Negotiating Values : Implementing Change in the Allocation of Transplant Organs

Stakeholders make rules for the allocation of transplant organs in the United States. This book considers how well stakeholder rulemaking taps relevant expertise and balances competing values in efforts to implement new allocation frameworks. It assesses strategies for successfully implementing planned organizational change involving high stakes.

In the United States stakeholders make rules for the allocation of deceased-donor transplant organs. More than 110,000 Americans are currently awaiting transplants and more than 1,200 die annually before they get transplants; more than 1,700 leave the waiting list annually because they've become too sick to receive transplants. Contributing to better organ transplantation policy is thus socially valuable with life and death consequences. In Negotiating Values, David Weimer deals with this important policy issue. He considers how well stakeholder rulemaking, an example of constructed collaboration, taps relevant expertise and he exploits the unusual opportunity it provides to study the implementation of a substantial planned organizational change. He also explores the implications of “street level” responses for the operation of systemwide allocation rules. Most broadly, Weimer contributes to our understanding of complex multigoal decisionmaking by explicating the interplay between values and evidence in responding to a demand for substantial policy change.