Susanne Lundin

The boundless body: Cultural perspectives on xenotransplantation

Abstract Todays technology is able to intervene in biological processes in a highly concrete way. Technology thus shapes and reshapes our world in a very special way, not just biologically but also culturally. This raises questions relevant to the cultural sciences. In this article I discuss biotechnology and cultural transformation by considering xenotransplantation. The focus is on patients who have received animal cells, and on their attempts to make it possible to handle both medical interventions and societys ideas about these technologies. This requires a shift from discourse analysis to a more action‐oriented analysis: to capture how people live the discourse. In this context, I view peoples bodies as meeting places for different figures of thought and practices. My initial assumption is that this requires a demystification of the body, that is, interpretations proceeding from diversity and flexibility rather than fixed categories.

Attitudes of Swedes to marginal donors and xenotransplantation

The aim of our survey was to capture the attitudes of Swedes to marginal donors and xenotransplantation. Modern biotechnology makes it possible to replace non-functioning organs, cells, and genes. Nonetheless, people may have reservations and fears about such treatments. With the survey, Attitudes of the General Public to Transplants, we have sought to expose the ambivalence that arises when medical possibilities are juxtaposed with ideas of risk. The design of the questionnaire originates from the interdisciplinary cooperation between ethnologists, medical scientists, and geneticists. By combining qualitative and quantitative methods, it is possible to illustrate the complexity that characterises people’s view of modern biomedicine. People’s reflections are based on a personal and situation bound morality, which does not necessarily coincide with what they generally consider as ethically justifiable.

Organ economy: organ trafficking in Moldova and Israel

Organ trafficking is an illegal means of meeting the shortage of transplants. The activity flourishes for several interacting reasons, such as medical needs, poverty and criminality. Other factors are fundamental conceptual structures such as the dream of the regenerative body as well as the view of the body as an object of utility and an object of value. The article aims to go behind the normative discussions that usually surround organ trafficking. Why this is happening, and what the societal consequences are, is examined through ethnographic fieldwork. The focus is on the shadow economies that govern existence and in which people, goods, weapons, money, bodies, etc. constitute components of the global market.

Creating identity with biotechnology: the xenotransplanted body as the norm

One of todays great issues is how an advanced medical technology like xenotransplantation should be applied. It is well known that medicine brings not only potential but also risk. On the cultural level, xenotransplantations are equally complicated; they arouse thoughts about whether our outlook on humanity will be influenced now that modern techniques can “correct” our defective bodies. The article asks whether xenotransplantation creates new cultural meanings. That is, how do newly emerging ideas of a technologically created normality raise a set of moral questions about nature and culture, mind and body? The discussion is based on interview studies with patients suffering from diabetes and Parkinsons disease. The former have been given porcine islets, while the others have had human fetal cells transplanted into the brain; the latter are also potential recipients of xenotransplants. This empirical material becomes the basis for discussing how diseases can lead to a crisis in which it is essential—on a concrete, everyday level—to find strategies for dealing with the consequences. In this process of identity and normalization, advanced biomedicine is an important factor.

Framing the public: the policy process around xenotransplantation in Latvia and Sweden 1970–2004

A crucial debate is under way concerning the publics participation in biotechnology decision-making processes. This study, concerning the policy process around xenotransplantation (XTP) in Latvia and Sweden in the period 1970–2004, focuses on how scientific experts and politicians view the public and the publics participation in the process of developing policy regarding XTP. Drawing on interviews with actors involved in XTP in each country, we analyse and explain the inclusion and exclusion of publics in policy decision-making processes. In particular, we highlight the significance of the role of scientists and politicians in generating discourses which exclude the public from participation in policy decision-making. Copyright , Beech Tree Publishing.

Genetics and democracy-what is the issue?

