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Overview: Projects to organ transplantation of the research group Prof. Schicktanz

2014-2016

continued
from
04/2018

“I would prefer not to”. Organ donation between unease and criticism. A sociological and ethical analysis (with Prof Frank Adloff, University of Hamburg) (sponsored by German Research Foundation, https://www.wiso.uni-hamburg.de/en/fachbereich-sozoek/professuren/adloff/forschung/forschungsprojekte/dfg-unbehagen-organspende.html

Seit 2012

ELPAT working group: Public Issues of organ Transplantation (with Gurch Randhawa (UK)); http://www.esot.org/organisation/ELPAT-Structure

2008-2014

Decision making in living organ donation - medico-ethical and anthropological aspects

2009-2013

Survey: Attitude and willingness towards organ donation. The influence of gender and educational background

2009-2010

Book: Teaching Ethics in Organ Transplantation and Tissue Donation. In Cooperation with Amnon Carmi UNECO Chair in Bioethics

2004-2007

"Challenges of Biomedicine", funded by the EU, 6th framework programme ´Science & Society´
http://www.univie.ac.at/virusss/cobpublication

1998-2001

Medical- and animal ethical aspects of xenotransplantation. A science ethical investigation into the current state of research from Silke Schicktanz (DFG-Graduiertenkolleg „Ethik in den Wissenschaften“ am Interfakultären Zentrum für Ethik in den Wissenschaften (IZEW), University Tübingen)

Publication List

Publications (PDF)


“I would prefer not to”. Organ donation between unease and criticism. A sociological and ethical analysis.

Contact:

Dr. Solveig Lena Hansen shansen(at)gwdg.de
Prof. Dr. Silke Schicktanz sschick(at)gwdg.de
Duration: 2014-2016

Funding: German Research Foundation (DFG)

The project explores how people deal with the public demand for being an organ donor in Germany, especially when they take a critical or skeptical position.

The sociological subproject (PI: Prof. Dr. Frank Adloff, University of Erlangen-Nuremberg) conducts interviews and focus groups with citizens addressing their uncertainties, disappointments, fears, and vulnerabilities towards post-mortem organ donation.

The bioethical subproject (PI: Prof. Dr. Silke Schicktanz, University Medical Center Göttingen) analyzes various German poster campaigns that were carried out in the last ten years. At first glance, they conceptualize organ donation predominantly as a free decision everyone should make for themselves. However, the analysis examines which implicit claims and commitments the campaigns put forward visually.

Moreover, drawing on the empirical data of the sociological subproject, the Göttingen project analyzes the moral perspective of laypeople, who are skeptic or at least uncertain towards organ donation, as well as their moral intuitions concerning those contemporary campaigns.

The project assumes that uncertainty and skepticism are legitimate intuitions. Based on these premises, ethical theorizing includes asking how far anthropological attitudes towards corporeality and mortality can be rationally communicated and publicly debated in a society characterized by liberalism and value pluralism.

The bioethical analysis of public moral encouragement and further development of socio-theoretical and normative approaches reflects the social significance of transplantation medicine and aims to develop ideas how to deal with ethical problems in public discourse.

Project Results:

Pfaller, L/Hansen, SL/Adloff, F/Schicktanz, S (2018): 'Saying no to organ donation': an empirical typology of reluctance and rejection. Sociology of Health and Illness, DOI: 10.1111/1467-9566.1277

Adloff, F/Pfaller, L (2017): Critique in statu nascendi? The reluctance towards organ donation. Historical Social Research 42(3), DOI: 10.12759/hsr.42.2017.3.24-40.

Schicktanz, S/Wöhlke, S (2017): The Utterable and Unutterable. Anthropological Meaning of the Body in the Context of Organ Transplantation. Dilemata, 9, 23, 107-127.

Schicktanz, S/Wöhlke, S (2017): Leben im Anderen. Vorstellungen zur Personalitätsübertragung zwischen kulturell Sagbarem und Unsagbarem. In: H. Knoblauch et al. (Hg.): Transmortalität und Organspende. Weinheim, 75-105.

Hansen, SL; Schicktanz S (2017): Bilder fürs Leben: Versteckte moralische Botschaften als Reaktion auf die Krise der Organspende. In: A. Esser et al. (Hg.): Die Krise der Organspende. Anspruch, Analyse und Kritik aktueller Aufklärungsbemühungen im Kontext der postmortalen Organspende in Deutschland. Berlin: Duncker & Humblot, 85-114.

