Organ donation as transition work: Policy discourse and clinical practice in The Netherlands

Impact Factor:1.137 | Ranking:21/36 in Social Sciences, Biomedical | 81/136 in Public, Environmental & Occupational Health | 5-Year Impact Factor:1.396Source:2012 Journal Citation Reports® (Thomson Reuters, 2013)
An increasing number of patients become eligible for organ transplants. In the Netherlands, at the level of policy discourse, growing waiting lists are often referred to as a persistent “shortage” of organs, producing a “public health crisis.” In this way, organ donation is presented as an ethical, social, and medical necessity. Likewise, policy discourse offers a range of seemingly unambiguous solutions: improving logistical infrastructure at the level of hospitals, developing organizational and legal protocols, as well as public information campaigns. Instead of taking these problem and solution definitions as given, we critically examine the relationship between policy discourse and clinical practice. Based on a historical review, first, we trace the key moments of transformation where organ donation became naturalized in Dutch policy discourse, particularly in its altruistic connotation. Second, based on in-depth interviews with medical professionals, we show how those involved in organ donation continue to struggle with the controversial nature of their clinical practice. More specifically, we highlight their use of different forms of knowledge that underlie clinicians’ “transition work”: from losing a patient to “gaining” a donor.

© 2013 SAGE Publications. Los Angeles, London, New Delhi, Singapore and Washington DC

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U.S. watchdog allows delay to smooth transition to swaps trading

By Douwe Miedema

WASHINGTON, Sept 28 | Sat Sep 28, 2013 2:58pm EDT

WASHINGTON, Sept 28 (Reuters) - The U.S. derivatives regulator late on Friday gave a new and untested type of trading platform a bit more time to comply with some of its rules, to smooth the transition to regulated trading next week.

The Commodity Futures Trading Commission (CFTC) has been rushing through permits for the platforms - called Swap Execution Facilities - that must open their doors for customers on Wednesday.

The agency wanted to be ahead of a possible U.S. government shutdown next week, but has refused to give in to industry demands to delay the Oct. 2 deadline by which the newly created SEFs have to comply with its rules.

Swaps are complex financial contracts that can be used to offset financial risk, but are predominantly a favorite speculation tool for hedge funds, and were widely blamed for exacerbating the 2007-09 global financial crisis.

The new platforms are one measure to regulate the $630 trillion market - dominated by investment banks such as JP Morgan Chase & Co, Bank of America and Citigroup - to make it more transparent and less risky.

Late on Friday, the CFTC issued three letters delaying some of the strict new rules for the SEFs, which are run by large derivative brokers such as ICAP and GFI but also by Bloomberg LP and Thomson Reuters.

They can now delay trade reporting by one month for foreign exchange swaps, and by two months for equity and other commodity swaps, one of the letters said.

CFTC Chairman Gary Gensler said on Friday that there would be no delay for data reporting for fixed income and credit swaps, the bulk of the market.

The companies can also delay certain documentation and technological connectivity requirements, collectively known as onboarding, by up to a month.

A spokesman for Gensler said the onboarding delay would be for two weeks, but Commissioner Bart Chilton pushed for a two-month delay and the period was then extended at the last minute.

The delay in onboarding will be welcomed by SEF clients such as large asset managers who had complained there wasn't enough time to go through all the rule-books and make an informed choice who they wanted to do business with.

The third letter granted swap counterparties the same reporting delay as the SEFs, because the reporting by the former can depend on that by the latter.

The SEF rules ban the practice of privately negotiating swap deals - something that was largely done over the phone and was therefore hard to control.

Deals must now be entered into systems that are more like stock exchanges, though negotiating over the phone will still be allowed as long as buyers and sellers can prove that they have spoken to more than one counterparty. (Editing by Christopher Wilson)

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