Which countries are known to legally pay for plasma donation?
April 4, 2018 8:10 PM Subscribe
For those that do not pay, any published discussions about why not?
A friend is currently donating plasma 1-2x a week in a South Western American state and earning what to me was a surprising amount of extra money-- sometimes $500 for the month. We wondered if other countries pay plasma donors or if they require it to be a true donation.
We are interested in the ethical discussion about selling this and other body tissues, so we would be very interested in books/articles discussing any particular nation's decision to not pay for these kinds of services.
That is our main question, but we were also curious if places that do pay have any kind of citizenship requirement or any kind of restriction like that? Upon reflection, I am just surprised that a decade as a young traveler scheming ways to stay abroad, I never heard chat around the backpacker crowd about making extra money by signing on to be a plasma donor.
A friend is currently donating plasma 1-2x a week in a South Western American state and earning what to me was a surprising amount of extra money-- sometimes $500 for the month. We wondered if other countries pay plasma donors or if they require it to be a true donation.
We are interested in the ethical discussion about selling this and other body tissues, so we would be very interested in books/articles discussing any particular nation's decision to not pay for these kinds of services.
That is our main question, but we were also curious if places that do pay have any kind of citizenship requirement or any kind of restriction like that? Upon reflection, I am just surprised that a decade as a young traveler scheming ways to stay abroad, I never heard chat around the backpacker crowd about making extra money by signing on to be a plasma donor.
You've only recently been able to get paid to donate in Canada. However it is not anywhere near as lucrative as the US (~$50 a week max plus draw incentives). There are also limits on how much you can donate during a rolling six month window (I don't personally donate so I'm not sure how much of a concern that is in practice).
There isn't a citizenship requirement but you do have to be able to legally work in Canada, have a SIN and photo ID, and have a permanent residence within 100km of a donation centre. Plus the initial process to apply to be a donor takes 16 weeks. It's not something a transient international traveller is likely to bother with.
posted by Mitheral at 8:55 PM on April 4, 2018
There isn't a citizenship requirement but you do have to be able to legally work in Canada, have a SIN and photo ID, and have a permanent residence within 100km of a donation centre. Plus the initial process to apply to be a donor takes 16 weeks. It's not something a transient international traveller is likely to bother with.
posted by Mitheral at 8:55 PM on April 4, 2018
In New Zealand, donors are not paid for plasma or for whole blood donations. I cannot say with any confidence why this is, but it is my understanding that the World Health Organisation believe offering payment can compromise the quality of donations so that may have something to do with it.
posted by BeeJiddy at 9:01 PM on April 4, 2018
posted by BeeJiddy at 9:01 PM on April 4, 2018
The NHS does not pay for donation - it would be against its whole ethos. I certainly wouldn’t donate every four months if it was for cash rather than altruistic. I’m not sure why - it would just feel like less of an obligation. I’d assume other donors would step forward if there was cash involved.
This Guardian article has some links you might find interesting.
posted by tinkletown at 2:34 AM on April 5, 2018 [1 favorite]
This Guardian article has some links you might find interesting.
posted by tinkletown at 2:34 AM on April 5, 2018 [1 favorite]
More generally, in ethical theory, paying for plasma donation or whatever can be a coercive force, thus compromising autonomous decision making and taking advantage of “vulnerable” groups, eg poor people. Not really about the quality of donations; there will be other safeguards for that. Blood is screened and tested before going into the pool to be used in transfusions etc.
In research & medical ethics, if you’re paying or otherwise offering incentives to participants, it should only be to compensate for their time or to cover their cost of coming to your lab or wherever. It should equalise what you’ve given up to come take part in research and not be a carrot away from other things like your normal day job or cause you to compromise your wellbeing.
In Australia we don’t pay for blood donations but people get lunch and space to recover if they feel woozy. And medical attention if you have some kind of bad response.
posted by stellathon at 4:07 AM on April 5, 2018 [1 favorite]
In research & medical ethics, if you’re paying or otherwise offering incentives to participants, it should only be to compensate for their time or to cover their cost of coming to your lab or wherever. It should equalise what you’ve given up to come take part in research and not be a carrot away from other things like your normal day job or cause you to compromise your wellbeing.
In Australia we don’t pay for blood donations but people get lunch and space to recover if they feel woozy. And medical attention if you have some kind of bad response.
posted by stellathon at 4:07 AM on April 5, 2018 [1 favorite]
[I]t is my understanding that the World Health Organisation believe offering payment can compromise the quality of donations so that may have something to do with it.
