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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Engineering the fitness of older patients for chemotherapy: An exploration of Comprehensive Geriatric Assessment in practice

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)
Alexandra L McCarthy al.mccarthy{at}qut.edu.au

Institute of Health and Biomedical Innovation, Queensland University of Technology; Division of Cancer Services, Princess Alexandra Hospital, Australia Peta S Cook

University of Tasmania, AustraliaPatsy Yates

Institute of Health and Biomedical Innovation, Queensland University of Technology; Division of Cancer Services, Princess Alexandra Hospital, Australia Clinicians often report that currently available methods to assess older patients, including standard clinical consultations, do not elicit the information necessary to make an appropriate cancer treatment recommendation for older cancer patients. An increasingly popular way of assessing the potential of older patients to cope with chemotherapy is a Comprehensive Geriatric Assessment. What constitutes Comprehensive Geriatric Assessment, however, is open to interpretation and varies from one setting to another. Furthermore, Comprehensive Geriatric Assessment’s usefulness as a predictor of fitness for chemotherapy and as a determinant of actual treatment is not well understood. In this article, we analyse how Comprehensive Geriatric Assessment was developed for use in a large cancer service in an Australian capital city. Drawing upon Actor–Network Theory, our findings reveal how, during its development, Comprehensive Geriatric Assessment was made both a tool and a science. Furthermore, we briefly explore the tensions that we experienced as scholars who analyse medico-scientific practices and as practitioner–designers charged with improving the very tools we critique. Our study contributes towards geriatric oncology by scrutinising the medicalisation of ageing, unravelling the practices of standardisation and illuminating the multiplicity of ‘fitness for chemotherapy’.

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

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Product of the Week: Lexis Practice Advisor

Product: Lexis Practice Advisor series:  Mergers & Acquisitions module.

Manufacturer: LexisNexis Legal and Professional, New York.

Description: The new LPA module, like existing modules (e.g., Business & Commercial, Financial Restructuring & Bankruptcy, California, Corporate Counsel, and Securities & Capital Markets), helps practice groups complete transactions faster and more efficiently. It offers practical guidance and content from LexisNexis experts and legal editors, to help users execute transactions. All LPA modules use the new Lexis Advance research platform that provides research history, alerts, work folders, and interactive forms. The goal of the M&A module is to speed the document editing process to quickly complete a deal.

The M&A module also debuts Market Tracker, powered by Matterhorn. It helps users  locate and compare transactions across approximately 1,000 deals and more than 900 deal points, such as consideration type, target industry, and deal amount. The comparison tool views search results in the a Microsoft Excel-like web page with analytical features to compile and recompile lists and filter views. See Figure 1.

Figure 1 shows a comparison of two cash-based technology acquistions in the Market Tracker, a tool in the Lexis Practice Advisor, Mergers & Acquisitions module. Click image to enlarge.

You can expect Market Tracker to compete with other market tracking tools for transactional lawyers, such as Exemplify and the Practical Law Company's What's Market tool (now owned by rival Thomson Reuters). With Market Tracker, you can apply granular filters to search results and hone in on deals by target and acquiring company, and negotiated terms, and find market-tested deal documents to use for a current client or project. Once you find relevant deals, you can compare and analyze them online or download them to your computer.

The new module covers key transactions in M&A practice groups, such as public company M&A, private asset acquisitions, private stock acquisitions, and private mergers. It provides information on representing core functions of M&A attorneys, structuring deals, negotiating agreements, conducting due diligence, and drafting and negotiating purchase or merger agreements.

Target market: Law firm merger and acquisition practice groups.

Price: The Mergers & Acquistion practice module is available for $140 per person per month.

Methodology: The product of the week is chosen by Law Technology News' editors from products or services that have been launched or upgraded within the last four weeks. To be eligible, the product or service must be of use to law firms, law departments, or other legal organizations to support the practice or business of law. The product must be available on or before the publication date. Press releases may be submitted to lawtech@alm.com.

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The Learning Network Blog: Test Yourself | Editing Practice, June 7, 2013

The Learning Network provides teaching and learning materials and ideas based on New York Times content.

Teachers can use or adapt our lessons across subject areas and levels. Students can respond to our Opinion questions, take our News Quizzes, learn the Word of the Day, try our Test Yourself questions, complete a Fill-In or read our Poetry Pairings.

Join the conversation by commenting on any post. We'd love to hear what you think!

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