Decision-making and Folklore in the Matter of Life and Death: Brain Death, Organ Donation, and Miracle Narratives Hicran Karataş Associate Professor, Bartın University, Bartın, Turkiye, hkaratas@bartin.edu.tr ABSTRACT: Turkiye and the rest of the world have been experiencing insufficient cadaveric organ donations. Although Turkey laws regulating organ transplantation allow the harvest of organs from the brain-dead who donated their organs while they were alive, Turkish social norms prohibit physicians from applying the written procedures. Therefore, both verbal and written consent of the close relatives of the possible cadaveric donors must be obtained after the brain death is announced. The ambiguity of the concept of brain death, invented in the 50s, and the terminology of modern medicine limit people’s ability to comprehend the states of coma, vegetative life, and brain death. Even though cross-cultural studies verify that the most common reasons for reluctance in cadaveric organ donations are religious concerns, interviews with donors and refusers, who are the relatives of brain-death people, revealed that folklore transmitted to generations within the context of beliefs, rituals, social norms, and oral genres also affect the judgment of prospective donors. As will be discussed in this paper, miracle narratives are particularly referenced in rejecting the reality of brain death in the conducted interviews. This paper will explore how such narratives affect decision-making process of refusers concerning the death of one and the survival of another. KEYWORDS: Culture, folklore, cadaveric organ donation, decision-making, miracle narratives Introduction Brain death is an invented form of death due to the advances in resurrection and intensive care. Before then, medical understanding of death was uniformly acceptable worldwide and defined as irreversible loss of functions of the heart and lungs. When C. Beck successfully defibrillated his patient in 1947, medical practitioners discovered that death was reversible (Beck et al. 1947). If the heart could be resuscitated, lung failure death must have also been reversible. Piston ventilators had been used in operating rooms since 1947, but the possibility of lung resurgence first came true in 1950. A year after the piston ventilator was developed for medical purposes, in 1954, Robert Scwab evaluated a coma patient with brain damage. The patient didn’t show any life signs apart from the heart maintaining circulation. He turned the respirator off and announced the patient's death (De Georgia 2014, 673). At the time, practitioners had not known the concept of brain death. The concept of death began to change with the mass production of ventilators. After ventilators were mass-produced in 1955 and became more accessible to doctors, doctors faced diagnostic and ethical dilemmas, particularly concerning patients in a coma (Feng and Lewis, 2023; Beck, Pritchard, and Feil 1947; De Georgia 2014). While these discussions arose, the first successful organ transplantation was performed in 1954 (Merrill et al. 1956). Parallel breakthroughs in resuscitation and intense care, clinic findings in coma patients regarding nervous integration and consciousness, organ transplantation, and ethics coincided (De Georgia 2014, 674). Ethical concerns regarding end-of-life care shifted from whether patients could have euthanasia to avoid further suffering to whether doctors had to prolong the lives of incurable patients. Afterward, ethical concerns regarding end-of-life care moved from academia to the church. Pope Pius XII responded to these concerns with an ordinance in 1957 declaring that doctors did not have to provide extraordinary treatment if it were hopeless. A few years later, F. Ayd suggested to his colleagues that withdrawing care was their duty when death was inevitable. According to him, physicians must recognize RESEARCH RESEARCH ASSOCIATION for ASSOCIATION for INTERDISCIPLINAR INTERDISCIPLINARY Y STUDIES STUDIES RAIS August 3-4, 2023 DOI:10.5281/zenodo.8310065