Abstract:
This paper examines how the procurement and exchange of human organs has come to be understood in the U.S. over the past 20 years. Drawing on a variety of qualitative sources, I show how advocates of organ transplantation articulated and refined a cultural account of donation that described and motivated organ donation. This account, which emerged from a range of alternatives, helped solve two problems: (i) harvesting organs introduced a utilitarian calculation at the time of death, and (ii) exchanging organs threatened to place a cash value on human life. The cultural account initially stressed the sacred aspects of the exchange. As structural pressure on the system has increased, so has the possibility of commodification. This is not a simple process of “marketization”, however. Instead, recent changes should should be understood in the context of organizational efforts to (i) produce viable accounts of caring and altruism and (ii) manage the expressive dimensions of money in this kind of exchange system.