The Political Economy of Organ Transplantation: Where Do Organs Come From?

215 Pages·2022·4.578 MB·English

by  Hagai Boas

The Political Economy of
Organ Transplantation
This innovative work combines a rigorous academic analysis of the political econ-
omy of organ supply for transplantation with autobiographical narratives that il-
luminate the complex experience of being an organ recipient.
Organs for transplantations come from two sources: living or postmortem or-
gan donations. These sources set different routes of movement from one body
to another. Postmortem organ donations are mainly sourced and allocated by
state agencies, while living organ donations are the result of informal relations
between donor and recipient. Each route traverses different social institutions,
determines discrete interaction between donor and recipient, and is charged with
moral meanings that can be competing and contrasting. The political economy of
organs for transplants is the gamut of these routes and their interconnections, and
this book suggests how such a political economy looks like: what are its features
and contours, its negotiation of the roles of the state, market, and the family in
procuring organs for transplantations, and its ultimate moral justifications. Draw-
ing on Boas’ personal experiences of waiting, searching, and obtaining organs,
each autobiographical section of the book sheds light on a different aspect of the
discussed political economy of organs – p ostmortem donations, parental dona-
tion, and organ market – and illustrates the experience of living with the fear of
rejection and the intimidation of chronic shortage.
A Political Economy of Organ Transplantation is of interest to students and ac-
ademics with an interest in bioethics, sociology of health and illness, medical
anthropology, and science and technology studies.
Hagai Boas is a sociologist of health and an organ recipient. He is positioned as
the director of the science, technology, and society unit at Van Leer Jerusalem
Institute and is an adjunct senior lecturer at Ben Gurion University of the Negev.
His fields of interest include the sociology of transplant medicine and bioethics.
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Edited by Erich Griessler, Lenka Slepicˇková, Heleen Weyers, Florian Winkler and
Nicolle Zeegers.
The Political Economy of Organs Transplantation
Where Do Organs Come From?
Hagai Boas
Techniques of Hearing
History, Theory and Practices
Edited by Michael Schillmeier, Robert Stock and Beate Ochsner
For more information about this series, please visit: https:// www.routledge.com/
R outledge-S tudies- in-t he- Sociology- of-H ealth-a nd-I llness/b ook-s eries/R SSHI
The Political Economy of Organ
Transplantation
Where Do Organs Come From?
Hagai Boas
First published 2023
by Routledge
4 Park Square, Milton Park, Abingdon, Oxon OX14 4RN
and by Routledge
605 Third Avenue, New York, NY 10158
Routledge is an imprint of the Taylor & Francis Group, an informa business
© 2023 Hagai Boas
The right of Hagai Boas to be identified as authors of this work has been
asserted in accordance with sections 77 and 78 of the Copyright, Designs
and Patents Act 1988.
All rights reserved. No part of this book may be reprinted or reproduced
or utilised in any form or by any electronic, mechanical, or other means,
now known or hereafter invented, including photocopying and recording,
or in any information storage or retrieval system, without permission in
writing from the publishers.
Trademark notice: Product or corporate names may be trademarks
or registered trademarks, and are used only for identification and
explanation without intent to infringe.
British Library C ataloguing-i n-P ublication Data
A catalogue record for this book is available from the British Library
Library of Congress C ataloging-i n-P ublication Data
A catalog record has been requested for this book
ISBN: 9 78-1 - 032-2 6567- 4 ( hbk)
ISBN: 978-1 -0 32-3 3111-9 (p bk)
ISBN: 978-1 -0 03-2 8888-6 (e bk)
DOI: 10.4324/9781003288886
Typeset in Goudy
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Contents
List of figures and tables ix
Preface xi
Acknowledgments xix
Jerusalem 1973 1
1 Exercising Shortage 7
2 The Making of Utopia and Dystopia in Organ Transplantations 33
Tel Aviv 1999 59
3 Living and Deceased Organ Economies 65
Istanbul 2004 87
4 Global organ economy 93
5 The New Ethics of Organ Donation 117
June 2020 141
6 Contested Bioethics: The History of Organ
Transplantations in Israel 148
Epilogue: When the Shortage Ends 180
Index 189

Figures and Tables
1.1 Waiting list, donations, and transplantations in the United
States 1 988–2 019 8
1.2 The ratio between people on waiting lists and actual transplants
in the United States 1988– 2019 9
4.1 Percentages of living donations out of total organ donations in
five countries: 2 000–2 019 109
5.1 Donation patterns between relatives in the United States 1998– 2020 128
5.2 Trends in living organ donation patterns in the United States,
1998– 2020 134
4.1 Percentages of living donations out of total organ donations in
four countries: 2000– 2019 102