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Matching Organs with Donors

Matching Organs with Donors: Legality and Kinship in Transplants

Marie-Andrée Jacob
Copyright Date: 2012
Pages: 248
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  • Book Info
    Matching Organs with Donors
    Book Description:

    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 Transplants examines 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 Donors describes 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 Donors deepens our understanding of the law and management of informed consent, decision-making among hospital professionals, and the shadowy borders between altruism and commerce.

    eISBN: 978-0-8122-0650-0
    Subjects: Anthropology

Table of Contents

  1. Front Matter
    (pp. [i]-[iv])
  2. Table of Contents
    (pp. [v]-[vi])
  3. Introduction: Matching
    (pp. 1-15)

    In autumn 2005, at HaMagen Hospital, a kidney donor, about thirteen hours after a transplant, died following severe internal bleeding in his stomach. The donor was a thirty-eight-year-old man. His family did not know about the donation; he had not informed them. To explain his absence, he had told members of his family that he was on a trip to Barcelona with his secretary. At the request of the family, his body was taken to a forensic institute for an autopsy: a plastic clip that served to close the blood vessels had slipped after removal of the kidney, causing a...

  4. CHAPTER 1 Ethnography Through Transplants and Vice Versa
    (pp. 16-37)

    I met Don Patterson during my second visit to the Southern hospital in the United States. I was told by the staff that there was a potential donor in the wing who had come for a two-day evaluation (“eval”). As I entered the room in which he was sitting, I introduced myself and asked if he would be willing to hear about my research, to see whether he would like to participate. He smiled and immediately interrupted me with “Whatever you say.” I tried, clumsily, to object and to go on with my informed consent script but was rebuffed. “Whatever...

  5. CHAPTER 2 Consent Forms, Differences, and Indifference
    (pp. 38-61)

    I met Sandra Benedict for the first time in her room in the transplant unit at the HaMagen hospital. At that time she was undergoing her two-day pre-transplant evaluations. Sitting on her hospital bed, she seemed in good form in her white and blue nightgown, wearing make-up and an elaborate hairdo. “To whom are you making a donation, to a friend?” I asked.

    Well, it is a friend now. It all began three years ago, it’s a long story . . . I don’t know if you have enough time. . . .

    My husband is a pastor in a...

  6. CHAPTER 3 Kinship as Template
    (pp. 62-96)

    During spring 2005 in Israel I was made aware of the contentious case of “the father who took from his son.” First I wondered about labeling: Why not call it “the father who received from his son” or “the son who gave to his father”?

    A father experienced problems of rejection a few months after he received his son’s kidney, and came to the hospital for post-transplant follow-up. The nephrologist recounted the story to me in her office, in front of the father, who sat across from her desk: “He got a kidney from his son, and it is not...

  7. CHAPTER 4 Committee-ing “Family Donations”
    (pp. 97-117)

    The HaMagen hospital family donations committee is meeting today. I hope. When I arrived in October 2004, I was told that the hospital committee responsible for approving donations from family members met on a regular basis. By the time I had succeeded in meeting with the chair of the committee and had received authorization to attend its meetings, it was already the tenth month of my fieldwork. Today’s meeting had had to be rescheduled twice: “People are busy here.” But this morning, Sarah, the coordinator, announces to her colleagues, “I’m going to Zemer’s,” and she indicates that I should come...

  8. CHAPTER 5 The Evidence of Altruism
    (pp. 118-142)

    Yossi Medina, an Israeli in his sixties, had recently traveled to India to get a kidney transplant but was found medically ineligible by the Indian transplant facility. He came back to Israel and got an appointment with Professor Birenbaum, a senior transplant surgeon at HaMagen. Yossi entered the surgeon’s office accompanied by a younger woman, Ayelet. Sitting across from Birenbaum’s desk, with his wrinkled shirt and knitted kippah, he looked irritated, discomfited, but mostly tired. Ayelet also frowned, though she was more alert. When asked by Birenbaum to explain his situation, Yossi mumbled “It’s all in the file,” to which...

  9. CHAPTER 6 Exits and Promises: Signatures, Loopholes, and Swaps
    (pp. 143-157)

    Moshe and Dalia are husband and wife. I met them in the waiting room of the HaMagen transplant unit. As we chatted they invited me to go outside with them. Surprised, I immediately agreed and followed them to the end of the corridor. Moshe opened a door, then another—an emergency exit—and we found ourselves on the outside fire escape. “Now let’s talk, and have a cigarette,” they said.

    Moshe: The doctor says I need a transplant . . . my brothers came, but they suffer from diabetes, so they can’t donate.

    Dalia (interrupting): So I said I’ll come...

  10. Conclusion: Kin Relations, Legal Relations, and Transplants
    (pp. 158-164)

    All exchanges are risky, containing the possibility of failure. Bureaucratic encounters between patients, donors, and professionals are no exception. The stories crafted and exchanged by agents, their clients, and donors to perform before bureaucrats—who may or may not believe them—are fraught with risk. Then, too, risk emerges in handing meticulously produced paper documents over to patients who do not take them seriously. Chapter 2 explored how the concerns of American bureaucrats with the materiality of consent forms are met with indifference, irony, and even scorn on the part of patients. In addition, what may have looked like failed...

  11. Appendix A: Living Organ Transplant Directive
    (pp. 165-172)
  12. Appendix B: National Organ Transplant Act (NOTA) (1984 Pub. L. 98–507) United States Code Title 42, Chapter 6A, Subchapter II, Part H
    (pp. 173-174)
  13. NOTES
    (pp. 175-194)
    (pp. 195-210)
  15. INDEX
    (pp. 211-218)
    (pp. 219-221)