Healy QOTD: An Organizational Approach to Organs

Kieran Healy’s (2006) Last Best Gifts: Altruism and the Market for Human Blood and Organs is a staggeringly good book.* Reading it, I’m reminded of the comparison between the Encyclopædia Galactica and the Hitchhiker’s Guide to the Galaxy, although that comparison here is totally inapt:

In many of the more relaxed civilizations on the Outer Eastern Rim of the Galaxy, the Hitchhiker’s Guide has already supplanted the great Encyclopaedia Galactica as the standard repository of all knowledge and wisdom, for though it has many omissions and contains much that is apocryphal, or at least wildly inaccurate, it scores over the older, more pedestrian work in two important respects.

First, it is slightly cheaper; and second, it has the words “DON’T PANIC” inscribed in large friendly letters on its cover.

Last Best Gifts (LBG) is not wildly inaccurate, and is not intended to be a comprehensive treatment of all knowledge and wisdom. But, like the Hitchhiker’s Guide, LBG is quick to read and, despite weighing in at just 132 pages (for the main text), doesn’t sacrifice in terms of depth or rigor.

Substantively, LBG examines the organization of blood and organ donation across the US and in international comparison. The book shows that organizational factors account for much of the difference in procurement rates, in contrast to (for example) evolutionary arguments for altruism, which may explain the existence of altruistic acts but not the wide variation across states or countries. In some ways, the book makes the most classic of sociological moves: it argues that a rate of individual behavior (organ donation) is not simply a consequence of individual characteristics, but of the organizational context of those actions. Healy explains this perspectival switch from existing literature clearly in the introduction and in a later chapter on cross-national variation in blood donation:

Put in its broadest terms, my argument is this: to understand this world of goods we must get away from the character and motives of individual donors and look instead to the cultural contexts and organizational mechanisms that provide people with reasons and opportunities to give. (2)

[B]lood can be seen not so much as something that individuals donate but as something that organizations collect. (71)

For details on the findings themselves, you’ll have to read the book. Fortunately, like the Hitchhiker’s Guide, LBG can be read in a single enjoyable sitting. Highly recommended for anyone looking for an excellent example of how to write an academic work of sociology that treats an important issue in a tractable way.

*I know I’m late to this particular party, but I’ll try to make up for it with effusive praise.

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