Organ Donation as a Social Practice

Tina Larsen & Anne Bøg Starkner

Student thesis: Master thesis

Abstract

Theories of planned behaviour and rational choice are not able to properly explain the current situation on organ donation in Denmark. According to such theories, Denmark should have a high number of registered organ donors, which is not the case. 80 per cent of the population is positive towards organ donation, yet only 20 per cent has registered with the Danish Donor Registry. This calls for a new approach to researching organ donation, which we do by researching organ donation as a social practice. The specific practice chosen is that of Danes registered for deceased organ donation, and the aim is to provide a more nuanced picture on organ donation than what is currently the case. The hope is that this knowledge in turn may lead to an increase in the level of registrations due to changes in public policy framing. Social practice theory is the main theoretical framework in this thesis, however other theories and concepts are applied in order to analyse the data. These include but are not limited to relational work (Zelizer, 2000, 2012), bodily metaphors (Belk, 1990, Schweda and Schicktanz, 2009) and theses on modern death as a taboo (Walter, 1991). Placing ourselves within social constructivism and phenomenology, we conducted semistructured life-world interviews with 11 registered organ donors in order to understand their world views, motivations and considerations for organ donation. All but one participant are registered online, the last one carries a donor card. Further selection was made based on the demographic criteria of age and gender found in the Danish Donor Registry, thus making the thesis representative for the practice of registered organ donors to the widest extent possible. Using grounded theory methodology allowed us to constantly revise the theoretical framework to encompass the findings that emerged from the data. The findings are that the practice of organ donation is about helping others by passing something on that the donors no longer use. It is an altruistic act that has no room for reciprocity in terms of financial incentives. Financial incentives would cause the practice to lose its legitimacy. A legitimacy that is mainly build on trust in the system as opposed to knowledge about how the system of organ donation works. The donors engage in the practice by perceiving their organs as spare parts, which they own and can dispose of as pleased. Organ donation is also compared to recycling, which may hold potential for public framing. The metaphors of spare parts and recycling are objectifying language that minimises the symbolic and emotional aspects of organ donation. The findings also show that the donors’ social ties with their families are very important and consideration for the family implies especially two things. The first one is that it is considered a prerequisite for a good death to have decided on organ donation, which also holds potential for future framing. While deciding is a prerequisite for a good death, it is important that no one is pressured to donate their organs; it is equally acceptable to say no. The donors do however believe that people should be pressured to decide. Many of the donors are in favour of presumed consent while a few favours mandated choice. The second implication of the consideration for the family is the decision whether to make the donation contingent or non-contingent on the family’s acceptance. Which of the two is perceived the most considerate varies greatly within the practice. While consideration for the family is an inherent trait, organ donation is not a topic of conversation. It is a weak taboo that is hidden but not forbidden, as people seem to refrain from talking about organ donation, as you cannot talk about it without also talking about your own death. Several avenues for further research have been identified. The first is to conduct the study of organ donation as a social practice on a larger scale.The second is to apply the framework of social practice theory to the 60 per cent of the Danish population who is positive towards organ donation but unregistered. The third is to apply social practice theory to recipients, donor families and medical staff as well. While the three first suggestions are further expansions of social practice theory, specific topics have also emerged in the findings. These include the potential of framing organ donation as recycling, if and how to implement presumed consent and if preferential status could hold a place in organ donation

EducationsMaster of Business, Language and Culture, Intercultural Management, (Graduate Programme) Final Thesis
LanguageEnglish
Publication date2018
Number of pages122
SupervisorsAna Alacovska