CBS was created in 1998, along with Héma-Québec, to replace the old Red Cross blood donation service after a tainted blood scandal caused mass infections of hepatitis and HIV.Jeff McIntosh/The Canadian Press
Tom Koch is an author and medical ethicist at the University of British Columbia. His most recent book is Ethics in Everyday Places: Mapping Moral Stress, Distress, and Injury.
I miss the orange juice and Oreos that volunteers would give me after I donated blood. It was a postdonation, cautionary offer that assured donors didn’t leave the building too early and faint. But that 15 minutes was also fun – a nice time to gossip with my neighbours.
I don’t donate any more and am therefore one of the reasons the Canadian domestic blood supply is dangerously low these days. I feel badly about that, but honestly, Canadian Blood Services (CBS) is to blame.
For years in Toronto, I gave blood regularly whenever a pop-up collection site was announced in my neighbourhood. Signs would appear on local street corners announcing a donor clinic at St. Alban’s Church, the community centre or some other site within a few blocks of my house. While the blood was distributed widely, its donation was about community, a local affair.
It’s the central theme of Richard Titmuss’s famous 1970 academic work, The Gift Relationship: that a non-profit system where blood is supplied by unpaid donors works better than a commercial one based on monetary incentives. Offering compensation for blood donation may “crowd out” voluntary donors, Prof. Titmuss argued – a point that was met with skepticism when his book was first released. In the following decades, however, his argument gained support from the field of social psychology, where fellow scholars found that “the introduction of monetary payments may reduce the intrinsic motivation to behave altruistically,” as one study noted. Others who have studied the psychological impact of blood donation have also found a positive correlation between donating blood and donors’ happiness.
This effect has sadly not been replicated by the current CBS donation system. There is no feel-good atmosphere today, owing largely to the fact that donation centres are few and far between, blood drives are rare and there appears to be little active encouragement on CBS’s part to change matters.
To give blood these days, I need to take three separate buses to a CBS collection centre far from my neighbourhood. In Vancouver, I wait an average of 10 minutes for each bus transfer for a travel time of perhaps 50 minutes, followed by the inevitable wait time for processing at the collection centre, a slew of tests, then an interview, all before CBS decides if I might be allowed to donate. After 20 minutes of actual blood donation and 15 minutes with my orange juice and Oreos, I have the same travel time returning home.
The whole affair takes perhaps three hours, with people I don’t know, in a neighbourhood not my own. These days, it seems to take less time to register with the Armed Forces than to sign up and serve as a blood donor.
It was not always this way – and it doesn’t have to be now. But CBS hasn’t shown any interest in returning to the labour-intensive, community donation model that worked well in the past. Nor does it seem to want to return to “blood mobiles” – large vans that served as travelling collection centres and would park at densely populated sites such as university campuses.
With its new deal with Spanish pharmaceutical firm Grifols, which will allow a private company to oversee blood-plasma collection in Canada, CBS has officially embraced a commercial-style collection model that is, at best, inconvenient for would-be donors like me and, at worst, outright discouraging for potential volunteers. Instead of focusing on making the donation system easier for voluntary contributions, CBS is instead working with a corporation to increase our depleted domestic plasma supplies.
In my estimation, that spells the beginning of the end of the voluntary model for blood donation in Canada.
CBS was created in 1998, along with Héma-Québec, to replace the old Red Cross blood donation service after a tainted-blood scandal caused mass infections of hepatitis and HIV. It embraced a set of principles that focused upon the idea of voluntary donation and blood as a public resource, not a commodity. Now, CBS is moving away from those principles to a business model that will only further alienate former donors like me.
Maybe it’s time to return the responsibility for Canada’s domestic blood supply to the Red Cross and bring back its community-based collection system. In that case, I’d be willing to donate again.
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