Altruism and blood product donation: Problematizing altruism and voluntary donation


Mary Berger, Centre for Advancing Health Outcomes

Blood product donation (BPD) is perceived to be a socially and morally valued act within society (Titmuss, 1971). In the Canadian context, BPD is always voluntary and people who donate never know who receives their donation except in extreme cases. Due to these factors and based on Titmuss’ work (1971), BPD has been dubbed the last purely altruistic act. However, viewing unpaid, voluntary BPD as a purely altruistic act has negative implications for those who experience marginalization in the blood donation space. The value placed on voluntary BPD gives those who face limited barriers a privileged status in the blood donation space. Therefore, privilege and status determine the ability to be altruistic. Conversely, the inability to perform altruistic acts, like BPD, prevents marginalized groups from engaging in socially desirable acts, which only reinforces their stigmatized identity. The inability to engage in blood donation demarcates those worthy of giving and those who are not. Historically, people who have been disproportionately banned or discouraged from donating have been BIPOC communities (Tran et al., 2013) and those belonging to the LGBTQ+ community, specifically gay men (Grace et al., 2021). The exclusion of these marginalized groups from BPD has long-lasting negative impacts on how they are perceived within the context of blood donation. Moreover, the emphasis on altruism as the ‘gold standard’ for donor motivations produces problematic taken-for-granted assumptions that those who can donate with few barriers are selfless heroes and those who cannot are potentially dangerous or high-risk donors (Valentine, 2005). The gatekeeping of who is a good donor or bad donor has wide-reaching implications for marginalized groups, and can threaten their right to citizenship. The assumptions of liberal policies and capitalist economic principles propose that rationality, autonomy, and productivity are necessary to be considered a full citizen (Carey, 2009; Erevelles, 2002). However, not everyone can fit these assumptions, which limits their rights and access to public services. In the context of BPD, limiting access to socially desirable behaviours restricts their rights and ability to be viewed as altruistic. We propose using Goffmans Presentation of Self Theory to understand the experiences of those othered in blood donation spaces. Altruism can be framed as a way for people to manage their impression as socially conscious citizens. Prioritizing altruism in BPD gatekeeps those who face structural and systemic barriers from giving, making it more challenging to present themselves as altruistic. While altruism bolsters some individuals moral standing, it can simultaneously highlight stigmatizing aspects of ones identity that exclude them from socially valued practices. Thus, the emphasis on altruism in BPD exacerbates the divide between privileged and marginalized groups. Marginalized groups must engage in impression management to mediate the impact of preclusion from donation on their identity, or risk further oppression.

Non-presenting authors: Adam Easterbrook, Centre for Advancing Health Outcomes; Nick Bansback, Centre for Advancing Health Outcomes

This paper will be presented at the following session: