Table of contents for Last best gifts : altruism and the market for human blood and organs / Kieran Healy.

Bibliographic record and links to related information available from the Library of Congress catalog.

Note: Contents data are machine generated based on pre-publication provided by the publisher. Contents may have variations from the printed book or be incomplete or contain other coding.

<!table of contents, page vii!>
List of Illustrations
1 Exchange in Human Goods
Procurement rates for blood and organs vary strikingly. This variation 
has its roots not in individual dispositions to give but in institutional 
differences between procurement systems. Organizations responsible for 
procuring blood and organs create and sustain altruism by providing 
opportunities to give and by producing and popularizing accounts of what 
giving means.
2 Making a Gift
Advocates of organ transplantation have, over the past thirty years, 
articulated and refined a cultural account that has changed public 
understanding of organ procurement and exchange. This account has 
described and motivated donation, in part by addressing two problems: 
harvesting organs both introduces a utilitarian calculation at the time of 
death and threatens to place a cash value on human life. As structural 
pressure on the transplant system has increased, so has the possibility of 
commodification. Recent changes in discourse should be understood in the 
context of organizational efforts to produce viable accounts of caring and 
altruism and to manage the expressive dimensions of money.
3 The Logistics of Altruism
There is no donation without a procurement organization, but some 
organizations are more successful than others at finding donors. 
Structural and organizational characteristics of organ procurement 
organizations explain much of the variation in procurement rates within 
the United States. Small changes in organizational strategy can have large 
effects on procurement. These findings are in sharp contrast to the 
emphasis on individual motives for giving found in both public accounts of 
donation and much of the research on donation.
4 Collection Regimes and Donor Populations
Procurement systems also vary cross-nationally. Data on blood collection 
in Europe shows that variations in national collection regimes affect both 
donation rates and the composition of the donor pool. Some systems 
attract many once-off donors, others have smaller populations of regular 
donors. Blood collection regimes produce their donor populations by 
providing differing opportunities to give to different sorts of people. For 
example, Red Cross systems take greater advantage of personal ties to 
transfusion recipients than do state-run systems or those based on blood 
5 Organizations and Obligations
Procurement organizations do not stand outside the exchange system or 
manage donors in a purely strategic way. Like individual donors, decision 
makers within these organizations may be affected by the moral economy 
of exchange. When HIV appeared in the U.S. blood supply, there was a 
crucial period of uncertainty about the nature of the disease and its 
presence in the blood supply. The structure of institutionalized exchange 
relations shaped how organizations that collect blood from unpaid donors 
and those that buy plasma from sellers perceived their environments and 
helps to explain why they reacted differently.
6 Managing Gifts, Making Markets
A complex technical infrastructure determines a great deal about how 
systems of exchange in human goods work, irrespective of whether the 
core exchange is for-profit or voluntary. In many ways, whether exchange 
is commodified matters less than whether it is industrialized¿that is, 
administered by rationalized organizations that try to collect goods like 
blood and organs as efficiently as possible. The proliferation of secondary 
markets in human goods exposes a tension between the short-run 
logistical demands faced by procurement organizations and the long-run 
development of ideas about the "gift of life" that legitimate the exchange 
system. Treating human goods either as ordinary commodities or presents 
given without obligation results in similar problems.
Appendix: Data and Methods

Library of Congress Subject Headings for this publication:

Procurement of organs, tissues, etc.
Procurement of organs, tissues, etc. -- Economic aspects -- United States.
Transplantation of organs, tissues, etc. -- Economic aspects -- United States.
Tissue banks -- United States.