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Review
“The issue of organ transplantation has attracted growing interest from sociologists and anthropologists over the last decade. As high medical technology, organ transplantation raises serious philosophical, ethical, and sociological problems. . . . [This] is the most comprehensive book on organ transplantation published so far. . . . Spare Parts is very well written, and the material is well organized and presented.” —Orit Ben-David, Contemporary Sociology “Spare Parts: Organ Replacement in American Society. . . considers medical history and new major developments in the field of organ replacement. . . . College-level readers will appreciate the survey of biomedical advances, social and cultural changes in the perception of organ transplantation, and the history of the Jarvik-7 artificial heart in the U.S. Descriptions are based on primary data gained from interviews, participant observation, and analysis of medical journals and newspapers alike, with a new introduction reviewing some recent developments in the field.” —The Health/Medicine Shelf “Spare Parts is a historical, sociological, and moral essay on organ replacement in American society, culminating 40 years of research into the biomedical and sociocultural significance of kidney dialysis. . . and transplantation. . . . But this is more than just an academic study. Through its careful, grounded analysis, Spare Parts is a powerful indictment of recent trends in American biomedicine and American culture.” —Gail Henderson, American Journal of Sociology “Fox and Swazey are the most knowledgeable and experienced analysts of the development of organ transplantation. Their previous study, The Courage to Fail, set the standard for studies of the social, ethical, and policy implications of medical research. This book continues their study of organ transplantation by concentrating on developments in the 1980s and early 1990s.” —George J. Annas, Annals of Internal Medicine “In some ways a continuation of their earlier work (The Courage to Fail, 1974), Renée Fox and Judith Swazey’s Spare Parts: Organ Replacement in American Society offers a close, critical examination of the contemporary American project of organ transplantation. They undertake this examination in two parts, dividing their discussion into a review of biomedical advances in transplantation in the 1980s and an in-depth analysis of the rise and fall of the artificial heart that draws on their sojourn as participant-observers of the first human trials of the device at the University of Utah and Humana Hospital Audubon, St. Louis. . . . In addition to extensive endnotes for each chapter, Fox and Swazey include a lengthy biography of sources on organ transplantation in particular and bioethics in general.” —Bette-Jane Crigger, Medical Anthropology Quarterly “In Spare Parts, Renee Fox and Judith Swazey have updated us on their continued and lifelong study of the ethical, moral, social, and cultural processes of therapeutic innovation. . . . Their 'research physicians' have adapted to market forces as the field of transplantation exploded from the experimental kidney transplant. . . to broad acceptance of transplantation of the heart, liver, heart and lung, and more experimental segmented organ transplants, in efforts to save or prolong life. . . . Much can be learned from the experiences reported by Fox and Swazey in Spare Parts and applied to AIDS and other new fields of endeavor in this decade.” —Robert E. McCabe, Journal of the American Medical Association “A collaboration of nearly a quarter century between medical sociologist Renée Fox and biologist and historian of medicine Judith Swazey has produced the second of two major works on organ transplantation in America. . . . The text under review brings the earlier work up to date by charting the extraordinary developments of the 1980s, including an astonishing proliferation of organs and organ groups considered transplantable and a significant shift in the medical discourse on transplantation from 'gift giving' to commodities in short supply. . . . The authors’ long engagement in the field provides a unique perspective on the medical and sociocultural issues attending the expansion of organ replacements.” —Donald Joralemon, Medical Anthropology Quarterly “Transplantation of hearts, livers, and kidneys is now accepted therapy for a variety of end-stage organ diseases. . . . Despite its successes, many people remain deeply troubled by organ transplantation. . . . It is refreshing to see a book that cuts through the perfervid media attention that often surrounds organ transplantation and challenges us to assess the practice more realistically. . . . Fox and Swazey provide valuable insights into the abuses that can occur in the process of technological innovation and identify many of the problematics of solid-organ transplantation.” —John A. Robertson, Science "Provides a unique view of the world of transplantation. . . . a fascinating behind-the-scenes view." —Paul J. Brooks, American Journal of Hospital Pharmacy "Can be profitably read by those looking for a concise source of details about recent trends in transplantation. Readers will find many useful references and quotations, as well as interview materials gathered by the authors that are not available elsewhere. . . . A wealth of details and analysis." —Peter A. Ubel, The Journal of Clinical Ethics "Spare Parts offers a critical and compelling account of US medicine's ongoing fascination with organ replacement. In Spare Parts, Fax and Swazey deliver an engrossing account of medicine's preoccupation with organ replacement through a combination of insightful observations, lively argumentation, and moving personal accounts." —AMA "The authors' perspective highlights the personal and societal problems engendered by these immensely difficult, risky, costly procedures. This fascinating book has messages for all of us." —The Pharos "An encyclopedic source. . . . This is an important book which warrants close study and thought by all those who share an in-depth or even cursory interest in the area of replacement therapy or organ transplantation." —vor Lensworth Livingston, Howard University, Social Science and Medicine, UK "Excellent—very current information, easy, enjoyable to read." —Lydia D. Schafer, PhD
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About the Author
Renée C. Fox is Annenberg Professor Emerita of the Social Sciences and emerita senior fellow of the Center for Bioethics at the University of Pennsylvania. She is the author of numerous books.
