The exchange of any biological material between human beings takes place in a social context. We are our bodies, and they are also ours to give. The donating of blood, therefore, raises in a quiet, intimate and modest way, many of the most fundamental questions about how we live in our bodies and in the social worlds we inhabit.
Up and down Britain, thousands of men and woman give blood every day. That is to say, for American readers, they give it freely meaning without payment. They don't do it for selfish reasons. They do it for friends, neighbours — and for people they will never know. Anyone from across the United Kingdom who has either needed blood, or has a loved one who has, while being treated by our National Health Service, will know that feeling of gratitude. Blood donors save countless lives.
But this coalition government, although denying that it is privatising blood donation, is proposing to let big business profit from blood donations, threatening to shatter the virtuous link between donors and recipients.
The fundamental questions implicit in this gift of blood should now be a matter of urgent public concern as the dominant ideological model of the social world seeks to characterise it as nothing more than a gigantic economic marketplace: a mass of individual consumers and producers united only in their pursuit of profit.
The government’s Big Society rhetoric is a childish attempt to dress up economics as ethics. Its plans for privatizing blood donation — the reality, despite the political denial — are a particularly naked illustration of this deceit.
Why do people give blood? The research evidence shows that altruism — “a general desire to help people” — is the most common single reason: we recognize that, because it is life-giving, blood is also life-saving. If we have ourselves benefitted from the gift of blood or know someone who has, the desire to help may have a personal edge to it, but offering our bodies for the promotion of the public welfare nonetheless is likely to be driven by a concept of the “universal stranger”, an unknown but real social being. This motivation to give is depleted by the presence of monetary rewards, and/or when the organizational structures supporting blood donation are commercialised. The picture changes: blood becomes a commodity, not a gift.
The philosopher of the welfare state — and my father — Richard Titmuss published his classic study of The Gift Relationship subtitled From human blood to social policy, in 1970. The core of the book is a comparison between the privatized blood donation system of the USA and the not-for-profit model established as part of the NHS in Britain. Titmuss showed that making money out of blood was both economically inefficient and health-damaging; sold blood is more likely to transmit disease. Equally crucially, he argued that a system of blood donation which does not rely on economic motives and values allows people to make a morally healthy contribution to society.
Social cohesion depends on individuals having a sense of the “universal stranger”, an unknown but real social being. Titmuss contended that people have a right to give just as they have a right to shelter and housing and to speak their minds, and he said that this right to give must be protected by policy-makers.
A Big Society may be Big but it will never be Good unless altruism is encouraged as an essential value and activity, not just a piece of rhetoric. From this point of view, the NHS is an instrument of social policy, “the most unsordid act of British social policy in the twentieth century”, according to Titmuss, and one that, if dismantled, will take a sense of social cohesion with it.
The Gift Relationship had a considerable impact on policy. It led directly to changes in the American system of blood donation and almost certainly encouraged Margaret Thatcher not to tamper with the British model. Clearly members of the current government have not read it. Why should they? All governments, it could be argued, are primarily interested in maintaining their own positions of power. They are much less, if at all, concerned with hard evidence about how best to promote national wellbeing. But in its programmes and policies across the board this government is displaying a quite unparalleled disregard for the kinds of facts that studies such as Titmuss’s are able to put at the service of policy-makers. The more we rely on the profit-motive as an inspiration for human behaviour and public policy, the more likely we are to build a morally bankrupt society.
A national petition — “Stop Blood Money, not everything has a price” — can be found here.