Crises as window of opportunity : the German government response to the 2012 organ transplant scandal

In 2012-2013 the German transplant system suffered from a large public scandal over the manipulation of patients’ data to move them up on the Eurotransplant’s waiting list. Similar manipulations are reported to have occurred in the U.S., though on a different scale. On one hand the article explores the effects of the introduction of rewards to doctors in the form of performance bonuses. On the other, the article reflects upon the highly problematic nature of gaming when it escalates at all levels of a governance system and when it involves unethical decisions, defined as subversion of ethical standards.