Reassessing the 'gift relationship': the meaning and ethics of blood donation for genetic research in the UK

This thesis is based on a critical re-appraisal of Richard Titmuss' classic formulation of gift relationships, which has long been a point of reference for thinking about blood donation in Britain. It argues that Titmuss' interest in the intersections of social systems and health care, together with his concern with mutuality, has been lost in the characterisation of blood donation as a uniquely altruistic activity. This argument is applied to some key assumptions about blood donation in Britain in the thesis, which considers their historical and political contours, and interrogates them in the light of the development of large biobanks which require blood samples for genetic research. In examining the revival of this 'mobilising metaphor' for genetic biobanks, interview data from UK National Blood Service donors and with others donating blood for a genetic research project is generated and analysed. This reveals that the notion of gifted blood has considerable acuity in summoning up social allegiances based on a sense of community. It is suggested however that mutuality (not one-dimensional altruism) is the model implied by these participants' stance to blood donation or participation in research. This resonates with the re-evaluation of Titmuss' work, in which debates about practical mutual provision and social insurance are more prominent than is generally acknowledged. Biobanks, as with blood banks of a traditional kind, are bound up with an assertion of common interests. The tacit use of notions of gifted blood and solidarity in the context of contemporary policies on biobanks are revealed as problematic. The thesis concludes by underlining the importance of having an explicit political debate about the UK Biobank, and of developing mechanisms to negotiate and protect the collective interests to which it refers

Reassessing the 'gift relationship': the meaning and ethics of blood donation for genetic research in the UK

This thesis is based on a critical re-appraisal of Richard Titmuss' classic formulation of gift relationships, which has long been a point of reference for thinking about blood donation in Britain. It argues that Titmuss' interest in the intersections of social systems and health care, together with his concern with mutuality, has been lost in the characterisation of blood donation as a uniquely altruistic activity. This argument is applied to some key assumptions about blood donation in Britain in the thesis, which considers their historical and political contours, and interrogates them in the light of the development of large biobanks which require blood samples for genetic research. In examining the revival of this 'mobilising metaphor' for genetic biobanks, interview data from UK National Blood Service donors and with others donating blood for a genetic research project is generated and analysed. This reveals that the notion of gifted blood has considerable acuity in summoning up social allegiances based on a sense of community. It is suggested however that mutuality (not one-dimensional altruism) is the model implied by these participants' stance to blood donation or participation in research. This resonates with the re-evaluation of Titmuss' work, in which debates about practical mutual provision and social insurance are more prominent than is generally acknowledged. Biobanks, as with blood banks of a traditional kind, are bound up with an assertion of common interests. The tacit use of notions of gifted blood and solidarity in the context of contemporary policies on biobanks are revealed as problematic. The thesis concludes by underlining the importance of having an explicit political debate about the UK Biobank, and of developing mechanisms to negotiate and protect the collective interests to which it refers

Trust, Nostalgia and Narrative Accounts of Blood Banking in England in the 21st Century

Historically, cultural accounts and descriptions of blood banking in Britain have been associated with notions of altruism, national solidarity and imagined community. While these ideals have continued to be influential, the business of procuring and supplying blood has become increasingly complex. Drawing on interview data with donors in one blood centre in England, this article reports that these donors tend not to acknowledge the complex dynamics of production and exchange in modern blood systems. This, it is argued, is congruent with nostalgic narratives in both popular and official accounts of blood services, which tend to bracket these important changes. A shift to a more open institutional narrative about modern blood services is advocated, as blood services face current and future challenges