9 Gift-of-life? The Psychosocial Experiences ... 225general principles in the allocation of scarce resources, in which people
judged ‘irresponsible’ arouse less pity and sympathy, more disgust and
distaste and are considered less deserving of scarce healthcare resources
than those with uncontrollable and/or external causes of need for help
(Skitka and Tetlock 1992 ). Liver recipients are more susceptible to sus-
picions of ‘bad’ (antisocial/unhealthy/unworthy) behaviour than recipi-
ents of other organs, and such judgements of ‘undeservingness’ have
significant consequences for their experience of transplantation.
The male liver recipients (five of the six liver recipients) in my
research demonstrated a resistance to health discourse and to worthi-
ness narratives more generally. While the female liver recipient and
prospective recipient had ‘justifiable’ reasons for their liver disease (i.e.
both reported their liver failure was the result of a disease/infection they
had contracted), and were consequently able to find a place for them-
selves in the ‘deserving and grateful’ narrative, the male recipients did
not attempt to stake a claim to being worthy of the gift. They openly
acknowledged a pre-transplant lifestyle that incorporated practices not
in keeping with social understandings of a healthy (i.e. moral) life. All
described themselves, in various ways, as being ‘big drinkers’ and some
also spoke of many years of drug use. They often reinforced the view
that overuse of alcohol, and other drugs, was typical of people who
needed liver transplants. Despite reproducing this stereotype themselves
in their discussions around liver transplantation, these liver recipients
also appeared sensitive to the public’s judgement of them. Doug, for
example, reported: ‘With alcoholism, you know ... Um, there’s a big,
there’s a lot of stuff, judgmental stuff goes on about that, you know ...
[The public ask] “Why are you wasting organs on eeuuww?” [grimaces]’.
He later stated: ‘[The public think] “You’re not perfect, you shouldn’t
have that” ... Are, are you worthy of that gift?’ The liver recipients
indicated their understanding that those with alcohol-related liver dis-
ease are judged and found wanting, and the general public are sceptical
about their worthiness of receiving a transplant.
The gift-of-life metaphor emphasises the magnitude of the exchange
that occurs in organ transfer and firmly establishes the transplant story
as one that entails gratitude. Although normatively expected in the
context of transplantation, the moral imperative to be grateful was not
http://www.ebook3000.com