9 Gift-of-life? The Psychosocial Experiences ... 231constructs donated organs (rather than medical treatments) as ‘gifts’.
A focus on what they have not received yet, a kidney, or on the more
negative aspects of their treatment is not likely to lead to the cognitive
processing (e.g. benefit-finding) that is associated with gratitude (Wood
et al. 2008 ).
All of the prospective kidney recipients were aware of gift-of-life
understandings of transplantation but discursively (re)defined trans-
plantation as the gift-of-freedom. Transplantation was thus relegated to
a lesser role in their ongoing treatment for ESRD. It meant freedom
from the inflexible routines that dialysis entailed, freedom from the
restrictions dialysis imposed on their lives and/or freedom from the
discomforts/pain/sickness that some experienced as a consequence of
dialysis. With respect to this redefined understanding of kidney trans-
plantation, it could, thus, be viewed as a less valuable ‘gift’ than dialysis
and less valuable relative to other (life-saving) organs. Prospective kid-
ney recipients’ understanding of transplantation as the gift-of-freedom
supports the view that the particular organ being received informs the
experience of transplantation and also that the gift-of-life understanding
of transplantation cannot be uniformly applied. Organ recipients and
prospective recipients are not best served by the routine application of a
generic, single and singular, model of transplantation that does not nec-
essarily ‘fit’ with their experience. This may be particularly so in health-
care settings where the application of a model that does not fit with
the experience of those involved is likely to have the most pronounced
influence.
Conclusion
It is important that a purely biomedical approach is not adopted when
attempting to understand health, illness and the effect of biotechnolo-
gies on the individual and his/her life: failure to recognise and acknowl-
edge the situatedness and contingencies of a person’s life can prove
detrimental to medical efficacy and appropriate care. Throughout my
research, I found that not all participants were telling the story that
one might expect: that is, ‘the gift-of-life story’, with morally expected
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