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"Hamdy, Sherine"
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Our bodies belong to God
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 God sheds new light on contemporary Islamic thought, while challenging the presumed divide between religion and science, and between ethics and politics.
eBook
Lissa : a story about medical promise, friendship, and revolution
\"Anna is the daughter of Americans working in Cairo. But she feels more at home with the humble family of her friend Layla, who lives in the doorman's shack adjacent to Anna's apartment building. As the women grow up, their unlikely friendship is put to the test as they each face a family health crisis. Gulfs of misunderstanding emerge as Anna deals with her family history of breast cancer and Layla makes difficult decisions about her father's kidney failure\"-- Provided by publisher.
BOOK
Egypt’s Popular Uprising and the Stakes of Medical Neutrality
Amidst the recent political uprisings in the Arab region, physicians and other healthcare workers have found themselves in the crossfire. This paper focuses on Egypt’s doctors, paying special attention to how many have both appealed to and practiced medical neutrality as its own potent and contested political stance, particularly since the period of military rule following Mubarak’s removal from power. Our paper draws on interviews with physicians who served as volunteers in the field hospitals in the days of unrest and violence, and with others who played a major role in documenting protesters’ injuries, police brutality, and other forms of state violence against unarmed citizens. Based on interviews with doctors who belong to organizations such as “Tahrir Doctors” and “Doctors Without Rights,” our paper reveals how these doctors’ commitment to professional ethics put them at odds with the orders of military personnel, rendering their appeal to “medical neutrality” a weighty political act in and of itself.
Journal Article
When the state and your kidneys fail: Political etiologies in an Egyptian dialysis ward
In this article, I describe how poor Egyptian kidney-disease patients understand and experience their illness in terms of Egypt's larger social, economic, and political ills. The suffering that patients in end-stage renal failure endure, as they articulate it, extends beyond the pathological kidney and implicates corrupt institutions, polluted water, the mismanagement of toxic waste, and unsafe food. End-stage kidney failure patients in Egypt depend on state-provided medical services, which they deeply mistrust. In this context, they understand the breakdown of their kidneys, their dialysis machines, and their bodies as a direct outcome of the breakdown of the welfare state. I argue that patients' perceptions of their disease and their mistrust of medical treatment and state service provision should make us reconsider how all etiologies are political. Further, the \"political etiologies\" in this case inform ethical decisions about kidney transplantation and maintaining life on dialysis.
Journal Article
Islam, Fatalism, and Medical Intervention: Lessons from Egypt on the Cultivation of Forbearance (Sabr) and Reliance on God (Tawakkul)
One of the most fundamental ways that religious devotion is held to be \"anti-biotechnology\" is in its emphasis on submission to divine will. This article seeks to re-orient discussions of religious \"fatalism\" through ethnographic analysis of terminally-ill dialysis patients in Egypt who argue that they would rather \"accept God's will\" than pursue kidney transplantation. I argue against the presumptions that this is a religious constraint on a potentially beneficial treatment, or that this reaction is merely a \"comfort mechanism\" to appease those without access to treatment. I argue that we should not think of people's perceptions of the amount of control they can exert over their lives in terms that would place analyses of social benefit and religious belief in opposing or even in discretely separate categories. I also demonstrate that, far from being passive, the disposition of accepting God's will must be actively cultivated through work on the self.
Journal Article
Strength and vulnerability after Egypt's Arab Spring uprisings
Following the revolts that unseated Hosni Mubarak in February 2011, a contradictory discourse has emerged in which Egyptians imagine themselves to be resilient in body and spirit but also enfeebled by years of political corruption and state negligence.During the mass protests in Cairo's Tahrir Square, the regime's orchestrated violence neither crushed the movement nor provoked activists to abandon their vow of peaceful protest. However, Egyptians' pride in the physical and moral resilience that enabled this feat is infused with an understanding of its fragility; many face vulnerabilities to disease within the context of environmental toxins, malnutrition, and a broken, overtaxed health care system. And they mourn the deterioration of moral principles and values after years of brutal oppression and social injustice. These conflicting views— of vitality and vulnerability— have led to a dizzying oscillation between optimism and despair; even as people celebrate the accomplishments of the uprisings, they are also keenly aware of the formidable challenges that lie ahead.
Journal Article
Nationalism, Authoritarianism, and Medical Mobilization in Post-revolutionary Egypt
In this article, we investigate the links between medical practice and expertise, on the one hand, and nationalist discourses, on the other, in the 2011 Egyptian uprising and the years that followed, which witnessed a consolidation of authoritarianism. We ask how it is that doctors, whose social capital in part rests on their being seen as “apolitical,” played a significant role in countering consecutive regimes’ acts of violence and denial. We trace the trajectory of the doctors’ mobilization in the 2011 uprising and beyond and demonstrate how the doctors drew on their professional expertise and nationalist sentiment in their struggles against a hypernationalistic military state. Borrowing the ideas of immanence and transcendence from religious studies and philosophy, we argue that the doctors put forth an immanent vision of the nation as a force that is manifested in the lives of its citizens, in contrast with the State’s transcendent vision of nationalism, in which the nation resides outside of and beyond citizens’ lives. Relying on interviews and media analysis, we show how medicine has served as a site of awakening, conversion narratives, and building of bridges in a polarized society where the doctors were able to rely on their “neutral” expertise to present themselves as reliable witnesses, narrators, and actors.
Journal Article
Not quite dead: why Egyptian doctors refuse the diagnosis of death by neurological criteria
Drawing on two years of ethnographic fieldwork in Egypt focused on organ transplantation, this paper examines the ways in which the “scientific” criteria of determining death in terms of brain function are contested by Egyptian doctors. Whereas in North American medical practice, the death of the “person” is associated with the cessation of brain function, in Egypt, any sign of biological life is evidence of the persistence, even if fleeting, of the soul. I argue that this difference does not exemplify an irresolvable culture clash but points to an unsettling aspect of cadaveric organ procurement that has emerged wherever organ transplantation is practiced. Further, I argue that a misdiagnosis of the problem, as one about “religious extremism” or a “civilizational clash,” has obfuscated unresolved concerns about fairness, access, and justice within Egyptian medical spheres. This misdiagnosis has led to the suspension of a cadaveric procurement program for over 30 years, despite Egypt’s pioneering efforts in kidney transplantation.
Journal Article
Islam, fatalism, and medical intervention: lessons from Egypt on the cultivation of forbearance
One of the most fundamental ways that religious devotion is held to be \"anti-biotechnology\" is in its emphasis on submission to divine will. This article seeks to re-orient discussions of religious \"fatalism\" through ethnographic analysis of terminally-ill dialysis patients in Egypt who argue that they would rather \"accept God's will\" than pursue kidney transplantation. I argue against the presumptions that this is a religious constraint on a potentially beneficial treatment, or that this reaction is merely a \"comfort mechanism\" to appease those without access to treatment. I argue that we should not think of people's perceptions of the amount of control they can exert over their lives in terms that would place analyses of social benefit and religious belief in opposing, or even in discretely separate categories. I also demonstrate that, far from being passive, the disposition of accepting, God's will must be actively cultivated through work on the self. [Keywords: medicine, Islam, Egypt, fatalism, bioethics, organ transplantation, illness, suffering, divine will]
Journal Article