Here's a 123-page WHO report from 2010 on their goal of attaining a 100% voluntary donation system for blood and blood products. The rationale for preferring voluntary donors rather than paid donors (or family/replacement donors, who donate to a specific person) is laid out on pages 14–20. In brief: in addition to the safety concerns (voluntary donors are more likely to forgo donation when they're higher-risk) and the ethical concerns about exploitation, having a larger pool of occasional voluntary blood donors rather than a smaller pool of regular paid blood donors also means that it's easier to meet transfusion needs during a disaster.
posted by Johnny Assay at 4:39 AM on April 5, 2018 [4 favorites]
Here's a 123-page WHO report from 2010 on their goal of attaining a 100% voluntary donation system for blood and blood products. The rationale for preferring voluntary donors rather than paid donors (or family/replacement donors, who donate to a specific person) is laid out on pages 14–20. In brief: in addition to the safety concerns (voluntary donors are more likely to forgo donation when they're higher-risk) and the ethical concerns about exploitation, having a larger pool of occasional voluntary blood donors rather than a smaller pool of regular paid blood donors also means that it's easier to meet transfusion needs during a disaster.
posted by Johnny Assay at 4:39 AM on April 5, 2018 [4 favorites]
In France, body part donations, including blood and blood part donations, cannot be paid for, in whatever form (so no direct cash, but also no coupons or anything -- for blood donations we do get food for health reasons).
It's in the Code de la Santé (Health Code), though no justification is offered.
posted by snakeling at 5:22 AM on April 5, 2018
It's in the Code de la Santé (Health Code), though no justification is offered.
posted by snakeling at 5:22 AM on April 5, 2018
You've only recently been able to get paid to donate in Canada.
You still can't be paid in most provinces, and there is a lot of ongoing debate over whether allowing paid donations could reduce the number of regular (unpaid) donations, which patients rely on for plasma transfusions. In Canada, paid plasma donations are processed into plasma protein drugs like IVIG; plasma transfusions are always from unpaid donors (who are, statistically speaking, at lower risk of transmissible disease than paid donors are).
Notably, Canada currently relies heavily on paid plasma donations from the US to manufacture plasma protein drugs, as a very large amount of plasma is needed to meet the rapidly growing demand for them.
There's quite a bit more information about this on the Canadian Blood Services website (e.g. Plasma main page).
posted by randomnity at 9:31 AM on April 5, 2018
You still can't be paid in most provinces, and there is a lot of ongoing debate over whether allowing paid donations could reduce the number of regular (unpaid) donations, which patients rely on for plasma transfusions. In Canada, paid plasma donations are processed into plasma protein drugs like IVIG; plasma transfusions are always from unpaid donors (who are, statistically speaking, at lower risk of transmissible disease than paid donors are).
Notably, Canada currently relies heavily on paid plasma donations from the US to manufacture plasma protein drugs, as a very large amount of plasma is needed to meet the rapidly growing demand for them.
There's quite a bit more information about this on the Canadian Blood Services website (e.g. Plasma main page).
posted by randomnity at 9:31 AM on April 5, 2018
I should also clarify that CBS, the nonprofit organization responsible for the blood system in Canada, does not use paid donors in Canada (despite buying US paid plasma to allow the manufacture of sufficient plasma-derived drugs to meet the Canadian need). All paid plasma centres in Canada are private, for-profit companies.
posted by randomnity at 9:45 AM on April 5, 2018
posted by randomnity at 9:45 AM on April 5, 2018
I can't fully answer your questions, but I think you need to separate out *donation* of whole blood and blood components from the *sale* of plasma.
Definitions that are relevant here:
- Whole blood: What you normally think of as "blood", containing red cells, white cells, platelets and plasma.
- Plasma: a component of whole blood that can be used for transfusion, or for making medical therapies and drugs.
When you donate blood at a non-profit blood bank, you can donate either whole blood or just a component (such as plasma or platelets). This blood is used by hospitals for transfusions directly to patients. In the United States, donations must* be made by volunteers who are not compensated financially. This is in order to prevent people who do not meet the criteria from lying on their intake.
What's commonly called "donating plasma" is really *selling* plasma to a for-profit company (this happens in the United States as well). Your plasma is purchased at the market rate by medical companies that process and use it for various medical therapies (random example). Here's a rather damning article about the industry from The Atlantic.
I realize this is super confusing to anyone who doesn't work in blood banking!
*There are some exceptions, but this is largely true.
posted by radioamy at 11:42 AM on April 5, 2018
Definitions that are relevant here:
- Whole blood: What you normally think of as "blood", containing red cells, white cells, platelets and plasma.
- Plasma: a component of whole blood that can be used for transfusion, or for making medical therapies and drugs.
When you donate blood at a non-profit blood bank, you can donate either whole blood or just a component (such as plasma or platelets). This blood is used by hospitals for transfusions directly to patients. In the United States, donations must* be made by volunteers who are not compensated financially. This is in order to prevent people who do not meet the criteria from lying on their intake.
What's commonly called "donating plasma" is really *selling* plasma to a for-profit company (this happens in the United States as well). Your plasma is purchased at the market rate by medical companies that process and use it for various medical therapies (random example). Here's a rather damning article about the industry from The Atlantic.
I realize this is super confusing to anyone who doesn't work in blood banking!
*There are some exceptions, but this is largely true.
posted by radioamy at 11:42 AM on April 5, 2018
This thread is closed to new comments.
posted by Rob Rockets at 8:54 PM on April 4, 2018