Hansen, SL; Eisner, MI; Pfaller, L; Schicktanz, S (2017): "Are you in or are you out?!" Moral Appeals to the Public in Organ Donation Poster Campaigns - a Multimodal and Ethical Analysis. Health Communication, DOI:10.1080/10410236.2017.1331187

Schicktanz, S; Pfaller, L; Hansen, SL; Boos, M (2017): Attitudes towards brain death and conceptions of the body in relation to willingness or reluctance to donate: results of a student survey before and after the German transplantation scandals and legal changes. Journal of Public Health, DOI: 10.1007/s10389-017-0786-3 

Schicktanz, S; Pfaller, L; Hansen, SL (2016): Einstellungen zur Organspende - kulturell tief verwurzelt. Deutsches Ärzteblatt 113, 37, A1586-1588.

Hansen, SL; Eisner, MI; Pfaller, L; Schicktanz, S (2017): "Are you in or are you out?!" Moral Appeals to the Public in Organ Donation Poster Campaigns - a Multimodal and Ethical Analysis. Health Communication, DOI:10.1080/10410236.2017.1331187

Schicktanz, S; Pfaller, L; Hansen, SL; Boos, M (2017): Attitudes towards brain death and conceptions of the body in relation to willingness or reluctance to donate: results of a student survey before and after the German transplantation scandals and legal changes. Journal of Public Health, DOI: 10.1007/s10389-017-0786-3

Downloads:

Projektflyer (PDF)

Conference Flyer, Erlangen, July 2016 (PDF)

International Workshop, October 7th, 2015

You can download the Program here (PDF)

You can download the Poster here (PDF)


“I would prefer not to”. Organ donation between unease and criticism. A sociological and ethical analysis. (Follow Up)

Contact:

Dr. Solveig Lena Hansen shansen(at)gwdg.de
Prof. Dr. Silke Schicktanz sschick(at)gwdg.de
Duration: 2018-2020

Funding: German Research Foundation (DFG)

The project is a sequel to the project ‘I would prefer not to.’ Organ donation between unease and criticism. In the first stage, the motives of skeptics of organ donation as well as of the undecided were examined along with the posters of German organ donation campaigns of the past 20 years. The main results highlight four types of criticism which are not directly linked to the recent events in the transplantation system. However, they also highlight six different moral messages in the posters that are historically associated with important events and disruptions in the transplantation system. These results indicate that specific positions and aspects are excluded both in the public discourse and in health policy.

In the second stage, strategies of the public discourse and of health communication which systematically exclude positions are to be reconstructed as well as their consequences for the critics. Moreover, these strategies of exclusion should be reflected normatively for the development of ideas concerning concrete discursive inclusion of positions that are currently being declassified as "irrational".

The sociological project will, from a theoretical perspective, question how the arguments of these "irrational" positions can be understood as well-founded arguments. In addition, the project will analyse the strategies that exclude these positions in daily life as well as in health policy and the academic discourse.
Particularly, the one-sidedness of the analysed campaigns illustrates the conflict of interest of the Transplantation Act. On the one hand, institutions of health policy have to inform neutrally about the topic in order to allow a self-determined decision. On the other hand, organ donation should be promoted to increase the number of transplants. Accordingly, the bioethical subproject questions how a normative concept of public health communication can be designed to achieve a reflective balance between individual self-determination and the collective interest in organ transplants. Therefore, the analysis aims at critically addressing the question of what comprises 'good' information in such a sensitive field. Moreover, the personal attitudes and moral convictions for and against organ transplantation are to be better understood.

By developing socio-theoretical and normative approaches, both subprojects aim at a critical analysis of the high symbolic value of organ transplantation for the self-conception of modern high-tech medicine.


ELPAT working group: Public Issues of organ Transplantation (since 2012)

Head oft he group: Silke Schicktanz, Gurch Randhawa
http://www.esot.org/organisation/ELPAT-Structure


ELPAT is a European platform that brings continuity and progress in European research and dialogue on „Ethical, Legal and Psychosocial Aspects of organ Transplantation”. Within ELPAT, there are seven working groups. Each working group addresses a specific topic in the field of ethical, legal and psychosocial aspects of organ transplantation

One of the Working Groups, Public Issues had been bringing together a range of experts and professionals from all around the world to share their experiences and insights into why and how public engagement was progressing.

