Structured Forgetting and the Social Organization of Kidney Exchange in Ontario
Bibliographic record
Abstract
Theoretical resources regarding the creation of objects and orientations in ideology and material practice are drawn on to develop an original, theoretical account of organ transplantation. This analytical lens is then used to advance understanding of the social relations that enable and inhibit the exchange of kidneys for transplantation. The argument is that customary claims about how to increase organ donation, set within an altruism versus market framework, deflect attention from a significant variable: the legitimacy and limits of removing kidneys from their owners – in other words, alienability. Two sets of rules are revealed, with one set, the rules of altruism, requiring and eliciting public engagement, and the other set, the rules of alienability, being pushed by experts within their realm of authority. Both sets of rules demarcate boundary lines through a fundamental tension between recipients, intermediaries and donors that is demonstrated to be imbalanced by a recipient-centric orientation. As a result, public discourse is focused on a small set of variables and distanced from a far more complex set of dynamics predominantly emerging from the relationality of donors and recipients.Seeing the deflection of attention challenges both the legitimacy of conventional wisdom about transplantation, especially as it informs public policy, and the common view of a complete distinction differentiating altruism from capitalist modes of body part exchange. It also raises new questions about persuasion and public knowledge that trouble altruism, and shows how efforts to alleviate the suffering of some, (potential) recipients, has largely unintentionally led to a structured forgetting of the suffering of others, (potential) donors. This is demonstrated for both deceased donation and living donation using a case study of one organ, the kidney, in one jurisdiction, Ontario, Canada, from 2000 to 2014, with a focus on donors and intermediaries.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.025 | 0.009 |
| Scholarly communication | 0.005 | 0.002 |
| Open science | 0.001 | 0.006 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".