Current developments in genetics and genomics entail a number of changes and challenges for society as new knowledge and technology become common in the clinical setting and in society at large. The relationship between genetics and ethics has been much discussed during the last decade, while the relationship between genetics and the political arena—with terms such as rights, distribution, expertise, participation and democracy—has been less considered. The purpose of this article is to demonstrate the connection between genetics and democracy. In order to do this, we delineate a notion of democracy that incorporates process as well as substance values. On the basis of this notion of democracy and on claims of democratisation in the science and technology literature, we argue for the importance of considering genetic issues in a democratic manner. Having established this connection between genetics and democracy, we discuss this relation in three different contexts where the relationship between genetics and democracy becomes truly salient: the role of expertise, science and public participation, and individual responsibility and distributive justice. As developments within genetics and genomics advance with great speed, the importance and use of genetic knowledge within society can be expected to grow. However, this expanding societal importance of genetics might ultimately involve, interact with, or even confront important aspects within democratic rule and democratic decision-making. Moreover, we argue that the societal importance of genetic development makes it crucial to consider not only decision-making processes, but also the policy outcomes of these processes. This argument supports our process and substance notion of democracy, which implies that public participation, as a process value, must be complemented with a focus on the effects of policy decisions on democratic values such as distributive justice.

Organs for Sale An Ethnographic Examination of the International Organ Trade

After four years of queuing on the Swedish list for transplant kidneys, Sam was tired of waiting – he went to Pakistan and bought a new kidney. But where did the new kidney come from? And was the donation of the organ he received really voluntary? In this book, Susanne Lundin explores the murky world of organ trade, where desperate patients like Sam are small pieces in a big puzzle. In her ethnographic work, she tracks exploited farm workers in Moldova, prosecutors in Israel and surgeons in the Philippines. Utilizing unique source material she depicts a rapidly growing organ market characterized by both advanced medical technology and human trafficking.

Substandard and falsified medical products are a global public health threat. A pilot survey of awareness among physicians in Sweden

Abstract Background Substandard and falsified medical products are a public health threat, primarily associated with low- and middle-income countries. Today, the phenomenon also exists in high-income countries. Increased Internet access has opened a global market. Self-diagnosis and self-prescription have boosted the market for unregulated websites with access to falsified medicines. Aim To describe the state of knowledge and experience on SF medical products among emergency physicians (EPs) and general practitioners (GPs) in Sweden. Methods An online survey with anonymous answers from 100 EPs and 100 GPs. Physicians were recruited from TNS SIFO’s medical database. The term in the survey was ‘illegal and falsified medicines’ which was common in Sweden at that time. It corresponds well with the term ‘substandard and falsified medical products’ that the WHO launched shortly after our data collection. We report our results with this term. Results In Sweden, 78.5% of the physicians had heard the term ‘illegal and falsified medicines’ and 36.5% had met patients they suspected had taken it. Physicians lacked awareness of the use of the reporting system and wanted more knowledge about how to deal with patients who have possibly used falsified medicines. Conclusions To meet the public health threat of SF medical products, physicians need more knowledge.

The Brokers in Israel

When I finished my fieldwork in Moldova, I received information that the Moldovan doctor who organized the black organ market between Moldova and Turkey, had also built up an organ trafficking network in Israel. This was the beginning of my fieldwork in Israel. I cooperated with the state prosecutor in Nazareth who had brought the Moldovan doctor and his partners to justice. Through my contacts I had opportunities to interview sellers, buyers, and doctors. This chapter also discusses the specific situation that prevails in Israel — a country that, during my research turned out to have a key position in terms of medical travel.

The Sellers in Moldova

This chapter is based on those who sell their organs. Moldova is one of Europe’s poorest countries where a quarter of the population is abroad in search of work in the black market. Since a few years, this also applies to selling organs. Typically, these organ sellers are contacted at home in Moldova and then attracted to, for example, Turkey with the promise to earn big money. In the end it turns out that these people are forced to give away a kidney, either against a very small amount of money, or simply are being robbed of this body part.