Good Blood, Bad Blood, and the Market: The Gift Relationship Revisited

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Abstract
The Gift Relationship (Titmuss, 1970) argued that the UK system of voluntary blood donation was economically, medically, and morally superior to the American system, in which many blood suppliers are paid. The argument was badly put and fiercely attacked, but substantially correct. Developments since Titmuss wrote, especially AIDS, have tragically reinforced his main point: more than half of the severe haemophiliacs in the UK have been infected with the AIDS virus, almost certainly through imported blood products. Titmuss's normative argument is reconstructed, and defended against neoclassical economists who have been his fiercest critics. Finally, policy implications are briefly discussed.