11 Valued Matter: Anthropological Insights ... 269transplant medicine elsewhere for granted, and to show instead how a
comparative perspective can open up and focus in on alternative modes
of value-making.
Ethnographic Focus
This chapter draws on ethnographic fieldwork conducted in Mexico
during 2011 and 2012, the aim of which was to document the
ways in which Mexico’s uninsured population of Chronic Kidney
Disease (CKD) patients attempt to access intermediate forms of
Renal Replacement Therapy (RRT) and, ultimately, an organ trans-
plant. Access to this population was via the nephrology department
at the Hospital Civil de Guadalajara. The research strictly adhered
to the ethical codes of practice set out in the requirements of the
American Anthropological Association and the Association of Social
Anthropologists, UK. Both written and verbal consent were taken.
Consent was verbal in cases where participants were uncomfortable
providing a signature on forms, suspicious of bureaucratic processes
or during informal ethnographic interviewing where it was not always
appropriate to request written consent. Ethics approvals were awarded
by the University of Liverpool and the Hospital Civil de Guadalajara
research ethics committees.
An important aspect of the study was to examine transplant medi-
cine within its political economic context: in this case, one where access
to health care is administered via a complex social welfare system, con-
tingent on labour-market position and where market-driven approaches
increasingly overlap with state-supported infrastructures (Eibenschutz
et al. 2008 ; Garcia-Garcia et al. 2010 ; Kierans et al. 2013 ). Under this
system, salaried workers in the private sector have health insurance pro-
vided by Instituto Mexicano de Seguro Social (IMSS, Mexican Institute
of Social Security). IMSS is Mexico’s largest healthcare provider and
supports 44% of the population. Those working for the State, i.e. civil
servants and federal workers, some 5% of the population, are cov-
ered by Instituto de Seguridad y Servicios Sociales de los Trabajadores
de Estado (ISSSTE, Institute of Social Security and Services for Civil
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