All members of the working group are members of the European Platform ELPAT

Workshop: Working group Public Issues ELPAT Meeting,  Juan les Pins, France,  November 2013.

 

Randhawa, Gurch; Schicktanz, Silke (Eds.): Public Engagement in Organ Donation and Transplantation, Pabst Publisher

 

http://www.pabst-publishers.de/Medizin/buecher/9783899678215.htm

Public campaigns in different European countries highlight an increasing awareness that public acceptance of organ donation is a crucial factor for the medical field of organ transplantation. However, addressing this complex matter requires a fresh perspective as to how governments truly engage with their public on issues which touch upon health care, morbidity, and mortality.

The book provides detailed recent analysis of cultural impacts and religious attitudes of communities, patients, and even professionals. Furthermore, various forms of public engagement, including dialogues, campaigns, and media are discussed from methodological as well as theoretical perspectives.

Project: Decision-making processes in the context of living kidney donation - medical ethics and medical anthropological aspects

Contacts:
Dr. des. Sabine Wöhlke: swoehlk(at)gwdg.de 
Prof. Dr. Silke Schicktanz: sschick(at)gwdg.de

In this interdisciplinary project, our research topics are the underlying moral motivation and the role models and decision criteria for living donors and transplant recipients. Using socio-empirical methods we want to reflect our findings in a medical ethical and medical anthropological perspective. The particular view of those affected directly and indirectly (living kidney donors, recipients, family members) is important to us.
This research approach seeks to contribute to the question of how to assess the currently negotiated positions in medical law and ethics on the extension or limitation of live organ donation and possible physical or social incentives from a practical point of view, and find out which theoretical and practical issues must be clarified here.
Using focus group discussions and individual interviews, attitudes and motivations of different affected groups will be studied (male and female donors, recipients, potential organ recipients, family members, etc.). This well-established socio-empirical method allows for focusing on values and working out similar and divergent opinions within a group. Furthermore, this qualitative study will be complemented by a representative survey in Germany (including non-affected lay-persons) with respect to possible motives and values involved in a donation.

The central research questions are:

By taking into account the cultural background we want to elicit a comprehensive and nuanced picture of differences and similarities in values and morally relevant motives of donors and recipient. Additionally, we will address these issues with reference to gender.

During the project period different objectives will arise:
 A most comprehensive and highly differentiated picture of the affected side, donors and recipients, regarding the decision for or against a living organ transplantation shall be gained. This is a context-sensitive medical ethical and medical anthropological study whose objective is the exploration of moral ideas, social and ethical issues and the development of possible solutions with the aid of theoretical considerations:
• The everyday life of medical laypeople and their families before and after a donation
• influencing factors (people, events, institutions, information, etc.) that have contributed to the decision to consider a living donation

• The theory of the Gift in the process of living organ donation. In this, the influence of the respective role perceptions and the motives for voluntary action, the reciprocity in the process of decision making will be elicited empirically

The starting point builds on two basic research approaches that integrate different empirical and ethical questions:
From an empirical point of view the question is:  to what extent do different moral, psychological and social aspects in the donors’ and recipients’ self-conception of donors and recipients (such as altruistic motivations, expectations regarding possible expectations of reciprocity, knowledge about medical risks and recovery expectations, gender roles) affect the decision-making process in living organ donation. We are particularly interested in the relationship of donors and recipients, but also of lay people and experts. From a normative point of view the question addresses the motivation underlying the decision-making processes which deserves to be considered , and thus contributes to the question which ethical criteria need to be developed to judge self-determination and the donors’ informed consent as well as the institutional and structural conditions of the decision-making process.

Results and publications

Book:“So you can continue to live: The gift of kidney” – Affected people tell their story

A living kidney transplantation is actually a routine medical procedure. But at the same time, donor and recipient have to deal with a variety of issues, feelings and decisions. "Do I need to be forever grateful for my donation?" Such questions often change the whole structure of relationships.

In numerous field reports on those directly affected and their relatives, Sabine Wöhlke and Lutz Doyé show how complex the issue of live donation is. Besides the biographies of those directly involved in the book there are many scientific articles on the topic from the fields of medicine, medical ethics, theology, or the law.

The book means to encourage chronically ill patients to make the right decision for themselves and is an important guide for the duration of follow-up.

The book was only published in German.

