Receiving an organ: The ambivalence of the debt and the question of giving back

Abstract

Taking the Maussian gift paradigm as its theoretical framework (to give-to receive-to repay), this article adopts an original approach to analysis of the lived experiences of organ recipients on an individual and psychological level. Clinically oriented interviews with 9 transplant patients and semi-structured interviews with a further 13 patients reveal the existence of four forms of mental processing around organ donations and the existence of a debt in three of these forms. These debts are ambivalent and recipients experience them both positively and negatively. Organ donation seems to fit into the gift paradigm in an original way inasmuch as, instead of repaying it directly, recipients settle their debt by giving back to others and by other means, whether to real people or to their fantasy donor. In order to improve the well-being of transplant patients, recommendations are set out for the biomedical agencies: a humanised donor discourse should be developed alongside the traditional mechanistic discourse around the body and long-term, multifaceted psychological support should be made available for transplant patients and their families. The marketing implications of our research are also put forward with a view to turning transplant patients into promoters of organ donation. The results are also transferred to other social marketing contexts. Finally, the gift exchange paradigm is proposed as a means of enriching marketing fundamentals in a society in which consumers are increasingly searching for connections and meaning beyond the goods and services they consume.