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"Transplantation of organs, tissues, etc.-United States"
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When death becomes life : notes from a transplant surgeon
A transplant surgeon discusses the pioneers, science, and ethical challenges of organ transplantation as well as the ways that organ transplants have revolutionized medical care, and offers illuminating stories of his own patients.
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The transplant imaginary
In The Transplant Imaginary, author Lesley Sharp explores the extraordinarily surgically successful realm of organ transplantation, which is plagued worldwide by the scarcity of donated human parts, a quandary that generates ongoing debates over the marketing of organs as patients die waiting for replacements. These widespread anxieties within and beyond medicine over organ scarcity inspire seemingly futuristic trajectories in other fields. Especially prominent, longstanding, and promising domains include xenotransplantation, or efforts to cull fleshy organs from animals for human use, and bioengineering, a field peopled with “tinkerers” intent on designing implantable mechanical devices, where the heart is of special interest. Scarcity, suffering, and sacrifice are pervasive and, seemingly, inescapable themes that frame the transplant imaginary. Xenotransplant experts and bioengineers at work in labs in five Anglophone countries share a marked determination to eliminate scarcity and human suffering, certain that their efforts might one day altogether eliminate any need for parts of human origin. A premise that drives Sharp’s compelling ethnographic project is that high-stakes experimentation inspires moral thinking, informing scientists’ determination to redirect the surgical trajectory of transplantation and, ultimately, alter the integrity of the human form.
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She, myself, and I
After an experimental brain transplant gives quadriplegic Rosa a new life, she begins to obsess over Sylvia, her donor, prompting a road trip of self-discovery and a surprising new romance.
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Matching Organs with Donors
While the traffic in human organs stirs outrage and condemnation, donations of such material are perceived as highly ethical. In reality, the line between illicit trafficking and admirable donation is not so sharply drawn. Those entangled in the legal, social, and commercial dimensions of transplanting organs must reconcile motives, bureaucracy, and medical desperation.Matching Organs with Donors: Legality and Kinship in Transplantsexamines the tensions between law and practice in the world of organ transplants-and the inventive routes patients may take around the law while going through legal processes.
In this sensitive ethnography, Marie-Andrée Jacob reveals the methods and mindsets of doctors, administrators, gray-sector workers, patients, donors, and sellers in Israel's living kidney transplant bureaus.Matching Organs with Donorsdescribes how suitable matches are identified between donor and recipient using terms borrowed from definitions of kinship. Jacob presents a subtle portrait of the shifting relationships between organ donors/sellers, patients, their brokers, and hospital officials who often accept questionably obtained organs.
Jacob's incisive look at the cultural landscapes of transplantation in Israel has wider implications.Matching Organs with Donorsdeepens our understanding of the law and management of informed consent, decision-making among hospital professionals, and the shadowy borders between altruism and commerce.
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Kidney for Sale by Owner
Over the past decade in the United States, nearly 6,000 people a year have died waiting for organ transplants. In 2003 alone, only 20,000 out of the 83,000 waiting for transplants received them--in anyone's eyes, a tragedy. Many of these deaths could have been prevented, and many more lives saved, were it not for the almost universal moral hand-wringing over the concept of selling human organs. Bioethicist Mark Cherry explores the why of these well-intentioned misperceptions and legislation and boldly deconstructs the roadblocks that are standing in the way of restoring health to thousands of people. If most Americans accept the notion that the market is the most efficient means to distribute resources, why should body parts be excluded? Kidney for Sale by Owner contends that the market is indeed a legitimate—and humane—way to procure and distribute human organs. Cherry stakes the claim that it may be even more just, and more compatible with many Western religious and philosophical traditions, than the current charity-based system now in place. He carefully examines arguments against a market for body parts, including assertions based on the moral views of John Locke, Immanuel Kant, and Thomas Aquinas, and shows these claims to be steeped in myth, oversimplification, and contorted logic. Rather than focusing on purported human exploitation and the irrational \"moral repugnance\" of selling organs, Cherry argues that we should focus on saving lives. Following on the thinking of the philosopher Robert Nozick, he demonstrates that, with regard to body parts, the important core humanitarian values of equality, liberty, altruism, social solidarity, human dignity, and, ultimately, improved health care are more successfully supported by a regulated market rather than by well meant, but misguided, prohibitions.
