Courses

The blood and plasma industries have been in a feud since at least the 1970s, when Richard Titmuss published The Gift Relationship comparing the UK and U.S. blood collection systems. Giving blood is an archetypal, and, for many of us around the world the paradigmatic, instance of the gift relationship. It is identified with altruism. The blood industry uses the language of gifts and is organized with the gift relationship in mind. Selling plasma is an archetypal, but not a paradigmatic, instance of a commodity exchange relationship. It is identified with self-interested, cost-benefit calculation. The plasma industry wants to avoid this association, and also tries to use the language of gifts, but their efforts are mostly in vain. Many think we “see through” this “obfuscatory” ruse. While the 1970s saw the start of simmering tensions between these industries, it is now nearing a boiling point. Demand for the medicines that are made from blood plasma have been growing at 6-10% each year for more than a dozen years. To meet the demand, countries all over the world have come to rely on the United States more and more. In response, the U.S. has gone from 299 plasma collection centers in 2006, to 601 in 2016, to more than 1,000 today. The plasma industry is now the 11th largest industry in the United States, comprising nearly two per cent of all exports. The United States alone is responsible for 60-70% of the plasma used to make therapies for the world. Each of these numbers are growing. The non-commercial blood industry feels threatened by the commercial plasma industry. Are they right to feel so threatened? Does growth in the plasma industry come at the expense of the blood industry? This course is intended to explore the concrete, specific “feud” between the non-profit blood industry and the commercial plasma industry. We will look at this issue from a global perspective, including especially Canada and Spain, using legal, economic, and ethical lenses. The concrete case of these two industries will also be used to look at the more abstract “feud” between gift and commercial relationships. What will our answer to the above question say about these kinds of relations more broadly? Does the presence of commercial plasma undermine the gift relationship? Are commercial exchanges at odds with gift exchanges?