Hoeyer Klaus, Jensen Anja M B, Olejaz Maria
Centre for Medical Science and Technology Studies, Department of Public Health, University of Copenhagen, Denmark.
Sociol Health Illn. 2015 May;37(4):578-93. doi: 10.1111/1467-9566.12211. Epub 2015 Feb 6.
This article investigates valuations of organ transfers that are currently seen as legitimising increasingly aggressive procurement methods in Denmark. Based on interviews with registered donors and the intensive care unit staff responsible for managing organ donor patients we identify three types of valuation: the needs of recipients, respect for donors' autonomy and support of donors' relatives in their grieving process. Sometimes these modes of valuation conflict with each other, and we show how our informants then respond with a form of deliberate ignorance. We suggest that deliberate ignorance has a more general salience in the organ transplant field by way of facilitating a perception of organ transplantation as an abstract moral good rather than a specific good for specific people. Furthermore, we suggest that multiple forms of ignorance sustain each other: a desire for ignorance with respect to the prioritisation of recipients sustains pressure for more organs; this pressure necessitates more aggressive measures in organ procurement and these measures increase the need for ignorance in relation to the actual procedures as well as the actual recipients. These attempts to avoid knowledge are in remarkable contrast to the otherwise widespread policy emphasis on education and information in this medical domain.
本文探讨了器官移植的估值问题，目前在丹麦，这些估值被视为使日益激进的获取方法合法化的依据。通过对登记捐赠者以及负责管理器官捐赠患者的重症监护室工作人员进行访谈，我们确定了三种估值类型：受赠者的需求、对捐赠者自主权的尊重以及对捐赠者亲属悲痛过程的支持。有时这些估值模式会相互冲突，我们展示了我们的受访者如何以一种蓄意忽视的形式做出回应。我们认为，蓄意忽视在器官移植领域具有更普遍的显著意义，它有助于将器官移植视为一种抽象的道德善举，而非针对特定人群的具体善举。此外，我们认为多种形式的忽视相互支撑：对受赠者优先级的忽视欲望导致对更多器官的需求压力；这种压力使得在器官获取方面需要采取更激进的措施，而这些措施又增加了对实际程序以及实际受赠者相关情况进行忽视的必要性。这些避免了解情况的尝试与该医学领域其他普遍强调教育和信息的政策形成了显著对比。
