22 R.M. Shaw
discuss a range of issues in relation to decision-making around deceased
donation in the Intensive Care Unit context: the determination of death
and the perception by donor families that death is more than simply
biological, the welfare of the patient in relation to end-of-life care, ques-
tions around the salience of bioethical principles such as beneficence,
autonomy and consent, the allocation of scarce resources in relation to
cultural sensitivities and difference, and the question of competing inter-
ests between healthcare staff and families in a context of organ scarcity.
In their discussion, Coombs and Woods identify a series of dilemmas
encountered by families and healthcare staff in this environment, to con-
clude their chapter with recommendations for practice and policy.
Ciara Kieran’s chapter, which directly engages with the concept of
value as a way of thinking about the costs and benefits associated with
medical technologies, focuses attention on the strategies of uninsured
living-related kidney donors in Mexico and their kin recipients’ access
to organ transplantation procedures. Kierans draws on anthropologi-
cal scholarship and STS to argue that the political economy of organ
exchange in Mexico produces surplus value from the bodies and labour
of transplant recipients and their donors. The author’s contention is that
there are broader lessons to be learned from the Mexican case for think-
ing about the changing character of organ exchange elsewhere, with par-
ticular reference to the National Health Service in the UK.
Part IV: Breastmilk Exchange
The somatic ethics of breastfeeding and breastmilk exchange are his-
torical and wide ranging in scope. The discourses associated with
these practices, as well as public opinion around breastmilk exchange,
are never neutral. Contemporary media commentaries about pub-
lic breastfeeding, for example, tell us a great deal about gender and
women’s place in society, their citizenship rights and what women are
permitted to do in public spaces. Likewise, the debates about peer-to-
peer milk sharing and human milk donation alert us to the visibility
and invisibility of women’s embodied affective and reproductive labour.
Additionally, although breastfeeding is typically regarded as a natural
process associated with cisgender women, their biological infants, and
http://www.ebook3000.com