Organ donation as transition work: Policy discourse and clinical practice in The Netherlands

被引:3
作者
Paul, Katharina T. [1 ]
Avezaat, Cees J. J. [2 ]
Ijzermans, Jan N.
Friele, Roland D. [3 ]
Bal, Roland A. [4 ]
机构
[1] Univ Vienna, A-1010 Vienna, Austria
[2] Erasmus MC, Dept Neurosurg, Rotterdam, Netherlands
[3] Netherlands Inst Hlth Serv Res NIVEL, Utrecht, Netherlands
[4] Erasmus Univ, Inst Hlth Policy & Management IBMG, Rotterdam, Netherlands
来源
HEALTH | 2014年 / 18卷 / 04期
关键词
death dying and bereavement; health policy; profession and professionalization; research methodology; technology in health care; BRAIN-DEATH; TECHNOLOGY; ETHICS; CONSTRUCTION; ALTRUISM; SCIENCE; DONOR; GIFT;
D O I
10.1177/1363459313501357
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
An increasing number of patients become eligible for organ transplants. In the Netherlands, at the level of policy discourse, growing waiting lists are often referred to as a persistent "shortage" of organs, producing a "public health crisis." In this way, organ donation is presented as an ethical, social, and medical necessity. Likewise, policy discourse offers a range of seemingly unambiguous solutions: improving logistical infrastructure at the level of hospitals, developing organizational and legal protocols, as well as public information campaigns. Instead of taking these problem and solution definitions as given, we critically examine the relationship between policy discourse and clinical practice. Based on a historical review, first, we trace the key moments of transformation where organ donation became naturalized in Dutch policy discourse, particularly in its altruistic connotation. Second, based on in-depth interviews with medical professionals, we show how those involved in organ donation continue to struggle with the controversial nature of their clinical practice. More specifically, we highlight their use of different forms of knowledge that underlie clinicians' "transition work": from losing a patient to "gaining" a donor.
引用
收藏
页码:369 / 387
页数:19
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