Talking Plasma and Markets with my Mother

Matthew Herder shares a conversation with his mother about why she is a regular plasma donor.

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My mother came for a brief visit to Halifax in early April. One evening during her visit, she heard a story on CBC about Canadian Plasma Resources and its for-profit operations in Saskatchewan. She recited the story’s narrative as she went up the stairs to bed. Plasma (the watery part of blood that contains red blood cells) was in short supply and we needed a company like Canadian Plasma Resources to collect more plasma.

I asked my mother if she could spare a few minutes to talk to me about her experience as a donor of whole blood and plasma.

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Mum, how long have you been giving blood and why do you do it?

Since 2010. Thanks to your sister. She got me started. Just something, she thought, that was easy to do. I always thought that because I was O+, that they didn’t need my blood. But that was stupid; as the most common blood type, they sure could use it.

How many donations of whole blood and plasma have you made?

Seventy-five donations in total. Originally, I was a whole blood donor. But you can only do that every 56 days and so I’ve probably only given whole blood ten times or so. But if you do that consistently, they [Canadian Blood Services] start asking you to donate plasma or platelets. Until they know you’re a regular, they won’t ask you about donating plasma because this takes a full hour and donating platelets takes two hours. Whole blood donation only takes 20 minutes. I started giving plasma in 2011 or 2012. I give plasma every two weeks.

Why did you start giving plasma instead of whole blood?

One day I just noticed there were people in a sort of separate area at the blood donor clinic. I asked what they were doing. The staff told me they were giving plasma and that extra time was involved. I said I’d be willing to do that. I was surprised at how much better I felt after giving plasma compared to giving whole blood. After donating whole blood I felt woozy. But with plasma, I felt fine; it just takes longer.

Why do you think more people don’t give plasma?

I guess part of it is the time involved, but there are other factors too. With whole blood, there’s that whole slogan about giving blood to save three lives. With plasma, there’s nothing like that. They have to break it down and do other stuff with it before it’s used in chemo or to treat burns. So I guess maybe people don’t like that as much, not being able to say that they are directly saving lives. But I just don’t think they even try to pitch it to people. I don’t think they educate people at all about how much better you feel after giving plasma.

If a commercial plasma clinic paid you, say $25 for your plasma, would you go there?

To tell you the truth, the idea of being paid for it turns me off. I know there are people who would, people who could use that money. And I don’t judge them for it all.

I don’t know how representative my mother’s experiences or views about giving plasma are. But they raise important questions.

Will putting a price on plasma lead to a greater supply? The evidence on this point is complex. Recent studies suggest economic rewards (apart from money) spur donation, but we still don’t really know whether paying people for blood or plasma will help increase supply or scare off altruistic donors. My mother takes pleasure in knowing it’s a good deed that she can do for free; were she paid for it she’d stop.

Given uncertainty about the effect of payment on supply, coupled with the tragic history of Canada’s tainted blood scandal, why turn to the market to solve the problem of short supply before trying to improve voluntary plasma donation through better education and outreach?

Back in 2014, when Canadian Plasma Resources tried to establish its business next to a homeless shelter in downtown Toronto, the Ontario government passed a law banning payment for blood and plasma. The same year, similar legislation (the Voluntary Blood Donation Act) was introduced in Nova Scotia by a member of the opposition, but did not become law.

Now that Canadian Plasma Resources has set its sights on Nova Scotia, legislation may be needed to preserve the public system of blood and plasma donation. Provincial governments may also need to find new ways to work with Canadian Blood Services to improve its education and outreach to potential donors. If my mother’s experience serves as any indication, it appears there’s room for significant improvement.

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Matthew Herder is an Associate Professor, Health Law Institute, Faculties of Medicine and Law, Dalhousie University. @cmrherder