Talking about transplants: social representations and the dialectical, dilemmatic nature of organ donation and transplantation

In many westernized countries, organ donation rates are low in comparison with the need for life-saving organ transplants, and are at odds with generally high community endorsement of organ donation. This is particularly true for Western Australia, the location of this study. This contradiction between endorsement and donation is investigated within a framework that draws from Moscovici's (1984) theory of Social Representations, Guimelli's (1998) differentiation between normative and functional dimensions of the central core, and Billig's (1988) rhetorical position on the role of argumentation in discourse. Four focus group discussions on organ donation and transplantation were conducted. Analysis of the discourse suggests that the social representation of organ donation and transplantation can be understood best as a representational field organized around two dialectically 'opposed' images-the gift of life and the mechanistic removal and replacement of body parts. The normative and functional expression of these two images as a pro-donation stance and a qualified pro-donation stance is discussed, as is the role of argumentation in the production of a social representation.