El comercio infame: capitalismo milenarista, valores humanos y justicia global en el tráfico de órganos

This article documents the growth of “transplant tourism” and the global traffic in human bodies, desires, and needs. Organ transplantation today takes place in a transnational space with surgeons, patients, donors, sellers and brokers following new paths of capital and technology. In general, organs flow from South to North, from third to first world, and from poorer to richer bodies, and from black and brown to whites and from females to males. The “scarcity” of organs and tissues combined with the scarcity of patients of sufficient means to pay for these expensive operations, has spawned a lucrative business driven by the market calculus of supply and demand. The spread of new medical technologies and the new needs, scarcities, and commodities –for instance, fresh organs and tissues– that they inspire raises urgent public issues concerning: the reordering of relations between bodies and the state in late modernity; the appearance of “fluid” and divisible bodies that disrupt early modern notions of the indivisible and autonomous body-self; the emergence of new forms of barter and social exchange that breach the conventional dichotomy between gifts and commodities and between kin and strangers; the interplay of magic and science; and the power of rumours and urban legends to challenge the official medical and transplant “narratives” on the meanings of life, death, and sacrifice.Este artículo documenta el crecimiento del “turismo de transplante” y el tráfico global de cuerpos, deseos y necesidades humanas. El transplante de órganos tiene lugar hoy en día en un espacio transnacional en el que circulan cirujanos, pacientes, donantes, vendedores e intermediarios que siguen los nuevos caminos del capital y de la tecnología. En general, los órganos fluyen de sur a norte, del tercer al primer mundo, de los cuerpos más pobres a los más ricos, de negros y cobrizos a blancos, y de mujeres a hombres. La “escasez” de cuerpos y tejidos, en combinación con la escasez de pacientes con medios suficientes para pagar estas costosas intervenciones, han hecho surgir un lucrativo negocio impulsado por el cálculo de oferta y demanda de mercado. La extensión de nuevas tecnologías médicas y las nuevas necesidades, escasez y mercancías –por ejemplo, órganos y tejidos frescos– que inspiran, hacen surgir debates públicos de carácter urgente, relacionados con: la reordenación de las relaciones entre los cuerpos y el Estado en la modernidad tardía; la aparición de cuerpos “fluidos” y divisibles que ponen en cuestión nociones de la primera modernidad acerca de lo indivisible del cuerpo –self–; la aparición de nuevas formas de trueque e intercambio social que rompen la dicotomía convencional entre dones y mercancías y entre parientes y extraños; el juego mutuo entre magia y ciencia; y el poder de los rumores y leyendas urbanas de plantear un reto a las “narrativas” oficiales médicas y de transplantes acerca de los significados de la vida, de la muerte y del sacrificio

Is It Ethical for Patients with Renal Disease to Purchase Kidneys from the World's Poor?

Background to the debate: In many countries, the number of patients waiting for a kidney transplant is increasing. But there is a widespread and serious shortage of kidneys for transplantation, a shortage that can lead to suffering and death. One approach to tackling the shortage is for a patient with renal disease to buy a kidney from a living donor, who is often in a developing country, a sale that could—in theory at least—help to lift the donor out of poverty. Such kidney sales are almost universally illegal. Proponents of kidney sales argue that since the practice is widespread, it would be safer to formally regulate it, and that society should respect people's autonomous control over their bodies. Critics express concern about the potential for exploitation and coercion of the poor, and about the psychological and physical after-effects on the donors of this illegal kidney trade

Preparing Our Kids for Education, Work and Life: A Report of the Task Force on Youth Aging Out

Summarizes a study of Massachusetts youth transitioning out of foster care, and offers recommendations for policies, practices, and resource conditions, including "Five Core Resources" to prepare them for higher education, work, and adulthood

Citizens’ Juries: When Older Adults Deliberate on the Benefits and Risks of Smart Health and Smart Homes

open access articleBackground: Technology-enabled healthcare or smart health has provided a wealth of products and services to enable older people to monitor and manage their own health conditions at home, thereby maintaining independence, whilst also reducing healthcare costs. However, despite the growing ubiquity of smart health, innovations are often technically driven, and the older user does not often have input into design. The purpose of the current study was to facilitate a debate about the positive and negative perceptions and attitudes towards digital health technologies. Methods: We conducted citizens’ juries to enable a deliberative inquiry into the benefits and risks of smart health technologies and systems. Transcriptions of group discussions were interpreted from a perspective of life-worlds versus systems-worlds. Results: Twenty-three participants of diverse demographics contributed to the debate. Views of older people were felt to be frequently ignored by organisations implementing systems and technologies. Participants demonstrated diverse levels of digital literacy and a range of concerns about misuse of technology. Conclusion: Our interpretation contrasted the life-world of experiences, hopes, and fears with the systems-world of surveillance, e ciencies, and risks. This interpretation o ers new perspectives on involving older people in co-design and governance of smart health and smart homes