 

Including:

Wöhlke, Sabine (2011): Das Fremde im Eigenen: Gleschlechterunterschiede im Körper-Leib-Verständnis bei Lebendorgantransplantatierten. S. 194-210

Schicktanz, Silke (2011): Keine leichte Entscheidung - Ethische Aspekte für und wider die Lebendorganspende. S. 166-180

Informations on the book (click here)

Survey: Attitudes and willingness towards organ donation. The influence of gender and educational background (2009-2013)

Project leader: Prof. Dr. Silke Schicktanz

Research Assistants: Dr. des. Sabine Wöhlke; Dr. Julia Inthorn; Fabian Schmidt (med. Doktorand)

 

Public surveys are an important tool for assessing acceptance and (un)willingness to donate organs. Various opinion polls suggest, that a majority responds in favor of organ transplantation, but the number of individuals holding an organ donor card, has remained on a low level for years. Apart from the assumed laziness of the public to sign up for organ donor cards, other explanations for this attitude-action gap might be found in hidden cultural factors.

On the other side, since many years, health professionals and politicians discuss various options of financial incentives to increase the organ supply rather than relying on altruism in organ donation.

In ethical and economical debates about financial incentives it is generally assumed that incentives will work. Therefore the critical question rather seems, whether it is ethically and legally acceptable. However, there is a lacuna of empirical studies which have systematically investigated whether more citizens will donate encouraged by financial incentives. .

A quantitative survey has been conducted among students of medical science and economics at a mid-sized central German university to gain insights into the willingness to donate living and post mortem organs and attitudes towards different forms of commercialization (n=755).  The questionnaire consisted of 55 closed questions, amongst others the following: previous knowledge of organ transplantation, passive and active willingness to consent to postmortem and living donation, problems of allocation and commercialization and socio-demographic data.

 

Data have been analyzed in order to gain insights in the impact of university subject and sex on the willingness to donate and motivation through financial incentives.

 

Publications:

 

Julia Inthorn, Sabine Wöhlke, Fabian Schmidt, Silke Schicktanz (2014): Gender and professional Education Impact on Attitudes towards financial Incentives for Organ Donation: Results of a Survey among 755 Students of Medicine and Economics in Germany (PDF)

 

Sabine Wöhlke, Julia Inthorn, Silke Schicktanz (vorauss. 10/2014): The Role of Body Concepts for Donation Willingness. Insights from a Survey with German Medical and Economics Students. In: Ralf J. Jox, Galia Assadi, & Georg Marckmann (Hrsg.): Organ Donation in Times of Donor Shortage. Challenges and Solutions, Dordrecht Heidelberg u.a.: Springer [im Druck].

Book: Teaching Ethics in Organ Transplantation and Tissue Donation. Cases and Movies

Editor: Silke Schicktanz, Claudia Wiesemann und Sabine Wöhlke in Kooperation mit Amnon Carmi UNESCO chair in Bioethics

 Organ transplantation is a thrilling new option of modern surgery, giving hope to chronically ill patients, and, at the same time, stirring controversial ethical debates about human identity and the meaning of the human body. Being a transnational and global endeavour, organ transplantation raises universal ethical concerns but has to be adapted to culturally embedded believes. In this book, 30 international case studies collected from all over the world illustrate the range of global and local ethical, social, and cultural problems associated with this new form of treatment. Accompanied by a list of relevant movies, the collection provides a unique resource for ethics education in medicine, health care, philosophy, and religious studies. A systematic introduction into the field of transplantation ethics complements the teaching material.

Publisher: Göttingen University Press, 2010 Softcover, 81 pp.: 15,00 €
ISBN 978-3-941875-40-1

 

An online-version is available:

http://webdoc.sub.gwdg.de/univerlag/2010/schicktanz.pdf

 

Link to other teaching materials UNESCO Chair of bioethics:

http://www.unesco.org/new/en/social-and-human-sciences/themes/bioethics/ethics-education-programme/activities/educational-resources/


A review of the book can be found here:

 

www.bioethica-forum.ch/docs/12_2/13_Rezensionen.pdf

Challenges of Biomedicine - Socio-Cultural Contexts, European Governance and Bioethics (CoB) (Project No. SAS6-CT-2003-510238)

Project leader: Prof. Silke Schicktanz (sschick(at)gwdg.de)

Research Assistent: Dr. Mark Schweda (mschwed1(at)gwdg.de)

