Assembling organ donation: situating organ donation in hospital practice

Abstract

In this article I argue for the need to situate deceased organ donation in and as a hospital practice. This study puts the spotlight on the practical conditions that enable and emplace organ donation in the hospital setting. The analytical move serves the political purpose to inform and interrogate dominant policy framings intended to address the problem of organ shortage. I present an ethnographic investigation that draws upon a Science and Technology Studies (STS) approach to make visible the sociomaterial arrangements that bring together people, things and politics in the assembling of organ donation at a Catalan hospital. A progressive and indeterminate process which might fall through and become disassembled at any given time. This, as I explain, challenges current opt‐out policy that unnecessarily reduces donation to an individual choice to be decided upon in life. Instead, and drawing on ethnographic materials, I propose a situated and relational understanding of organ donation: an embedded health care and procurement practice enacted as a collective accomplishment. I conclude that (more) responsible donation policies need to be informed by, and attuned to, the situated practicalities and enduring tensions that condition and constrain the assembling of organ donation at the hospital setting.

Making it happen: data practices and the power of diplomacy among Danish organ transplant coordinators

“…Likewise, studies on data flows, the ethical work in data sharing, and how data are "done" (Hoeyer et al 2017;Mol 2002) have helped shaped my interest in the social aspects of data exchanges and the variety of medical professions coming together in the data practices of transplantation. Except for a recent study from Spain focusing on the collective achievements of transplantation foregrounding the "complex socio-material arrangements" in the work of transplant coordinators (Bea 2020) little attention has been paid to how the infrastructures underpinning transplantation also depend on all kinds of social relations. From matters of maintenance to the skill to input data accurately, to time pressure and necessary detail, infrastructures built for organ transplantation are deeply human in their work.…”

“…In Denmark, the clinical infrastructures of organ donation are organized around anonymity: the donor side and recipient side are carefully separated. This means that transplant coordinators know all the medical details of the donors but, unlike coordinators in Spain for instance (Bea 2020), they rarely meet them or their families, and primarily communicate with ICU staff over the phone. In order to be prepared for the speed and the intensity of an organ exchange, the ICUs alert coordinators about a potential organ donor while the patient is still a patient, not yet officially declared dead.…”

Explorations about the Family’s Role in the German Transplantation System: Epistemic Opacity and Discursive Exclusion

“…The empirical material we collected suggests that for many people, organ donation is not a purely individual decision. Rather, it is 'an integrated healthcare practice with enduring frictions' (Bea 2020(Bea , 1942 embedded in the shared realities of individuals and their loved ones. This continues after brain death diagnosis in clinical encounters when the family is involved in decision-making.…”