11 Valued Matter: Anthropological Insights ... 279Mexico—All of Our Futures?
I want to tease out, in this final section, how more complex compari-
sons might help us to arrive at a clearer understanding of the ways in
which different technological cultures produce different systems of
value. If the Mexican case is one which foregrounds an exploitative
political-economy via the disruptive character of transplant medicine,
transplant medicine in the UK, at least superficially, appears to reflect
back a smoother organisational infrastructure supported by a well-
entrenched welfare state.
Different to the interactional proximity of donor and recipient in
Mexico, the UK has relied on a system of deceased organ donation for
more than 50 years, a system fundamentally embedded within bureau-
cratic national governmental arrangements. The UK was one of the
first European countries to adopt a national programme of haemo-
dialysis, established in the context of a maturing welfare state. Funds
come directly from UK taxation and are delegated to the Department
of Health (DH). The provision of transplant services is enshrined in
the National Service Framework for Renal Services (NSF), which has
produced a standardised patient “pathway”, comprising a set of insti-
tutional “signposts”, incorporating patient referral and assessment, a
programme of preparation for starting Renal Replacement Therapies
(RRTs), which includes the provision of dialysis, transplantation and
end of life care. Unlike Mexican patients, British patients are made
aware of what they are entitled to and how their treatment will pro-
gress. Broadly reflective of the Weberian bureaucratic ideal, the organi-
sation and access of services can be described as predictable, routine and
with explicit formalisations of responsibility. What is more, the distri-
bution and spread of CKD in the UK is charted via the national Renal
Registry. Functioning as an apparatus for “seeing” CKD, its methods
are coeval with the techniques available for treating the condition. As a
site of knowledge production (Ruppert 2012 ), it systematically collects
and analyses data from Renal Units on the incidence, management and
outcome of renal disease. This integrated approach to counting renal
patients has produced a tightly governed population, with the incidence
of and treatment for CKD comprehensively mapped.
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