Organ donation and transplantation: the paradox of gifting and dis/embodiment

Since the 1950's, procuring organs for cadaveric transplantation has been based around a "gift of life" discourse, institutionalised through the carrying of donor cards/driving licence or registration on the NHS Organ Donor Register. Yet regardless of whether, or how, the deceased recorded their wishes to donate, their next-of-kin are always asked if organs can be removed. Little is known about the reasons families give for refusing or agreeing to an organ donation request. In order to identify the circumstances, in which an organ donation request is more likely to be accepted or refused by the family of a brain stem dead individual, eighteen semi-structured interviews were carried out in various areas of Scotland, in order to ascertain donor and non-donor relatives' beliefs, attitudes and experiences. The findings suggest that wider cultural beliefs embedded in society about the value of gifting, death and the body are brought to the specific context of an organ donation request. The interactions between these values and other factors, such as familial and hospital support and dynamics, and the perceived value of the outcome from donation, which affect whether families will donate or not. The findings of such an investigation will have obvious policy implications for those interested in increasing the present UK organ procurement rate, and can also inform debates about the merits of introducing alternative systems. However, a study of organ donation and transplantation can also provide the sociologist with a unique insight into several engaging areas of sociological interest: modern gift practices (including altruism and social exchange theory), the way meanings are constructed onto dead bodies by different groups, how and when death is defined, and finally, how individuals view the relationship between personal, social and corporeal identity