Have you ever donated blood? Many of us have stood in line or sat in a waiting room during a Red Cross drive until it was our turn to get hooked up to some medical siphoning equipment to do our part boosting local life-saving reserves.
Some generous, community-oriented people are frequent donors despite receiving no compensation other than a small wax cup of orange juice and a cookie (to raise the benefactor’s depleted blood sugar levels).
Every two seconds, someone in the United States needs blood.
Before the 1970s, though, blood centers paid donors. That all changed after an innovative British social researcher and teacher named Richard Titmuss (1907–1973). The author had published books and articles in the 1950s that were instrumental in identifying the definitive characteristics of the welfare state in that country at the close of World War II.
Titmuss was no lightweight in shaping his country’s socioeconomic future, having founded the academic discipline of Social Administration. He also held the founding chair in the nascent discipline of post-war Social Policy at the London School of Economics.
In 1970, Titmuss published a book called The Gift Relationship. In it, he argued that paying blood donors money in exchange for donating blood might crowd out the supply of healthy blood donors. The quality of the compensated donated blood would fall and viable blood collection would become inefficient economically.
Titmuss went on to charge that the American system of compensating blood donors with cash was unsafe. Furthermore, it was immoral for people to profit from giving their life-blood to help others in need.
This visceral attack on blood donation get-rich-quick schemes worked. No longer would donors of whole blood receive any money for their vital fluid.
In 1975, the World Health Organization (WHO) adopted a resolution encouraging countries to promote the development of national blood services based on voluntary nonremunerated blood donation. The international health agency also targeted 2020 as the year in which all blood donations would be collected from unpaid volunteer donors.
In 2008, a judge in South Florida gave a 16-year-old boy the choice of donating a pint of blood or paying a fine for under-age smoking at the mall:
“An Alabama judge, Judge Marvin Wiggins, gave offenders owing finds or fees for a variety of crimes the option to pay their fine or fee or give a pint of blood. If the offender didn’t have money to pay the fine, they were given the option to give a pint of blood and bring a receipt of that donation to satisfy their obligation.”
A 2013 article published in Science magazine defended the WHO’s blood donation policy, stating that:
“Evidence shows significantly lower prevalence of transfusion-transmissible infections among voluntary nonremunerated donors than among other types of donors.”
The fact remains that while U.S. donors are giving away their blood for free, blood banks, including the Red Cross, are selling some of the goods downstream. Some of them are resold for even more profit.
The U.S. Food and Drug Administration (FDA) has imposed no formal ban on the practice of paying for blood. Blood from paid donors must be labeled as such. However, hospitals refuse to use blood from people assumed to be unhealthy and economically destitute since they turned their blood into a revenue stream.
Having looked into the matter of offering incentives for blood contributions, Mario Macis, an economist at the Johns Hopkins Carey Business School, concluded:
“Even though it’s legal, it’s still considered not totally moral or ethical to pay cash to blood donors.”
The Red Cross, though, does sell some of the freely-donated blood they collect. The blood is sent to a Red Cross blood component laboratory where it is processed into several components such as red blood cells, plasma, platelets and/or cryoprecipitate. One blood donation may help as many as three different people.
Scientists have been separating blood into its components since the 1940s. Fractionation, as the process is called, raises the sales of blood products even higher. The situation is similar to parting out a car for more money than you would make selling it whole.
The Red Cross sells blood to hospitals, biomedical companies, academic centers, and pharmaceutical companies. The international humanitarian organization maintains that it is not motivated by greed but by common business necessity. Red Cross Communications Manager Christy Peters said:
“We operate on a cost-recovery basis, not profit. We supply approximately 40 percent of the nation’s blood supply. In order to recover the cost of recruiting blood donors and testing of blood, we recover that cost by being reimbursed by hospitals.”
Red Cross officials are dodgy when it comes to admitting that they sell donor blood. The company’s website uses vague terms such as “distribution” and phrases like “Blood is available to be shipped to hospitals 24 hours a day, 7 days a week,” and “The blood will be delivered to a Red Cross blood component laboratory…”
All that said, blood donors do help save patients of all ages every day. The case can be made that the gift of life is priceless.