The Ethics of Blood Donation
Moral egoism holds that we as human beings should always act out of a motivation of self-interest, even when it is possible or likely that others may be harmed - The Ethics of Blood Donation introduction. When discussing the ethics of donating blood, then, moral egoism would hold that blood should never, ever, be donated, but only possibly sold. If I am acting only in my own self-interest, why would I ever want to donate anything, especially the blood that courses through my veins, keeping me alive and healthy? Even though blood replenishes itself, what if donating blood makes me nauseous or dizzy, or perhaps even makes me feel somewhat poorly for the remainder of the day?
Then of course by this theory I shouldn’t give blood, end of story. If, on the other hand, I am being paid, especially generously paid, for my blood, then in the interest of taking care of me, I will donate blood and spend the money on a new pair of shoes for myself. The theory goes somewhat awry when we take into consideration the deep, unexplainable love we hold for our children, our families, or friends, and the knowledge that if they needed blood to stay alive we would give it in a heartbeat without any thought of self-interest or selfish motivations.
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The act utilitarian states that only the consequence of the act itself matters in any way when determining whether it is morally right or morally wrong. Well, the consequence of donating blood is that many, many people, who might otherwise die from lack of sufficient blood supply, will then live. We can look at it on an individual basis, and, say, find out from the hospital that a young man was severely injured in a motorcycle accident and was rushed to the local hospital where it was found that he has a fairly rare type of blood.
By an amazing coincidence I also have this type of blood, and even more amazing, yesterday, during the annual blood drive I donated blood. (even though I am a “needle sissy,” and dreaded doing so. ) Because of my act of selflessness, the young man, who has parents who adore him, a wife of just a year and a brand new baby, lives–a miracle indeed. Therefore, the consequence of my act is that this young man gets to return to his family and his life, and who knows what contributions he will give to the world? My act of donating blood must then be morally right.
Kant believed that only actions performed for the sake of duty have any moral worth, and that the more we desire not to do something that we perhaps have a duty to do, the higher the moral worth becomes. Conversely, if we perform an action just because we are inclined to do so, it holds little moral worth. This theory would hold that the moral rightness or wrongness of donating blood lies completely in your personal motivations. For instance, if I really, really, really, don’t want to donate blood, for whatever reasons, be they physical, moral, or just plain laziness, but I do it anyhow, then I have performed an act of moral worth.
If, on the other hand, I really enjoy donating blood, because I like the orange juice and cookies I get after the donation or I just want to get out of work, then my act has little moral worth. The same act, different consequences. What is my intention when I am donating blood? If my motives are pure, and I feel I have a duty to donate blood, then, by Kantian ethics, it is a morally responsible and right choice. The prima facie obligation theory is also known as a conditional duty and states that we are morally obliged to perform the duty of giving blood unless there is a choice “B” which is more incumbent than donating blood.
The $64,000 question of course being what would make any other choice “more incumbent. ” Suppose I feel that it is my moral duty to donate blood, therefore I should and shall. Suppose also, that a flyer is passed around at work stating the hospital is paying $50. 00 per pint of my exact blood type only this week. Well, it is certainly “more incumbent” for me to get paid for doing my moral duty as opposed to not getting paid, but is that really a fair comparison?
What if it is “more incumbent” for me to go to the Hamptons for the weekend, and I want to leave early on Friday, thereby making it impossible to do my moral duty and donate blood? I believe that the second choice has to be morally significant as well for there to exist a choice at all, and neither of the above examples qualify. If the morally significant alternative to my giving blood was to donate a kidney, then the kidney donation, or “door B” is probably more morally acceptable than donating blood.
In any case, prima facie obligation would hold that donating blood was a moral obligation unless there was a more significant moral obligation waiting around the corner. I personally believe that making blood a commodity for sale rather than a gift to be freely given and received is morally wrong. Even though I believe it is, in fact, my moral duty to donate blood, with the thought that another human being’s life could be saved, I dislike the system that begs me to donate, then turns around and sells what I freely donated.
While I understand there are many costs associated with the donation of blood, such as the nurse who draws the blood, the lab charges associated with typing and testing, and even the storage of blood, I don’t believe that there should be any kind of profit made from my gift. Perhaps if we could all be assured that only the absolute most necessary charges were being associated with the gift of blood, more people would freely donate. I know that in my own community when a specific person is ill and needs blood, there is never any shortage of people waiting in line to donate.
