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This old post, on the moral sta­tus of donat­ing blood, still attracts a trickle of Google searches to this blog. I won­der who the searchers are — per­haps peo­ple try­ing to get moti­vated to donate, peo­ple try­ing to ratio­nal­ize not donat­ing, or bio­med­ical ethics paper writers?

Any­way, I hadn’t donated blood in over six months so I finally went. And there’s some­thing that really both­ers me about the United Blood Ser­vices cen­ter that I visit: they really overem­pha­size all of these stu­pid rewards pro­grams for fre­quent donors. It’s tacky as hell, and some­how a lit­tle insult­ing. No, I don’t want to fill out a slip that will enter me in a sweep­stakes to win a car. No, I don’t want to log in online and trade my points for prizes. Just to top off the juve­nile atmos­phere, they have a pop­corn machine in the cen­ter, and so the whole place smells like a car­ni­val. (I used to give blood at a Red Cross cen­ter, and don’t remem­ber it being like this, but I see that even they have intro­duced an elab­o­rate racing-themed incen­tive sys­tem).

Obvi­ously, the point of these pro­grams is to offers donors some mate­r­ial ben­e­fits (or the chance of win­ning them), above and beyond any intrin­sic sat­is­fac­tion a per­son might receive from giv­ing blood. I’d be sur­prised if the pro­grams worked very well, but who knows? Peo­ple are funny. Just as I was con­temp­tu­ously eye­ing the pop­corn machine, a mid­dle aged lady ran in and excit­edly started scoop­ing some out for a pre-donation snack.

And donors have to set­tle for the stu­pid incen­tives or noth­ing, because most blood dona­tions in the U.S. can­not be com­pen­sated in cash, by law (I think only some plasma dona­tions are paid). But actu­ally, I’d rather receive noth­ing but a post-donation snack rather than be sub­jected to the incen­tives. They just make me feel like I’m back in ele­men­tary school, being baited with junky plas­tic toys to sell more over­priced wall­pa­per to my neigh­bors in some dumb fundraiser.

So, my blood dona­tion pref­er­ence ordering:

1. Paid dona­tion: This is num­ber 1 not so much because I want or need the money, but because there is a strong moral case to be made in favor of paid blood dona­tion. Unlike most organ dona­tions, blood dona­tions do not cost the donor much in terms of time, sac­ri­fice and health/safety. As such, it is not pos­si­ble for donors to be badly exploited. And there is good rea­son to think that blood would be avail­able in greater sup­ply if donors were paid, even min­i­mally. This is of moral sig­nif­i­cance, because blood saves lives. And a pay­ment, even a small one, sig­nals respect for donors.
2. Totally uncom­pen­sated dona­tion: Hey, at least you get to feel purely altru­is­tic. Some­times you get a “I gave blood” sticker, so that other peo­ple will see how vir­tu­ous you are.
3. Incen­tive sys­tems: Arguably and at least in my opin­ion, these do not show respect for donors. They prob­a­bly don’t encour­age any­one new to donate, and they are some­what insult­ing to those who would have given to begin with. Give us some­thing actu­ally of value to every­one ($, how­ever lit­tle) or just don’t even go there.