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Product details
Paperback: 283 pages
Publisher: Transaction Publishers; 1 edition (May 10, 2013)
Language: English
ISBN-10: 1412851572
ISBN-13: 978-1412851572
Product Dimensions:
6 x 0.6 x 9 inches
Shipping Weight: 14.9 ounces (View shipping rates and policies)
Average Customer Review:
5.0 out of 5 stars
1 customer review
Amazon Best Sellers Rank:
#3,751,766 in Books (See Top 100 in Books)
Organ replacement brings unhappiness on everyone. This book is a narrative of the development of organ replacement in the United States during 1968-1990. After these many years of field research, the writers have given up this field of study because it is too emotionally rending. Their closing complaint is of "...an overly zealous medical and societal commitment to the endless perpetuation of life and to repairing and rebuilding people through organ replacement"(210). Organ replacement, being a life-and-death technology, has plunged the symbolic act of giving into social norms that bring unhappiness on donors, personnel, and recipients.Organ replacements have come from problematic sources and have had problematic results. Animals, anencephalic infants, cadavers, living donors, and artifices (like the Jarvik artificial heart) were the sources to date. In results, the body rejects transplants, whether single or multiple organs, transplants within the body, or transplants among bodies. Anti-rejection drugs like Cyclosporine and FK506 had effects that interact, disable, and kill the recipients. Moratoria on natural and artificial replacements resulted.Suffering and death in organ replacement raise religious and ethical problems. A universal cultural complex is the "gift complex," first described by Marcel Mauss in the 1920's. Gift-giving everywhere in the world has these social norms: one must give, accept, return, and redouble a gift. Plunging this symbolic act into the normative system of organ replacement contaminates both donors and recipients. First, the obligations to give and to receive bring pressure to cooperate in the process. But, second, the obligations to return and redouble a gift are impossible to fulfill.Organ replacement converts gift-giving into a market. Live donors generally resist donation of own or other's organs and there is a natural shortage of cadavers, so there is a shortage. Resulting market forces include requiring patients and families be "offered the opportunity to consent," redefinition of brain death, largely ineffective laws against commercial marketing of organs, and the transition of the field away from service to the critically ill and toward services to those most likely to survive.Egalitarianism is the rationale for extending organ replacement to those who are most likely to survive becomes the rationale for generalizing organ replacement in the population. Price rationing becomes "non-price rationing," their evasive term for government death panels. They moan, "As poverty, homelessness, and lack of access to health care increase in our affluent country, is it justifiable for American society to be devoting so much of its intellectual energy and human and financial resources to the replacement of human organs"? (208)Their narrative everywhere exposes the government dog. NIH scandalizes medical universities and hospital corporations by offering enormous grants. Physicians, hospital, and universities want to win the race for technological prowess. Practitioners disguise their experiments as "therapy." All compromise by making themselves "gatekeepers," supposed to protect the patient (179). "Primary gatekeepers" are the medical establishment, who ignore safety data, write incompetent protocols, and lack technical expertise and sophisticated medical practice. "Secondary gate keepers" are the medical and administrative bureaucrats, like the government overseers who fund these experiments but are too august and sacred to submit to even an interview when the subjects die. "Tertiary gatekeepers" are the journalists, editors, peer reviewers, and social scientists who create unrealistic expectations of "wonder drugs," and "miracles," or just look on ("participant observation") with a patient tolerance that hopes for the best. All the gatekeepers meet, study, discuss, and fail to act responsibly.
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