A couple of years ago, I posted about an open letter about the ethics of compensating bone marrow stem cell donors. Peter M. Jaworski and I, who co-founded DonationEthics.com, recently published a second open letter about blood plasma donation in Canada (on the site newly redesigned by me!). A number of Canadian provinces have passed, or are considering, legislation that would effectively make it illegal to pay people for blood plasma donations. (The letter concerns donations used to create plasma-based products like immune globulin, not for transfusions.) We and a collection of signatories—ethicists and economists including Soupers Jason Brennan and Jeff Moriarty—argue that this is a mistake. Below is a brief overview of the arguments for these bans (as we understand them) and our responses (as well as a bit of personal editorializing). In my view, this is an open and shut case. We would love to hear what other Soupers think. Are there better arguments for the bans we are missing? We also welcome more signatories (especially Canadian ones!).

1. Supporters of the bans worry that paying for blood plasma is exploitative. The worry seems to be that compensation will induce the poor, who would otherwise not donate, to do so. We point out that compensation is not particularly hefty (typically $25-50 per donation) nor apparently too low given how low the costs of donation are (sitting around for 60-90 minutes while a bodily fluid that will replenish itself is extracted). Given this, it is hard to see why inducing the poor to donate would be objectionable (at least, any more than offering them payment to do anything).

2. Supporters of the bans worry that paying for blood plasma will encourage the view that people and/or their blood are “mere commodities.” There is no evidence, however, that such views are more prevalent in Canadian provinces or other countries where compensation for donation is permitted.

3. Supporters of the bans worry that paying for blood plasma will crowd out altruistic motivations for donation. Even if this is the case—which it needn’t be—it seems fairly clear that the potential for saving lives outweighs any such concerns. Should we ban the sale of food so as to encourage altruism, too?

4. Supporters of the bans worry that paying for blood plasma will lead to production of less safe plasma-based products. However, there is no evidence that this is the case. The regulations on products made from paid plasma are the same as those on products made from unpaid plasma. Many experts have stated that products made from unpaid plasma are no safer than those made from paid plasma. What’s more, Canada already gets the majority of its plasma-based products from the United States, where it is made from paid plasma.

Finally, we argue that the bans threaten Canada’s ability to meet its own needs for plasma-based products, making it a net drain on the world’s supply rather than (as we might hope) a net contributor.

3 Replies to “Open Letter Regarding Compensation for Blood Plasma Donation

  1. Good arguments, David. I think argument in paragraph #3 is applicable to all other points – the potential for saving lives outweighs all of them. If there is to be a debate it should be centered on acceptability of risks of plasma undersupply. If risks are acceptable then we can focus on finer points. Otherwise, we are trading people’s lives for very superficial concerns.

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