Perhaps this is because it becomes a more personal issue. Even if I do not know the person who is ill, somebody I know most likely does, therefore I feel good about donating because I can relate it to the life of a specific person. Our United States system, however, targets broke college students or the homeless, in particular, pays them nominally for donating blood, then sells it for a huge profit. I just can’t see the moral rightness in a situation such as this. So, do I have the “right” to sell my blood? From the act utilitarian I have the right because the consequence of my act is morally acceptable, i. . , a life is saved. From the libertarian point of view, or Nozick’s view in particular which states that all human beings have absolute rights to their person and the fruits of their labor, then again, I absolutely have the right to sell my blood. I have the right to my own person, which includes my own blood, and the fruits of my labor, or blood donation, could be a feeling of doing something worthwhile. Rawl’s egalitarian view states that we each have an equal right to the most extensive liberties that are also compatible with similar liberties for all other persons.
By this theory I only have the “right” to sell my blood if every other person has the same right. Since everybody in the United States does have an equal right to sell their blood, then by Rawl’s theory, it’s okay. Does the hospital have the right to charge patients for my blood that they received free of charge because of my moral belief in donating blood? According to the act utilitarian, it is the consequence of the hospital’s action that matters. Even though the hospital got my blood for free, and charged Jane Doe for it, they saved her life, therefore it is morally acceptable.
Nozick’s view doesn’t really apply so much as he is stating that human beings have absolute rights to their person and the fruits of their labors, but a hospital is hardly a human being, rather an institution. By this theory, then, the hospital essentially has no rights, therefore is not justified in selling donated blood. By Rawl’s theory, again, we are talking about an institution, not a human being, but if we equate one hospital with another, then if one has the right to sell donated blood, so do all the rest. The British system is such that blood is freely given and received and cannot be bought or sold.
By the act utilitarian, the consequences of saving lives with blood that is freely given and is not sold is that of saving a life, therefore must be morally right and just. If we apply Nozick’s view to the institution rather than the person, then even though the hospital has absolute rights over the fruits of its labor (to a hospital administrator this could mean that “his” staff drew the blood, “his” staff tested the blood and “his” building houses the blood, therefore the hospital as an institution has absolute rights over that blood), the hospital by virtue of not selling donated blood is absolutely just and moral.
By Rawl’s view, obviously other hospitals in Britain also share the same system of not selling donated blood, therefore, they are all moral and just! In a system where blood is bought and sold only, and cannot be donated, the only consequence of giving blood would be the check you receive when it is over. Therefore, the act utilitarian, holding that only the consequence matters, would have to judge both my consequences (money) and the consequences of the blood being sold to a person in need (saving a life. My consequences are hardly moral and just, but perhaps the hospital’s consequence of saving a life is the same whether the blood is sold or given. Nozick’s theory in this case would state that even though I was getting paid for giving blood, I am entitled to the fruits of my labor (money for giving blood) and the hospital is entitled to the fruits of their labor (money for saving a life). Rawl’s theory says that if the system is right and just for other humans and other hospitals, then it is right and just for me.
The U. S. system where some blood is bought and sold and some blood is donated gets a little stickier when determining the moral correctness. The act utilitarian would hold that the consequences are essentially the same whether the blood is bought, sold, or donated, and that consequence is saving a life, therefore either or both are morally right. Nozick’s theory of my being entitled to the fruits of my labor would make selling my blood more financially right, but donating it more ethically right.
Nozick’s theory in relation to the hospital’s giving or selling of blood would make it morally right for them to give the blood, but they would reap the rewards of their own labors by selling it. And finally, Rawls’ theory would hold that either system is acceptable, bought, donated or sold so long as it is equally acceptable for all people and all hospitals. Blood is used each and every day in hospitals across the world for a myriad of procedures, including transfusions for bleeding disorders, transfusions for trauma, surgeries, both elective and emergency, as well as organ transplants.
Blood also has a limited shelf life unless it is frozen, and must be used within a few weeks. Therefore each and every day brings an ongoing need for adequate blood supply and a fresh blood supply. If I am in the hospital, dying due to lack of adequate or fresh blood supply I am certainly going to be praying for a Good Samaritan to come to my aid for no other reason than sheer altruism. Paying for blood tends to bring an element of those who knowingly donate blood that is tainted by illness, disease or unhealthy lifestyle because of the financial incentive.
As stated before, poor college students or the homeless are targeted for paid blood donation because they are financially vulnerable, not because they are morally prompted. Voluntary and unpaid donation of blood does encourage safety, however we are such a cynical nation we tend to wonder about those who routinely donate blood—what’s their angle after all? What if we were to implement a “Good Samaritan” law and require each adult in the United State to donate blood twice a year, just in case we do turn out to be the one in the hospital?
Well, that’s going to be a difficult if not impossible law to uphold, after all, how can the United States require that each human come to the aid of a stranger? I am in favor of the donation of blood, even with the pitfalls involved, and the sale of blood only to the extent of recouping actual costs. I believe this to be the most fair, equitable and morally “right” choice in this situation.