Frontline direct care workers experiences of providing domiciliary care towards the end of life:a systematic literature review and narrative synthesis

Background An ageing population heralds a greater demand for palliative and end of life care. Many people approaching the end of life rely on domiciliary care services provided by a para-professional workforce. Despite low pay and status, these workers provide personal and social care to people at a difficult time in their lives. Little is known about the impact of this work on the workers themselves or how they are trained, supervised and supported. Methods A systematic search was conducted in six databases. All study designs were included. Titles and abstracts of retrieved papers were screened by two researchers working independently. Findings were analysed using a narrative synthesis approach. Results Of 747 retrieved references, 12 papers from six countries in four continents were selected for inclusion in the review. Few studies dealt directly with the experiences of direct care workers themselves. Most considered them as part of multi-professional care networks with many focusing on issues relating to the professionals involved in the teams under consideration. Internationally and within nations, workers job titles varied and in some cases obscured job role. Where this role was clear, there was much overlap between domestic, personal, social and health related tasks. There was little evidence of a consistent approach to training and supporting staff involved in care towards the end of life and a paucity of ‘voice’ for these workers in published studies. Conclusion The experiences of direct care workers in palliative homecare is poorly studied. There is considerable variability in how workers are named, the work they do, and who they report to. More research that privileges the voice of these workers and identifies the impact on them of caring for those approaching the end of life is required so that employing agencies may consider how to improve the training, supervision and support of this essential frontline workforce

Listening to the Outliers: Refining the Curriculum for Dissertation Camps

Seeking to support graduate student writers, writing centers at research universities have developed highly successful dissertation camps over the past 15 years. Previous research from North American dissertation camps has demonstrated significant benefits from these camps, as dissertation writers developed new writing habits and increased their productivity. In this study, however, a closer look at initial and follow-up survey responses provided by participants from dissertation camps at two institutions—an Upper Midwestern university in the United States that has held camps for 11 years and an Eastern European university that held an online camp during the 2020 pandemic—suggests that focusing on the positive responses may obscure some telling tensions between dissertation camps’ benefits and limitations. Our research reveals tensions around four key parts of dissertation camp curricula—developing writing habits and schedules, sustaining a community of writers, focusing on the drafting stage, and emphasizing cross- disciplinary participation. Listening more deeply to these outlier responses sheds valuable light on the affordances and limitations of dissertation writing camps and on how the curricula of dissertation camps might be reimagined to better articulate and embrace those tensions

Navigating in large hospitals

Navigating around large hospitals can be a stressful and time-consuming experience for all users of the hospital infrastructure. Navigation difficulties encountered by patients and visitors can result in missed appointments or simply create a poor impression of the hospital organisation. When staff encounter navigation difficulties this can lead to cost and efficiency issues and potentially put patient safety at risk. Despite the provision of an array of in-hospital navigational aids, ‘getting lost’ continues to be an everyday problem in these large complex environments. This study aims to to identify factors which affect navigation in hospitals. We do not seek to evaluate the effectiveness of a single navigation aid, instead the objective of this study was to understand the environment in which a new system must operate and the gaps in provision left by existing navigation aids. This study is intended to be used to inform the development of new in hospital navigational aids, be they technological or otherwise. Eleven participants, all users of a large hospital site, were asked to describe specific first hand experiences of navigating in a hospital. The ‘Critical Incidence Technique’ was applied in a series of semi-structured interviews to elicit information about a participants navigation experience. This work presents the results of these interviews, with concepts identified and organised into five themes: The ‘Impact’ of poor navigation, ‘Barriers’ to effective navigation, ‘Enhancers’ for effective navigation, ‘Types of Navigation Aids’ and user groups with ‘Specific Navigational Needs’. The number of navigation aids available to participants was identified as an issue in itself, we found examples of thirty seven distinct sources of information available to a hospital user. We begin by introducing previous work on in-hospital navigation before describing the study design employed in this research. The themes and categories identified from the interview data are enumerated and described, with examples given from the interview transcripts. Finally we go on to give a discussion of some potential navigation solutions in light of the identified factors. This study highlights that a candidate navigation aid must be carefully designed and implemented if it is to compliment the thirty seven other sources of navigation information available to the hospital user