Directed altruistic living donation : what is wrong with the beauty contest?

This paper explores the specific criticism of directed altruistic living organ donation that it creates a ‘beauty contest’ between potential recipients of organs. The notion of the beauty contest in transplantation was recently used by Neidich et al who stated that ‘altruism should be the guiding motivation for all donations, and when it is, there is no place for a beauty contest{\textquoteright}. I examine this beauty contest objection from two perspectives. First, I argue that, when considered against the behaviour of donors, this objection cannot be consistently raised without also objecting to other common aspects of organ donation. I then explore the beauty contest objection from the perspective of recipients, and argue that if the beauty contest is objectionable, it is because of a tension between recipient behaviour and the altruism that supposedly underpins the donation system. I conclude by briefly questioning the importance of this tension in light of the organ shortage

Visual Mapping of Identity: Negotiating Ethnic Identity

Purpose — the paper offers a novel participatory visual research method, the Mapping Of Identity (MOI) protocol that embraces the complex nature of contemporary consumers’ lived reality. Design/methodology/approach — the MOI protocol is a two phase methodology. The first phase includes collage creation, based on a taxonomy of attachments, followed by an elicitation interview structured around the participant’s collage. In phase two, the categories elicited in phase one are synthesised into key themes in collaboration between the researcher and the participant. Findings — MOI methodology provides an effective platform for participants to bring together disjointed memories, fragments and thoughts. Two individual cases are presented that seem similar on the surface; however, when deconstructing these narratives, their lived experiences and the effect that these narratives have on the construction of the self are very different. Treating participants as co-researchers and letting the choices they make in their collage creation lead the interview empowers the participant and enables the researcher to better understand their complex identity articulations. Originality/Value —marketing literature recognises the complex nature of contemporary lived reality; however, some of the intricate aspects of this reality have not been dealt with in all their complexity. A reason for this gap is the paucity of suitable research methods. The MOI protocol presented in this paper addresses this, providing an effective visual tool to explore the complex web of contemporary consumer life. Keywords: Visual Narratives; Collage Elicitation; Mind Mapping; Participatory Researc

South-west Essex-M25 corridor: applied geology for planning and development

This study was commissioned by the Department of the Environment and Lnded jointly by the Department and the British Geological Survey (BGS). Its principal aim was to produce a synthesis of geological information relevant to the planning of land use and development in south-west Essex and that part of the London Borough of Havering adjacent to the M25 London Orbital Road. This report was written specifically for those involved in planning and development. Geological terms have been kept to a minimum, but for those that are necessary a glossary is appended. Much of the information is provided by a series of thematic maps, each one highlighting a specific aspect of the geology. For those requiring a greater depth of geological background, additional sources of information relevant to the area are indicated

Empathy, social media and directed altruistic living donation

In this paper we explore some of the ethical dimensions of using social media to increase the number of living kidney donors. Social media provides a platform for changing non-identifiable ‘statistical victims’ into ‘real people’ with whom we can identify and feel empathy: the so-called ‘identifiable victim effect’, which prompts charitable action. We examine three approaches to promoting kidney donation using social media which could take advantages of the identifiable victim effect: i) institutionally organised campaigns based on historical cases aimed at promoting non-directed altruistic donation; ii) personal-case based campaigns organised by individuals aimed at promoting themselves/or someone with whom they are in a relationship as a recipient of directed donation; iii) institutionally organised personal-case based campaigns aimed at promoting specific recipients for directed donation. We will highlight the key ethical issues raised by these approaches, and will argue that the third option, despite raising ethical concerns, is preferable to the other two

Should We Reject Donated Organs on Moral Grounds or Permit Allocation Using Non-Medical Criteria?:A Qualitative Study

Conditional and directed deceased organ donations occur when donors (or often their next of kin) attempt to influence the allocation of their donated organs. This can include asking that the organs are given to or withheld from certain types of people, or that they are given to specified individuals. Donations of these types have raised ethical concerns, and have been prohibited in many countries, including the UK. In this article we report the findings from a qualitative study involving interviews with potential donors (n = 20), potential recipients (n = 9) and transplant staff (n = 11), and use these results as a springboard for further ethical commentary. We argue that although participants favoured unconditional donation, this preference was grounded in a false distinction between ‘medical’ and ‘non-medical’ allocation criteria. Although there are good reasons to maintain organ allocation based primarily upon the existing ‘medical’ criteria, it may be premature to reject all other potential criteria as being unacceptable. Part of participants' justification for allocating organs using ‘medical’ criteria was to make the best use of available organs and avoid wasting their potential benefit, but this can also justify accepting conditional donations in some circumstances. We draw a distinction between two types of waste – absolute and relative – and argue that accepting conditional donations may offer a balance between these forms of waste

Altruism in organ donation:an unnecessary requirement?

