ARGUMENTS IN FAVOR AND AGAINST PLASMA DONATION

This is quite literally “blood money”: Is it ethical for plasma donation centers to give monetary compensation to plasma donors?

The primary argument in favor of compensation for plasma donation argues that past attempts of encouraging voluntary plasma donation have failed to provide an adequate minimum amount to support the ability to produce medicine, and that the only successful path to meeting demand is to pay for it. On the other hand, opponents argue that financial incentives exploit the poor, who are reliant on additional, nontraditional income, and also that there are unknown health consequences to people who donate frequently.

Also, viewed from the opposite, individual perspective, is it right to sell your plasma for money?

In favor

“It is the biggest industry you’ve never heard of,” according to Peter Jaworski, associate professor at Georgetown University. Jaworski, who teaches business ethics, points out that the United States exports a very large amount of the world’s plasma, to the point that the exports are larger than steel and aluminum. He reports that “exports from plasma from the United States account for 1.6% of total exports by GDP (gross domestic product).”

In Jaworski’s publication to the Niskanen Center in 2020, “Bloody Well Pay Them: The Case for Voluntary Remunerated Plasma Collections,” he writes that countries that import a large percentage of their plasma, including the UK (imports 100% of plasma supply), Australia (52%), and New Zealand (13%), are dependent on other countries such as the U.S. to supply their deficits. In addition, he finds the fact that “5% of the world’s population is responsible for more than half of all the plasma collected in the world” leads to inflation of plasma prices and creates a higher burden on low- and middle-income countries.

He notes that there is a “stigma” about selling one’s blood for money, in that paying for plasma erodes altruistic intentions about “donating” plasma, in the manner of typical blood donations . However, he counters that belief, saying that it is possible to both be paid and to operate altruistically. He points out that he himself is a professor who does get paid but does not teach as a way to “maximize my income,” and argues that the same is true for teachers and physicians as he concludes that altruistic intent and getting paid are not mutually exclusive.

Concerns

As Jaworski points out the benefits that plasma has in helping others, doctoral student Analidis Ochoa raises concern that the benefits of plasma do not come without ulterior motives from the for-profit plasma industry, nor are they free of concerns for donors.

According to Ochoa, most of the plasma donation centers are specifically placed in locations where a high proportion of people live under the poverty line. Ochoa concludes that the plasma industry places its centers there to exploit low-income people “because these are the areas where people who are most in need of (outside) income live.” This finding is aided by the Center for Heath Care Research and Policy, which researched a similar topic and found data that supports Ochoa’s statement with the publication concluding that 43% of donors are unemployed, with an additional 20% consisting of college or vocational students.

In addition to exploiting individuals who need outside income, Ochoa also expressed concerns that there isn’t enough information on the safety of donors, especially the long-term health for frequent donors. The same publication cited above adds to this by finding that 70% of donors have had a side effect such as dehydration, bruising, and even fainting, and that 13% of donors have knowingly misled plasma center staff about their medical conditions so that they can donate.

While the FDA allows a maximum of two plasma donations per week, concerns about frequent donation has been raised by the American Red Cross, which recommends up to only 13 times a year, or once every 28 days, in stark contrast to the 104 donations that the FDA permits annually.

Firsthand experience

To gain firsthand knowledge about plasma donation, I volunteered to supply plasma at a donation center for a period of one month to get a better understanding of the usual routine a donor would go through. On my first visit, I would have a private physical exam to determine if I was an eligible candidate to be donating plasma. (Note: The technicians are NOT physicians and they do not claim to be.) Overall, the tests were brief and I was able to donate on my first visit; including the tests and exams, it took about 3 hours total but soon shortened to 1-and-one-half hours per visit. I donated the maximum of two times a week, with at least 24 hours spaced apart between donations.

For my efforts, I was paid $100 for each of my first 10 visits. After that, compensation varied from $40 to $100, with several different incentives for more numerous donations. I only suffered a bit of light-headedness on the first visit, and no other effects after.

One of the biggest things to note about the plasma industry is the use of the phrase “compensation” or “monetary compensation” used to describe the transaction of donors selling plasma. “Of course it doesn’t sound good for us to say that we are buying your plasma,” I was told by an employee who wished to remain anonymous.

When asked about the ethics of the industry the employee expressed mixed opinions. They confidently stated the business of selling plasma is for a good purpose of producing medicine that is used in treating shocks, burns and blood-clotting issues such as hemophilia.

When asked about why people donate, the emmployee immediately replied, “Because they are poor.” They then pointed out that while people will claim to donate out of altruism to disguise the blunt reality, plasma donations are only sustainably done with financial incentives. They added that most plasma donation centers are built only in low-income areas, which helps facilitate the plasma source they need.

Despite all the criticisms, the employee said they still believed that the industry provides a net positive. They compared the act of selling one’s plasma to being a pole dancer: “It is still your body and it is your right to use it how you see fit, just like that of a stripper,” they said. “Especially if it means being able to feed or house yourself. At least selling your plasma benefits people in a meaningful way.”