The gift of blood in Europe: An ethical defence of EC directive 89/381

Journal of Medical Ethics

Volumn 23, Issue 2, 1997, Pages 96-100

  Keown, John ^a  

^a QUEENS COLLEGE   (United Kingdom)

Author keywords

Blood; Donation; European community directive 89 381; Paid unpaid

Indexed keywords

ALTRUISM; ARTICLE; BLOOD DONOR; EUROPEAN UNION; HUMAN; PRACTICE GUIDELINE; VOLUNTEER;

EID: 0031004730     PISSN: 03066800     EISSN: None     Source Type: Journal    
DOI: 10.1136/jme.23.2.96     Document Type: Article

References (28)

1. See for example, Deer J. For love or money? The Sunday Times Magazine 1995 Oct 8: 46-55.
2. Institute for Bioethics. Marketing blood? Maastricht: Institute for Bioethics, 1994.
3. An internationally accepted definition of "self-sufficiency" is "the provision of blood and blood products from within a population to satisfy the clinical needs of that population". However, the UK has opted for a more relaxed definition of "self-sufficiency" as the provision of a sufficient range and quality of domestically-sourced blood products to meet the needs of all patients whose clincians prefer these to other products. Van Aken WG. The collection and use of human blood and plasma in Europe. Report prepared for the Council of Europe and the Commission of the European Communities. Brussels: EC Commission, 1992: 22. The reason for this wider definition - of satisfying clinical demand rather than clinical need - is respect for doctors' clinical freedom to prescribe the product of their choice, even if imported from outside the EC and derived from paid donation.
4. Moore RJ. Promoting blood donation: a study of the social profile, attitudes, motivation and experience of donors. Transfusion Medicine 1991; 1: 201.
5. Titmuss RM. The gift relationship. New York: Vintage Books Edition, 1972: 12.
6. National Blood Transfusion Service. Eleven good things that come out of blood. 1148A.
7. See reference 1: 46.
8. See reference 5: 235-6.
9. See reference 4: 205 table 4.
10. Singer P. Altruism and commerce: a defence of Titmuss against Arrow. Philosophy and Public Affairs 1973; 2: 315. (Original emphasis).
11. See reference 5: 12.
12. See for example, Arrow KJ. Gifts and exchanges. Philosophy and Public Affairs 1972; 1: 355; Stewart RM. Morality and the market in blood. Journal of Applied Philosophy 1984; 1: 227.
13. See for example, Arrow KJ. Gifts and exchanges. Philosophy and Public Affairs 1972; 1: 355; Stewart RM. Morality and the market in blood. Journal of Applied Philosophy 1984; 1: 227.
14. See reference 5: 225.
15. Murray TH. Gifts of the body and the needs of strangers. Hastings Center Report 1987; 17: 35.
16. See reference 14: 37.
17. See: The quality and safety of plasma used in the manufacture of blood products. Eastbourne: Armour Pharmaceutical Co Ltd.
18. Hagen PJ. Blood transfusion in Europe: a "white paper". Strasbourg: Council of Europe Press, 1993: 124.
19. Van Aken WG. Gift or good? Vox Sang 1992; 63: 1.
20. See reference 5: 219-220. For two contrasting perspectives on developments in the US see Eckert RD, Wallace EL. Securing a safer blood supply: two views. Washington: American Enterprise Institute, 1985.
21. Paull NB. Safeguarding donors: first, do no harm. Journal of the American Blood Resources Association 1993; Spring: 11, table 4.
22. World Health Assembly. Resolution WHA28.72. Utilization and supply of human blood products, Geneva, 1975. The General Assembly of the International Society of Blood Transfusion, at its XVIth congress in Montreal in 1980, reaffirmed its policy of self-sufficiency and stated in its code of ethics: "Financial profit must never be a motive either for the donor or for those responsible for collecting the donation. Voluntary non-remunerated donors should always be encouraged". At its XXIInd conference in Tehran in 1973, the Red Cross declared its belief that the "non-remunerated donation of blood in a nationwide non-commercial blood service produces the safest medical therapy and strengthens a nation's social structure through the value it places on this freely chosen individual act of humanitarian service" and urged all governments to provide a safe blood service on the basis of unremunerated donation.
23. See reference 5: 158.
24. For critiques of Titmuss's arguments for unpaid donation see Plant R. Gifts, exchanges and the political economy of health care. Journal of Medical Ethics 1977; 3: 166-173; Plant R. Gifts, exchanges and the political economy of health care. Part II. How should health care be distributed? 1978; 4: 5, and del Pozo PR. Paying donors and the ethics of blood supply. Journal of Medical Ethics 1994; 20: 31-5.
25. For critiques of Titmuss's arguments for unpaid donation see Plant R. Gifts, exchanges and the political economy of health care. Journal of Medical Ethics 1977; 3: 166-173; Plant R. Gifts, exchanges and the political economy of health care. Part II. How should health care be distributed? 1978; 4: 5, and del Pozo PR. Paying donors and the ethics of blood supply. Journal of Medical Ethics 1994; 20: 31-5.
26. For critiques of Titmuss's arguments for unpaid donation see Plant R. Gifts, exchanges and the political economy of health care. Journal of Medical Ethics 1977; 3: 166-173; Plant R. Gifts, exchanges and the political economy of health care. Part II. How should health care be distributed? 1978; 4: 5, and del Pozo PR. Paying donors and the ethics of blood supply. Journal of Medical Ethics 1994; 20: 31-5.
27. See reference 3: 22.
28. See reference 5: 198.