The ethics of blood donation: does altruism suffice?

Is the recommendation of the WHO, endorsed by all member states, that all blood donations should be voluntary and non-compensated ethically coherent and realizable in practice? In a recent paper, Farrugia et al have argued for a plurality of both compensated and non-compensated systems, claiming that, from both an ethical and practical perspective, the classical concept of the 'the gift relationship', advocated over 40 years ago by Richard Titmuss, is unnecessary and inadequate. This paper focuses on the ethical aspects of this debate, considering the concepts of altruism, reciprocity and social solidarity as they apply to the procurement of blood and blood products, as well as evidence regarding safety of different sources of blood and the motivations of regular donors. It concludes with a discussion of the view summarized in a recent publication by Campbell (2009), that, although the body may be monetized, doing so would result in a loss of human value.