Bloody Bioethics: Why Prohibiting Plasma Compensation Harms Patients and Wrongs Donors

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This is the first book to argue in favor of paying people for their blood plasma. It does not merely argue that offering compensation to plasma donors is morally permissible. It argues that prohibiting donor compensation is morally wrong--and that it is morally wrong for all of the reasons that are offered against allowing donor compensation. Opponents of donor compensation claim that it will reduce the amount and quality of plasma obtained, exploit and coerce donors, and undermine social cohesion. James Stacey Taylor argues that empirical evidence demonstrates that compensating plasma donors greatly increases the amount of plasma obtained with no adverse effects on the quality of the pharmaceutical products that are manufactured from it. Prohibiting compensation thus harms patients by reducing their access to the medicines they need. He also argues that it is the prohibition of compensation--not its offer--that exploits donors, fails to respect the moral need to secure a person's authoritative consent to her treatment, and prevents donors from giving their informed consent to donate. Prohibiting compensation thus not only harms patients but also wrongs donors. Bloody Bioethics will appeal to researchers, advanced students, and medical professionals interested in bioethics, moral philosophy, and the moral limits of markets. Cover Half Title Series Title Copyright Dedication Contents Acknowledgments Preface Introduction The Focus of This Volume: Financial Compensation for Plasma Donation Should Donors Be Compensated? A Focus on Ethics 1 Compensating Plasma Donors Is Safe and Effective Introduction Safety and Compensated Plasma Collection The Effectiveness of Compensated Plasma Collection Plasma Donation and Donor Health Conclusion 2 Donor Compensation and Informed Consent Introduction Informed Consent and the Requirement to Disclose Informed Consent in Autonomy Theory and Bioethics Information Relevant to Informed Consent Crowding Out and Compensated Donation Compensated Donation, Crowding Out, and Informed Consent Why Informed Consent Requires Donor Compensation Compensation, Signaling, and Charitable Donations The Irrelevance of Economic Value for Some Donors Objections and Responses The First Objection The Second Objection Well-Being, Autonomy, and Donor Compensation Conclusion 3 Coercion, Force, Autonomy, and Consent Introduction The Outline of This Chapter The Argument From Coercion Coercion and Autonomy The Argument From Coercion Fails The Argument From Force The Argument From Force and the Objective Value of Autonomy The Argument From Force and Donor Autonomy The Argument From Abdicated Control Two-Tier Consent Two-Tier Consent and the Narrowing Bounds of Permissible Exchange Back to Donor Compensation Conclusion 4 Exploitation Introduction An Analysis of Exploitation Defending This Account of Exploitation Conclusion 5 Donor Exploitation Introduction Exploitation and Plasma Donation Current Commercial Plasma Centers Do Not Exploit Their Donors Do Plasma Centers That Are Prohibited From Compensating Their Donors Exploit Them? The First Class of Vulnerable Donors: Those Who Would Donate Whether or Not Compensation Is Offered, but Who Would Prefer to Receive Compensation The Second Class of Vulnerable Donors: Those Who Would Only Donate if They Believed That There Will Be a Shortage of Plasma as a Result of the Prohibition of Donor Compensation Donor Exploitation Sauce for the Goose, Sauce for the Gander Stacking the Deck? Donor Compensation and Alternative Analyses of Exploitation Neo-Lockean Exploitation Marxian Exploitation Which Analysis of Exploitation Should We Accept? Blame and Exploitation Conclusion 6 Social Cohesion and Donor Approbation Introduction Social Cohesion and the Avoidance of Hypocrisy Approbation or Compensation? Two Tenets of Market Faith Altruism and Approbation The Myth of Stigmatized Compensated Donation Conclusion 7 Contamination, Cohesion, and Imagined Community Introduction The Tottering Domino of Social Cohesion The Gift of Blood and the Imagined Community Problems With This View A Better Alternative Conclusion Conclusion From Where Should Plasma Be Secured? Plasma as a Strategic Resource Moving Beyond Plasma: How Far Can the Arguments Extend? Finis Bibliography Index