Spare parts : organ replacement in American Society / Renée C. Fox and Judith P. Swazey ; with the assistance of Judith C. Watkins.

Includes bibliographical references (pages 223-244) and index.

The developments that have occurred in the field of organ transplantation during the 1980s and early 1990s, and the simultaneous rise and fall of the Jarvik-7 artificial heart, are the subject of this vividly written and absorbing new book. In Spare Parts, fascinating, interconnected stories of organ transplantation and the artificial heart are recounted in an interpretive framework that explores the vision of "the replaceable body." Themes of uncertainty, gift exchange, and the allocation of scarce material and non-material resources underscore a discussion that openly examines the escalating ardor about the goodness of repairing and remaking people with transplanted organs. Likewise, the stories open questions of life and death, identity, and solidarity. This important book offers insights into the symbolic and anthropomorphic meanings associated with the human body and its organs, and into the ways that medical professionals come to terms with the concomitant aspects of transferring vital body parts. Both artificial and donor organs, as well as the process of transplantation, are the subject of a thoughtful discussion which touches on the medical myths and rituals that they generate. Chronologically, Spare Parts begins where the authors' previous book, The Courage to Fail leaves off. More than a sequel, however, this work reflects their increasingly troubled and critical reactions to the expansion of organ replacement. Likely to be controversial, this book is must reading for bioethicists, medical sociologists and anthropologists, health-care lawyers, planners, and administrators, nurses, physicians, medical journalists and science writers, and concerned lay readers

Introduction: Rebuilding People -- I. Organ Transplantation: Patterns and Issues in the 1980s. 1. Of Wonder Drugs, the Transplant "Boom," and Moratoria. The "Advent" of Cyclosporine. The Expansion of Organ Transplantation. The Experiment-Therapy Status of Organ Transplantation. A Multiplicity of Clinical Moratoria. The Coming of FK 506. 2. Organ Transplantation as Gift Exchange. Marcel Mauss' Gift-Exchange Paradigm. Obligations to Give Organs. Obligations to Receive Organs and Patients' Reservations About Accepting Them. Obligations to Receive Organs and Surgeons' Reservations About Live Donations. Obligations to Repay the "Gift of Life" and the "Tyranny of the Gift" 3. Alterations in the Theme of the Gift. Who Are My Kin? Who Are My Strangers? Live-Donor Kidney Transplants. The Debut of Live-Donor Liver and Lung Transplants. Making a Live Donor: Bone Marrow Transplants. Efforts to Increase Gifts of Life. From Gifts of Life to Market Commodities? 4. Transplantation and the Medical Commons. The Transplantation Commons. Transplantation and the Medical Commons. Transplantation, Medicine, and the Societal Commons -- II. The Jarvik-7 Artificial Heart Experiment. 5. Desperate Appliance: A Short History of the Jarvik-7 Artificial Heart. Cast of Characters and Their Locales. Prologue. Act I: The Development of the Jarvik Heart. Act II: Barney Clark's Heart. Act III: The Move to Humana. Act IV: The Experiment Continues. Entr'acte: The Artificial Heart as a Bridge to Transplant. Act IV: Continued. Act V: Endings. Epilogue. 6. "Made in the U.S.A.": American Features in the Rise and Fall of the Jarvik-7 Artificial Heart. American Places, Portraits, and Scenarios. American Astronaut Imagery. The American Land of Oz. Factors Shaping the American Features of the Artificial Heart Experiment. Meanings of the Heart. The Role of Mormonism. Corporate Connections. The Rise and Fall of Cold Fusion. 7. Who Shall Guard the Guardians? Initiating Human Testing. Jarvik-7 Implants as Clinical Research. The Gatekeepers. Moratoria and Endings -- III. The Participant Observers: Final Journeys. 8. Leaving the Field.

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