, intelligence, sense of responsibility were far less often mentioned as desirable qualities. I also found that conflicting and unrealistic expectations contribute to the difficulties many Americans experience in the pursuit of intimate personal relationships. It seems that Americans incline to believe that all good things are compatible, as for example adventure and security, excitement and stability, the capacity for self-promotion and authenticity, being rich and charitable, self-realization and dedication to some community.

In the final analysis the worship of celebrities and the haphazard pursuit of intimate personal relationships have similar sources.

Paul Hollander is professor emeritus of sociology at the University of Massachusetts, Amherst, and author or editor of 15 books. His most recent book is Extravagant Expectations: New Ways to Find Romantic Love in America.

Schuman, Persichetti, and Mennin: Modern Musicians Remembered

By Walter Simmons

For many today—including those who consider themselves musical sophisticates—the names of William Schuman, Vincent Persichetti, and Peter Mennin hearken back half a century or more to the days when composers concerned themselves with writing “the Great American Symphony.” These figures –Schuman and Mennin especially--were very much regarded as “musical bureaucrats,” both having held the position of president of the internationally renowned Juilliard School. And while he was never an administrator, Persichetti had led the Juilliard composition faculty for some 35 years, rendering him the quintessential “academic.”

But the careers of all three were launched through their musical compositions, which had made a significant an impact when each was still quite young. Schuman’s musical activity had been limited to the world of Tin Pan Alley until he turned 20; nine years later his Symphony No. 2 was performed by the Boston Symphony Orchestra. Mennin completed the writing of his Symphony No. 3 on his 23rd birthday and performed later that year by the New York Philharmonic. Persichetti’s career developed more gradually, but only by comparison. In his 30s, he discovered the wind ensemble, for which he had a distinctive gift as a composer. Although his large catalog of works includes all genres, he is recognized today as the foremost American composer of music for wind band of his generation, and most of his works for that medium endure as classics.

As for my own relationship with these composers, their music proved a far more personal experience for me. I discovered their works when I was in my early teens—largely through my own high school band experience, thanks to a conductor who set high standards for his ensemble, which he refused to subject to holiday parades and football games. It was a very high-minded time in American culture—the JFK years. But while for most of my peers this exposure would always remain part of their high school experience, I loved this music with an intense passion As my interests developed, I began to reach beyond these composers’ works for band, delving into their compositions for orchestra, chorus, chamber ensembles, and solo instruments—and into the music of other American composers of their generation as well.

Studying their music, however, wasn’t enough for me: I also wanted to know them as people, to search for connections between their personalities and their creative lives. So I sought them out personally and eventually became acquainted with them and their families to differing degrees. All part of the question I sought to answer as to how mind and music resonate with one another, I dare say that the connections between their personalities and their creative work remain largely an enigma to me and may well be what makes theirs works as great as they are.

When I headed off to college in the mid-1960s, imagine my shock when I learned that these composers, whose music I had come to cherish were “out,” while serialism and other, more experimental approaches were now “in.” A gauntlet had been thrown down, and so I pursued graduate studies in theory and musicology for the specific purpose of uncovering the reasons why these composers, whose music had touched me so deeply, were now the objects of scorn. My researches only reinforced a deep-seated certainty that the disparagement of these composers had little to do with musical quality and much to do with musical politics. It was then I decided to devote my life to bringing greater attention to the music of these masters, arguing for its legitimacy and stature as fine creative art based on the principles of great music that have evolved over the centuries. Besides the hundreds of reviews I have written, weekly radio series I have hosted, and numerous premiere recordings I have produced, my two books are the culminations of this effort to bring these great composers—and others like them—back into the mainstream of musical greatness. I only my hope both books have supplied a sturdy foundation for others similarly excited by this body of music to pursue it in their study as performers and researchers.

Walter Simmons has received the National Educational Film Festival Award and the ASCAP/Deems Taylor Award for music criticism. He has contributed articles to The New Grove Dictionary of American Music, American National Biography, Fanfare, Music Journal, and Musical America. He is the author of Voices in the Wilderness: Six American Neo-Romantic Composers (Scarecrow, 2004) and the recently published The Music of William Schuman, Vincent Persichetti, and Peter Mennin: Voices of Stone and Steel (Scarecrow, 2010).

Shopping for an Organ Transplant?: The Pitfalls of Medical Tourism

By Katrina A. Bramstedt

In the US, thousands of patients are waiting for a kidney or liver transplant. Sometimes, they get so desperate, they contemplate traveling to a foreign country to buy an organ. In their desperation, patients often don’t think about the pitfalls and ethical problems of organ tourism, and there are many. Some organs are known to come from prisoners who did not give informed consent. Some organs are taken from women who are forced by their husbands to “donate” a kidney or liver tissue to pay a debt. Is this the setting for ethical medical care?

Other problems with organ tourism are issues such as the lack of medical records, or records which are written in a foreign language and unhelpful upon return to the US. Organs are sometimes also contaminated with viruses such as HIV and hepatitis. And what about these medical complications? Who pays for the treatment? What if there is malpractice? Can the patient obtain any recourse? The complexity of organ tourism is immense, clinically, ethically, and legally. So is there another option for patients who need a kidney or liver transplant?

Enter the Good Samaritan. These are people, right here in USA, who are ready and willing to give an organ to a stranger. They have no goal other than “to help”. Their organ gifts are “no strings attached” and often, they never even meet the person who receives their organ. For the Good Samaritan, all that matters is that they have something extra and they want to share it with someone who needs it. In the new book, The Organ Donor Experience: Good Samaritans and the Meaning of Altruism, 22 donors were extensively studied to learn their personalities and motivations for organ donation. In general, these givers are normal, everyday folk, of average means, with a genuine desire to serve their community. Often, they have a lengthy history of volunteerism and their parents did as well. They originate from all fields, law, law enforcement, health care, education, you-name-it. A Good Samaritan could be your neighbor down the street, the clerk at the grocery store, a local taxi driver, or even your bank teller. These people want to give, and with medical, surgical, and psychosocial screenings, they can be lifesavers.

References:

• Bramstedt K.A., Xu J. Checklist: passport, plane ticket, organ transplant. Am J Transplant. 2007 Jul;7(7):1698-701.
• Bramstedt K.A. Ethical minefields in medical tourism. Sonoma Medicine 2011.
• Bramstedt K.A. Steering clear of organ tourism. Kidney Review 2007.

Dr. Katrina A. Bramstedt is a noted medical ethicist associated with California Transplant Donor Network in Oakland, California. She also has a private practice in Marin County where she has performed over 800 ethics consultations and published over 75 articles in medical and bioethics journals. She lectures nationally and internationally and has made numerous appearances on television and radio discussing transplantation and donation. She is the co-author of The Organ Donor Experience: Good Samaritans and the Meaning of Altruism.