Altruism has long been taken to be the guiding principle of ethical organ donation in the UK, and has been used as justification for rejecting or allowing certain types of donation. We argue that, despite this prominent role, altruism has been poorly defined in policy and position documents, and used confusingly and inconsistently. Looking at how the term has been used over recent years allows us to define ‘organ donation altruism’, and comparing this with accounts in the philosophical literature highlights its theoretical shortcomings. The recent report from the Nuffield Council on Bioethics reaffirmed the importance of altruism in organ donation, and offered a clearer definition. This definition is, however, more permissive than that of altruism previously seen in UK policy, and as a result allows some donations that previously have been considered unacceptable. We argue that while altruistic motivation may be desirable, it is not necessary

Global kidney exchange : opportunity or exploitation? An ELPAT/ESOT appraisal

This paper addresses ethical, legal, and psychosocial aspects of Global Kidney Exchange (GKE). Concerns have been raised that GKE violates the nonpayment principle, exploits donors in low‐ and middle‐income countries, and detracts from the aim of self‐sufficiency. We review the arguments for and against GKE. We argue that while some concerns about GKE are justified based on the available evidence, others are speculative and do not apply exclusively to GKE but to living donation more generally. We posit that concerns can be mitigated by implementing safeguards, by developing minimum quality criteria and by establishing an international committee that independently monitors and evaluates GKE’s procedures and outcomes. Several questions remain however that warrant further clarification. What are the experiences and views of recipients and donors participating in GKE? Who manages the escrow funds that have been put in place for donor and recipients? What procedures and safeguards have been put in place to prevent corruption of these funds? What are the inclusion criteria for participating GKE centers? GKE provides opportunity to promote access to donation and transplantation but can only be conducted with the appropriate safeguards. Patients’ and donors’ voices are missing in this debate

Global Kidney Exchange: opportunity or exploitation? An ELPAT/ESOT appraisal

This paper addresses ethical, legal, and psychosocial aspects of Global Kidney Exchange (GKE). Concerns have been raised that GKE violates the nonpayment principle, exploits donors in low- and middle-income countries, and detracts from the aim of self-sufficiency. We review the arguments for and against GKE. We argue that while some concerns about GKE are justified based on the available evidence, others are speculative and do not apply exclusively to GKE but to living donation more generally. We posit that concerns can be mitigated by implementing safeguards, by developing minimum quality criteria and by establishing an international committee that independently monitors and evaluates GKE’s procedures and outcomes. Several questions remain however that warrant further clarificati

The Middle Pleistocene glacial evolution of northern East Anglia, UK: a dynamic tectonostratigraphic-parasequence approach

The Middle Pleistocene glacial history of northern East Anglia is a controversial topic with differing opinions surrounding chronology, provenance and the relative stratigraphic framework. Reconciling the stratigraphic framework of the region is an essential first step to developing onshore–offshore geological models and a robust event-driven chronological framework. Within this study a dynamic tectonostratigraphic–parasequence methodology is applied to deposits traditionally attributed to the Anglian Glaciation (Marine Isotope Stage 12). This approach offers an insight into ice-bed coupling during glaciation and how evolving boundary conditions influenced glacier dynamics. Six major tectonostratigraphic–parasequence assemblages (A1–A6) are recognized in northern East Anglia and correlate with successive advances into the region of North Sea or Pennine lobes of the British Ice Sheet. Individual tectonostratigraphic–parasequence assemblages are bound at their base by a sedimentary contact or, more commonly, a glacitectonic zone. The geometry and structural characteristics of these glacitectonic zones reflect temporal and spatial variations in ice-bed coupling (traction), a function of substrate rheology and, in turn, variations in lithology, porewater availability and thermo-mechanical properties. The role of permafrost may also be significant, promoting proglacial/ice-marginal thrust stacking in front of advancing ice and enhanced ice-bed decoupling during subsequent overriding and subglacial till accretio