Wednesday, 2 May 2012

Blood and money

Reviewing some books for Prospect (one of them by the Harvard philospher Michael Sandel), Rowan Williams offers his thoughts on paid-for blood donation, as practised in the United States (and, needless to say, generally frowned upon over here):

Predictably, most of the blood that is dealt with on a commercial basis comes from the very poor, including the homeless and the unemployed. The system entails a large-scale redistribution of blood from the poor to the rich... We hear of international markets in organs for transplant and are, on the whole, queasy about it; but here is a routine instance of life, quite literally, being transferred from the poor to the rich on a recognised legal basis.

Williams goes on to quote the Book of Revelation and Karl Marx while struggling to put his finger on just what is so objectionable about the "commodification of life". He then sets out his reflections with his trademark clarity of expression:

Sandel is describing an alienation of the subject from the body, of the will from the material world. What is lasting and “real” is the abstract ego, independent of its physical nature, its environment, even its actual history. The fundamental model being assumed here is one in which a set of unconditioned wills negotiate control of a passive storehouse of commodities, each of them capable of being reduced to a dematerialised calculus of exchange value. If anything could be called a “world-denying” philosophy, this is it.

But I'd like to go back to the starting point: the "redistribution of blood from the poor to the rich". A very strange expression that, suggestive of vampirism. Is that what is actually going on? For a start, most of those getting the blood will not be "rich" in any meaningful sense (though, this being the US, they will tend to be people with health insurance, or perhaps older people on Medicare). Even genuinely wealthy recipients will only be receiving it from the donors indirectly.

Furthermore, along with the homeless and the very poor (though not, of course, anyone with serious medical conditions, drug users, sex workers and other categories of person usually considered outside the pale and hence ineligible) will be a fairly high proportion of students or housewives looking for a small boost in their disposable income. So it's as simplistic to claim that the donors are poor as it is inaccurate to claim that the recipients are rich.

And if, as Williams claims, "life" was being "quite literally" transferred from the poor to the rich, the poor blood-donors would go into the clinic, be bled dry and never come out. Perhaps that's what the Archbeard imagines is going on over there, though I doubt it.

The redistribution, in fact, is from the healthy to the sick.

Or you could look at the system in another way, as a redistribution of money from the rich to the poor. After all, the poor person who sells his blood gains something absolute in exchange: money that can be exchanged for food, or put in the bank, or spent on otherwise unaffordable books. But all he "loses" is a substance which a healthy body can regenerate in a matter of hours. Indeed, there are positive health effects to blood donation, so the paid donor benefits twice.

There's no logical reason why paid-for blood donation should make Rowan Williams, or anyone else, particularly queasy. It's not like selling a kidney which you can never get back. Blood may be essential to life, but it strikes me as a less intimate product than sperm or eggs, in both of which there is a lively market. If you donate sperm, you're not merely giving up a renewable bodily fluid, you're offering your genetic identity, you're giving away your (potential) children. If you donate your eggs, you're doing all that and undergoing an invasive medical procedure and giving away something of which your body has a limited supply. And the result is not to save life but merely to add to an already overpopulated planet.

It is, nevertheless, interesting that selling one's blood is quite legal in the US, whereas in most states prostitution - which does not represent the commodification of the body but rather the provision of a service - is against the law.