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Medical Governance
Governments throughout the industrialized world make decisions that fundamentally affect the quality and accessibility of medical care. In the United States, despite the absence of universal health insurance, these decisions have great influence on the practice of medicine. InMedical Governance, David Weimer explores an alternative regulatory approach to medical care based on the delegation of decisions about the allocation of scarce medical resources to private nonprofit organizations. He investigates the specific development of rules for the U.S. organ transplant system and details the conversion of a voluntary network of transplant centers to one private rulemaker: the Organ Procurement and Transplantation Network (OPTN). As the case unfolds, Weimer demonstrates that the OPTN is more efficient, nimble, and better at making evidence-based decisions than a public agency; and the OPTN also protects accountability and the public interest more than private for-profit organizations. Weimer addresses similar governance arrangements as they could apply to other areas of medicine, including medical records and the control of Medicare expenditures, making this timely and useful case study a valuable resource for debates over restructuring the U.S. health care system.
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Matching organs with donors : legality and kinship in organ transplants
This sensitive ethnography reveals the methods and mindsets of doctors, patients, donors, and sellers in Israel's living kidney transplant bureaus. Matching Organs with Donors describes how these actors identify and adjudicate suitable matches between donor and recipient using terms borrowed from definitions of kinship.
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Bodies, Commodities, and Biotechnologies
In the United States today, the human body defines a lucrative site of reusable parts, ranging from whole organs to minuscule and even microscopic tissues. Although the medical practices that enable the transfer of parts from one body to another most certainly relieve suffering and extend lives, they have also irrevocably altered perceptions of the cultural values assigned to the body. Organ transfer is rich terrain to investigate—especially in the American context, where sophisticated technological interventions have significantly shaped understandings of health and well-being, suffering, and death. In Bodies, Commodities, and Biotechnologies, Lesley Sharp probes the ideological assumptions underlying the transfer of body parts, the social significance of donors' deaths, and the medico-scientific desires surrounding complex forms of body repair. Sharp also considers the experimental realm, in which nonhuman species and artificial devices present further opportunities for recovery and for controversy. A compelling scientific investigation and social critique, Bodies, Commodities, and Biotechnologies explores the pervasive, and at times pernicious, practices shaping American biomedicine in the twenty-first century.
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Last best gifts
More than any other altruistic gesture, blood and organ donation exemplifies the true spirit of self-sacrifice. Donors literally give of themselves for no reward so that the life of an individual—often anonymous—may be spared. But as the demand for blood and organs has grown, the value of a system that depends solely on gifts has been called into question, and the possibility has surfaced that donors might be supplemented or replaced by paid suppliers. Last Best Gifts offers a fresh perspective on this ethical dilemma by examining the social organization of blood and organ donation in Europe and the United States. Gifts of blood and organs are not given everywhere in the same way or to the same extent—contrasts that allow Kieran Healy to uncover the pivotal role that institutions play in fashioning the contexts for donations. Procurement organizations, he shows, sustain altruism by providing opportunities to give and by producing public accounts of what giving means. In the end, Healy suggests, successful systems rest on the fairness of the exchange, rather than the purity of a donor’s altruism or the size of a financial incentive.
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Scarce goods : justice, fairness, and organ transplantation
In 1841 the American sailing ship William Brown struck an iceberg. About half of the passengers and all of the crew were saved in two small, open boats. The next night, half of the passengers in the larger long-boat were thrown overboard because the boat was overfull. This was the first case of lifeboat ethics, of hard choices in the face of scarcity. Since then the question has been who should die so that others, equally needy, might live? Both the case of the William Brown and the ethics it spawned have been used in recent years to describe the problem of health care rationing generally, and organ transplantation specifically. Koch reexamines and reinterpretes the paradigm case of lifeboat ethics, the story of the William Brown, not as an unavoidable tragedy, but as an avoidable series of errors. Its relation to more general issues of distributive justice are then considered. The lessons learned from both the historical review and its application to distributive principles are then applied to the problem of graft organ distribution in the United States. Through the use of maps, the problem of organ distribution is considered at a range of scales, from the international to the urban. The contextual issues become more evident as one moves from international to hemispheric, fron national to regional, and then local systems. Finally, Koch reviews the lessons in light of other problems of distribution in the face of scarcity. The central lesson-that scarcity is exacerbated where it is not in fact created by our distributive programs-is explored thoroughly. The result is no good choices for anyone and the continuation of the scarcity that for most seems inevitable, but, from the evidence provided, is itself an outcome of inequalities of distribution at different scales of society. Of particular interest to students, scholars, and policymakers involved with issues of planning and health care economics, medical geography, and concepts of justice.
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