The gift relationship from human blood to social policy

Titmuss, Richard M.

doi:10.1016/s0033-3506(97)00096-6

Cited by 219 publications

(157 citation statements)

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“…Compassion, feeling with, requires and/or promotes a sense of kinship -the sense of social solidarity, on which the NHS was founded. Richard Titmuss (1970) famously theorised this in his study of blood donation in which British citizens experience the NHS in terms of generalised reciprocity; receiving healthcare free at the point of need induces a desire by citizens to give something back. In so far as healthcare staff and patients still experience it this way, the NHS does not operate on market principles, even though its economic structure is being moved in that direction.…”

Section: Theorising Compassionmentioning

confidence: 99%

Choice and compassion at the end of life: A critical analysis of recent English policy discourse

Borgstrom

Walter

2015

Social Science & Medicine

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End of life care in England has recently been framed by two very different discourses. One (connected to advance care planning) promotes personal choice, the other promotes compassionate care; both are prominent in professional, policy and media settings. The article outlines the history of who promoted each discourse from 2008 to early 2015, when, why and how and this was done.Each discourse is then critically analysed from a standpoint that takes account of bodily decline, structural constraints, and human relationality. We focus on the biggest group of those nearing the end of their life, namely frail very old people suffering multiple conditions. In their care within contemporary healthcare organisations, choice becomes a tick box and compassion a commodity.Informed choice, whether at the end of life or in advance of it, does not guarantee the death the person wants, especially for those dying of conditions other than cancer and in the absence of universally available skilled and compassionate care. Enabling healthcare staff to provide compassionate, relational care, however, implies reversing the philosophical, political and financial direction of healthcare in the UK and most other Anglophone countries. KeywordsEngland, end of life care, choice, compassion, discourse, old age, relational ethics, governmentality 2 Research Highlights• The 'choice' agenda arises out of (cancer) palliative care.• The 'compassion' agenda arises out of elder care scandals.• Compassion signifies care as a relationship rather than a commodity.• Compassion can be undermined by an overemphasis on autonomous individuals.

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Section: Theorising Compassionmentioning

confidence: 99%

Choice and compassion at the end of life: A critical analysis of recent English policy discourse

Borgstrom

Walter

2015

Social Science & Medicine

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“…However, the employment analogy merits special attention, partly because of its ubiquity in the debate, partly because it has more initial plausibility. The comparison with donation is open to the objection that gift exchanges and sales are morally different (Titmuss, 1970). The comparison with paid research participation will not convince those who doubt whether that activity itself should be permitted (McNeill, 1997).…”

Section: Similarly Stewart Cameron and Raymond Hoffenberg Arguementioning

confidence: 98%

“…In The Gift Relationship, Richard Titmuss (1970) famously challenged that assumption, arguing that markets in blood were less rather than more efficient than systems relying on unpaid donation because they discouraged altruistically motivated donors. Analogous concerns have been raised about buying and selling other body parts, including kidneys (Zutlevics, 2001, p. 301;Rothman and Rothman, 2006).…”

Section: Protecting Kidney Recipientsmentioning

confidence: 99%

“…Titmuss not only believed that markets in blood discouraged altruistic donors, but also that they might weaken the general sense of fellow feeling between strangers that society needs to flourish (Titmuss, 1970;Archard, 2002). This reflects a more general, longstanding worry about the corrosive effects of markets on different values and relationships.…”

Section: Protecting Societal Valuesmentioning

confidence: 99%

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Kidney Sales and the Analogy with Dangerous Employment

Malmqvist

2013

Health Care Anal

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“…The idea is that would-be providers who seek financial gain have an incentive to hide potentially disqualifying medical information, in contrast to providers who have the recipients' interest at heart. This concern has been raised in relation to blood donation (Titmuss 1970) and kidney donation (Rothman and Rothman 2006), but in principle it applies more broadly. Can body parts be distinguished on such grounds?…”

Section: Harm To Recipientsmentioning

confidence: 99%

Does the ethical appropriateness of paying donors depend on what body parts they donate?

Malmqvist

2016

Med Health Care and Philos

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Abstract:The idea of paying donors in order to make more human bodily material available for therapy, assisted reproduction, and biomedical research is notoriously controversial. However, while national and international donation policies largely oppose financial incentives they do not treat all parts of the body equally: incentives are allowed in connection to the provision of some parts but not others. Taking off from this observation, I discuss whether body parts differ as regards the ethical legitimacy of incentives and, if so, why. I distinguish two approaches to this issue. On a "principled" approach, some but not all body parts are inherently special in a way that proscribes payment. On a "pragmatic" approach, the appropriateness of payment in relation to a specific part must be determined through an overall assessment of e.g. the implications of payment for the health and welfare of providers, recipients, and third parties, and the quality of providers' consent. I argue that the first approach raises deep and potentially divisive questions about the good life, whereas the second approach invokes currently unsupported empirical assumptions and requires difficult balancing between different values and the interests of different people. This does not mean that any attempt to distinguish between body parts in regard to the appropriateness of payment necessarily fails. However, I conclude, any plausible such attempt should either articulate and defend a specific view of the good life, or gather relevant empirical evidence and apply defensible principles for weighing goods and interests.

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The gift relationship from human blood to social policy

Cited by 219 publications

References 0 publications

Choice and compassion at the end of life: A critical analysis of recent English policy discourse

Choice and compassion at the end of life: A critical analysis of recent English policy discourse

Kidney Sales and the Analogy with Dangerous Employment

Does the ethical appropriateness of paying donors depend on what body parts they donate?

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