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Dynamic contradictions: Social representations, symbolism, and organ donation and transplantation

Moloney, Gail (2002) Dynamic contradictions: Social representations, symbolism, and organ donation and transplantation. PhD thesis, Murdoch University.

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Abstract

On December 3rd, 1967, Dr Christian Barnard performed the world's first human heart transplant. This medical milestone propelled the technique of organ transplantation into the public arena, and simultaneously created a need for human organs that has never been met.

The disparity between the numbers of organs needed for transplantation and the numbers of organ donated has generated substantial research. Most of this research has focused on individual characteristics and behaviours in an attempt to understand the individual's decision to donate. In contrast, the research in this thesis emanates from the position that we must first investigate how organ donation and transplantation is socially understood.

The theory of social representations (Moscovici, 1984) proclaims an interdependence between the individual and the social, and their inseparability in the construction of social knowledge. Conceptualised thus, organ donation and transplantation moves from being understood in terms of an individual decision to a socially derived way of understanding a medical practice. Thus, the focus of the research presented in this thesis is a holistic conceptualisation of organ donation and transplantation as socially constructed knowledge.

Three studies were conducted, each addressing this issue from a different methodological perspective. The first study, which was exploratory in nature, investigated whether there was a representation pertaining to organ donation and organ transplantation, and traced the development of the representation through the printed media. Drawing from research into the structural properties of a representation (Abric, 1993, 1996), and the notions of themata, anchoring and objectification (Moscovici, 1984, 1993), the findings from this study set the direction and design of the two studies that followed. The main finding from this study was the suggestion that what was initially considered to be two representations was better understood as one representational field organised around conflicting images of organ donation and transplantation as a Gift of Life and the Mechanistic removal and replacement of body parts.

The findings, however, from the first study suggested a stasis to the representational field that did not accommodate the dynamism implied. Thus, the second study extended the findings of the first study and investigated the representational field through discourse from focus group discussions. The theoretical position here conceptualised consensus as consensual reality (Rose et al., 1995), and investigated the suggestion that the core of the representation is hierarchically arranged into normative and functional dimensions (Guimelli, 1998). The findings from this second study evidenced the contradictory nature of discourse around the issue of organ donation and transplantation. These were discussed in light of Billig' s (1988) rhetorical position of the role of argumentation in social thinking. The co-existence of contradiction was suggested through the differential elicitation of the normative and functional dimensions of the core (Guimelli, 1998).

The final study extended the findings of both earlier studies through a delineation of the core and peripheral elements within the representational field so as to specifically investigate the dynamic co-existence of contradiction within the one representational field. The study employed a mail-out questionnaire embedded with 8 experimental conditions. This manipulated two tasks, scenario and rating scale and word association, in order to investigate the elicitation of the representation in accordance with context. This study developed the notion of themata (Markova, 2000), the role of contradiction in a representation (Wagner et al., 2000), reflexive and non-reflexive thought, and an understanding of consensus as consensual reality (Rose et al., 1995).

The major conclusion of the thesis is that an investigation of the issue of organ donation and transplantation within the theoretical framework of social representations theory (Moscovici, 1984) reveals a contradictory representational field organised around the dialectical notions of Life and Death, emanating as two, seemingly contradictory, images of organ donation and transplantation as a Gift of Life and the Mechanistic removal and replacement of body parts. Moreover, the co-existence of this contradictory representational field is maintained through the differential elicitation of the normative and functional dimension of the representation in accordance with social context.

An integration of the findings within the theoretical tenets of social representations theory is given, addressing the interdependence between the representational process and what is being represented. The practical implications of these findings as they relate to the societal issue of organ donation and transplantation are also discussed.

Item Type: Thesis (PhD)
Murdoch Affiliation: Division of Social Sciences, Humanities and Education
Notes: Note to the author: If you would like to make your thesis openly available on Murdoch University Library's Research Repository, please contact: repository@murdoch.edu.au. Thank you.
Supervisor(s): Walker, Iain
URI: http://researchrepository.murdoch.edu.au/id/eprint/51279
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