218 G. O’Brien
‘the gift’), recipients are compelled to assume practices of self-care that
are, in effect, a form of reciprocation (i.e. an appropriate ethical/moral
response for the gift received). As Sothern and Dickinson ( 2011 ) define
it, care is a relational practice: a shared accomplishment that involves
others (including unknown others), institutions and technologies in
complex relationships. They suggest that such practices are owed to the
broader community, including the donor/donor family, prospective
recipients, those who will not ever receive an organ, healthcare profes-
sionals and all of the various ‘systems’ entailed in transplantation. By
complying, the recipient demonstrates both worthiness of, and reci-
procity for, the gift received. This prescribed way of caring for the gift,
however, does not necessarily allow for the full scope of the transplant
experience to be acknowledged by the recipient.
It has been argued that adoption of the term ‘gift-of-life’ is aimed at
metaphorically reworking human organs and the practice of transplanta-
tion such that the reality of the organ’s origin is obscured, or imaginatively
‘mystified’, and the moral unease associated with the practice of trans-
plantation is quelled (Sharp 2001 ). Many scholars posit (e.g. Shaw et al.
2012 ; Siminoff and Chillag 1999 ; Sothern and Dickinson 2011 ) that
the scarcity issue underlies the ubiquitous use of the gift-of-life metaphor
across donation campaigns (with a view to increasing donation rates)
and healthcare settings (with a view to ‘enforcing’ recipients’ compliance
with immunosuppression regimens and other post-transplant treatment).
While the metaphor serves to foreground some aspects of transplanta-
tion such as the potential to ‘save’ lives, it relegates the death of the donor,
inherent risks of the surgical procedure, possibility that the ‘new’ organ
might fail to function or be rejected, and the numerous difficulties of liv-
ing with a transplanted organ, to the background (Gunnarson 2012 ).
Psychosocial Experiences of Organ
Transplantation
This chapter is based on research undertaken as part of a PhD project
at Murdoch University in Australia, exploring the lived experience of
organ transplantation and how recipients’ and prospective recipients’