Project website: www.univie.ac.at/virusss/cobpublication

Project Description COB (PDF)

 

The socio-cultural background of modern biomedicine was examined in a comparative analysis of qualitative empirical data gathered in different European countries: Germany, France, the Netherlands, Sweden, Austria and Cyprus. Moreover, perspectives from Latvia and Great Britain were taken into account selectively. The emphasis of the project lies on the question how laypeople and patients view modern medicine and live with it. The interactions and interdependencies between medicine and culture were analysed along two main comparative axes. On a first level the countries involved were compared to trace different cultural approaches. Secondly, two different medical technologies, organ transplantation and postnatal genetic testing, were used as comparative examples. These two technologies raise different ethical and social problems and hence challenges for governance.
On this basis, the CoB project developed conclusions and recommendations for the academic context as well as for European and national policy makers. These address questions of European harmonisation, citizen participation and governance as well as bioethical issues.

 

Thematics objectives

  • Qualitative comparative research on different socio-culturally framed ways of dealing with modern biomedicine in selected European countries
  • Investigation on how members of the public assess the impact of modern biomedical technologies on their body, identity, ways of knowing and social relations
  • Analysis of how European citizens reflect on the socio-political consequences of modern biomedical technologies, different modes of governance as well as opportunities of public participation
  • Investigation of the role of cultural concepts like identity and bodily integrity in the present bioethical discourse
  • Reflection and evaluation of the consequences of the cultural plurality of moral conceptions on the debate on European bioethics
  • Recommendations for the development of ethical regulations and possibilities of governing research and practise in the field of medicine and life sciences

 

Methodological and theoretical objectives

  • Contribution to interdisciplinary research at the interface of bioethics, social studies of science and medical anthropology
  • Advancement of qualitative comparative methods for investigating patients’ and laypeople’s attitudes towards questions of biomedicine in an international and interdisciplinary research setting
  • Development of key concepts for an intercultural bioethical discourse
  • Establishment and structuring of a European network for the exploration of biomedicine from an ethical and sociological point of view

 

Institutions and people involved

  • University of Vienna, Department of Social Studies of Science Co-ordinator)
    Prof. Ulrike Felt, Maximilian Fochler, Ruth Müller, Peter Winkler
  • Humboldt University Berlin, Department of European Ethnology
    Prof. Stefan Beck, Katrin Amelang
  • University of Lund,Sweden, Centre for Theology and Religious Study & Dep. of European Ethnology
    Prof. Susanne Lundin, Helena Röcklinsberg, Anna Johansson
  • Makarios III Medical Centre, Cyprus, Nicosia Dept. of Clinical Genetics
    Violetta Christophidou Anastasiadou, Costas Constantinou
  • University of Utrecht, The Netherlands, Institute for Ethics
    Prof. Marcus Düwell, Annika DenDikken, Nils Nijsingh
  • University of Latvia, Latvia, Department of Sociology
    Aivita Putnina
  • University of Nancy, France, Research Group on Information, Communication and Propaganda
    Anne Masseran, Philippe Chavot
  • University of Leeds, UK, Institute of Health Sciences and Public Health
    Prof. Darren Shickle, Marcus Griffin

·         University of Goettingen, Germany, Department of Medical Ethics and History of Medicine
Prof. Silke Schicktanz, Mark Schweda


Scientific Output (PDF)

 

Biomedicine as a Socio-cultural and Ethical Challenge: Final Points to Consider and Recommendations for European and National Policy Makers and European Research.

 

"Challenges of Biomedicine - Aanbevelingen over socio-culturele en ethische kwesties en participatie (Dutch Version PDF)"

"Les enjeux de la biomédecine - Recommandations sur les aspects socioculturels, éthiques et de participation (French Version)"

"Herausforderungen der Biomedizin - Empfehlungen zu soziokulturellen, ethischen und partizipatorischen Fragen (German Version PDF)"

"Challenges of Biomedicine - Recommendations on socio-cultural, ethical and participatory issues (English Version PDF)"

"Challenges of Biomedicine - Recommendations on socio-cultural, ethical and participatory issues (Greek Version PDF)"

"Biomedicinas izaicinajumi - Rekomendacijas par socialajiem, kulturas, etikas un lidzdalibas aspektiem (Latvian Version PDF)"

"Biomedicinska utmaningar - Rekommendationer rörande socio-kulturella-, etiska- och medverkansfrågor (Swedish Version PDF)"