ABSTRACT

This chapter analyzes structural incongruence and tension within complex organisations such as organisation of organ transplantation systems (OTS). It suggests that a variety of organisational strategies that may deal with some of the problems. In the organisation of OTS, several organisational forms operate within an overarching network organisation. Various types of relationships are structured on the basis of two distinct dimensions, hierarchisation and formalisation. Organisational theorists increasingly refer to three types of social organisations: hierarchy or bureaucracy, markets, and networks. Market and contractual relations are largely non-hierarchical in character. Political elites and professional groups often form networks based on a common ethical outlook. The administrative order of the Swedish OTS was designed as an arrangement between estimated transplantation needs, production of services, and size of harvesting regions for each centre. The one chosen as central to the analysis is the formal-hierarchical one that is administrative, where transplantation patients are in a sense part of the social organisation.