Matching Organs with Donors by Marie-Andrée Jacob

Author:Marie-Andrée Jacob [Jacob, Marie-Andrée]
Language: eng
Format: epub
Tags: Social Science, Anthropology, General, Law, Medical Law & Legislation
ISBN: 9780812206500
Google: 3CNwE7tDMrsC
Publisher: University of Pennsylvania Press
Published: 2012-08-16T04:24:28+00:00

Out of the Committee, in the Corridor

By focusing on the contrast between documents and verbal communication in the business of committees, one can learn about the potential and limits of documentary forms. This contrast is made visible through a specific artifact: not actual files or forms, but the practice of “passing documents” from the transplant unit into the family committee. As discussed by expert members of the family committee, but in contrast to what some other theorists of documentation practices argue, documents do not necessarily subjugate agents.33 Further, this section inquires how limits of documents put ethnographies of documentary forms to the test.

It is common for staff to discuss a file while transmitting it from the transplant unit to the family committee. Because she is a member of the family committee, Nili cannot be part of the transplant unit itself, again given the concern about conflict of interest. She knows the staff of the transplant unit very well, though, and receives helpful insights from them about cases to be discussed by the family committee: “We know each other; sometimes they tell us their evaluation verbally, by heart, they tell us if there is something in the case they are not at peace with … it is not like a blood test, that is it ok or not ok, there are false positives … so they just want to make sure that we will give special attention.”

Nili reflected on the case of the wife who opposed her husband’s provisional plan to donate a kidney to his mother, on which I elaborated above. To Nili, this donation received an approval, because she and other committee members did not get to hear enough information about the case directly from the transplant unit. The problem “was only written in the file, but we had not heard it orally. Sometimes they also tell us about it.” Hearing the information in person is critical: “Sometimes Sarah tells me as a friend … when you get the info in vivo, I think it means there is something more to it.”

Even though Stanley Raffel defines a fact as a relation between a record and an event,34 and despite recorded facts’ reliability in bureaucratic and legal circles, files come second to the informal and unrecorded “truth” of corridor conversations, with regard to their impact on decision-making. Parallel to files’ routes and documents’ careers, an informal channel of information runs through the transplant milieu,35 where people warn each other verbally about the seriousness and “touchiness” of certain cases or tell each other to pay attention to certain cases. This parallel system of verbal contacts seems to be the one that is most professionally trusted and hence relied on to make “progress” on decisions, to the extent that problems mentioned only in the file are not considered so crucial. The medical file itself, where information is piled up and even duplicated, does not flag issues sufficiently. This makes clear the limits of documents and files as vectors of information in bureaucracies.

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