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Last Best Gifts: Altruism and the Market for Human Blood and Organs, by Kieran Healy. Chicago, IL: The University of Chicago Press, 2006. 193pp. $20.00 paper. ISBN: 0226322378.
Donations of blood, tissue, and organs save lives and restore health. Yet, even in rich countries, the promise of these medical miracles remains unfulfilled because of perennial shortages of donors. Because most organs and tissue come from cadavers, the life-saving gift of an organ typically follows a death. How then can supply be increased-and increased without reducing quality or cutting corners on full, informed consent of donors? Would it be wise to introduce more monetary incentives or should blood, tissue, and organs be treated as gifts?
These questions have been explored by philosophers, ethicists, legal scholars, and economists. Last Best Gifts will delight sociologists, though, because it confirms our discipline's most cherished article of faith: the action really is at the social level. Where others have focused on incentives and altruism, Healy looks instead at "the cultural contexts and organizational mechanisms that provide people with reasons and opportunities to give" (p. 2).
After a first chapter reviewing arguments about commodification of the body and the relationship between incentives and action, Healy considers a series of empirical puzzles about the cultural acceptability of organ donation, U.S. regional variations in organ donation rates, European national variations in blood donation rates, and the purity of American blood products coming from...