Substantial connections: the transacting of human organs as a moral economy

Publicly promoted as the gift of life`, organ donation offers a strong contrast with forms of gift giving familiar to anthropologists, where gift exchange is conducted to create and maintain relational networks. Allowing the removal of one's organs after death, to be transplanted into other bodies for the purpose of enhancing or extending life, is commonly understood, certainly in Britain, as a voluntary and anonymous gesture. It is presumed to entail no thought for any personal benefit and no intention of establishing a relationship N ith the recipients of one's organs. Implicit within this understanding of organ donation is a model of the Western person as an autonomous and bounded individual, operationalised in anthropology as an analytical tool with which to contrast `other' economies of personhood. This thesis critically re- assesses public and academic acceptance of the popular image of organ donation, and challenges the anthropological model of the Western person, revealing the partial nature of both. Using ethnographic data from a three year intensive study involving health care professionals, the families of deceased organ donors and the recipients of transplanted organs, a framework is developed within which human organ transactions can be analysed in their entire cycle. A primary focus on attitudes towards the bodies, and body parts, of deceased organ donors reveals an array of shifting subjectivities. The term refers both to the diverse perspectives held by various categories of participants and to the oscillating perspectives of individual participants, the researcher included. Studying how human organs circulate undermines the assumption that agency is (only) autoproductive. Rather less voluntarism is present than popular imagery suggests. Further, a consideration of the relationships within which organs circulate serves to illustrate that the production of self implicates other (non) -selves. What emerges is the notion of connective personhood, whereby donor families and transplant recipients inevitably participate in a self - making social relationship, through sharing the substance of the deceased donor