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Pay for plasma: The ethical debate

WATCH ABOVE: Brendan Leier from the John Dossetor Health Ethics Centre shares his thoughts on the ethics behind pay for plasma.

Ethics appears to be at the epicentre of most conversations surrounding pay for plasma clinics – should Canadians receive money for a bodily part or a bodily fluid, such as plasma?

Dory Wood, 30, has donated blood about eight times and said the reason he does is simple.

“I have no reason not to give blood. I’ve had a couple friends who have had to use blood donations so it takes nothing out of me.”

But if he were offered remuneration, Wood said he wouldn’t be interested.

“I don’t see any reason to make money off of something that I was already born with and can give freely out to people.”

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Pay for plasma: Would donors want compensation?
Pay for plasma: Would donors want compensation?

Harishcandra Ghimire, 42, has donated blood for approximately 10 years.

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“I feel good because I can save other’s lives,” he said.

READ MORE: Pay for plasma: How it works and where the feds, Alberta stand 

But the idea of getting money in return for his donation irks Ghimire.

“Donation for me is a kind of volunteering act. I want to donate. I want to save somebody’s life. I don’t like getting compensated for that.”

The issue of pay of plasma clinics is getting attention in light of clinics opening in Saskatoon where donors are paid for their contributions. Canadian Plasma Resources gives people $25 credit cards in exchange for a donation.

Medical ethicist Brendan Leier said gift-giving is a means of establishing reciprocity and leads to the expectation an individual will get something of the same value in return.

The researcher at the John Dossetor Health Ethics Centre said that concept makes donation of blood and blood products special.

“When you take a behaviour, a complex social behaviour like that, and say ‘we’re just going to buy blood, thanks for that anyway, thanks for that demonstration but we’re going to buy blood anyway because it’s cheaper or more convenient’, you sort of lose something magical that’s demonstrative about people,” he said.

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“One of the remarkable things about Canadians is part of their identity is forged around the way we care for one another and we have a strong connection to the way healthcare is done here.”

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The United States pays its donors but critics argue it preys on the vulnerable. Research shows paid plasma clinics cluster in neighbourhoods that are low-income and contain illicit drug use.

Barzin Bahardoust, CEO of Canadian Plasma Resources, defends the company’s practices.

“If someone is eligible to donate and they’re voluntarily making the donation – it’s a voluntary process – nobody is forcing anyone to donate plasma,” he said.

“If somebody likes to donate plasma and they’re eligible to donate plasma, we don’t discriminate based on their income. It’s their decision to make a plasma donation or not.”

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But Leier argues otherwise – he is against paid plasma donation systems because they can exploit the vulnerable.

READ MORE: Controversial plasma collection clinic now open in Saskatoon

“One of the most important vetting tools is self-reporting high-risk behaviour. When you introduce a financial incentive that problematizes that [safety] rationale. When people self-report, you expect all things being equal to be honest and forthright,” he said.

“But when there’s a financial incentive, there’s also an incentive to…speak falsely. Would you lie on a form if you’re paid $20 to do so? Most people would say no, but $20 is a huge incentive for some people if you have  no money or if you’re addicted to substances.”

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Dr. Graham Sher, the CEO of Canadian Blood Services, said the debate about paid plasma clinics is one about ethical and societal values.

“It’s a question of morals and values, whether we in Canada want to pay donors to collect plasma. Do we wish to pay donors and how do we go about doing that? But we also need to recognize we also buy drugs that come from paid American donors,” he said.

The conversation about paying for a bodily part is already taking form in another segment of health.

Researcher Maeghan Toews, who works in Health Law Institute at the University of Alberta, studies organ donations and said policy makers and researchers are discussing whether payment is a direction that they need to move toward.

“There are similar debates happening about the use of financial incentives as a potential way to try and increase donation rates,” she said.

“There’s a whole range of financial incentives being discussed [such as] potentially paying for funeral expenses for a deceased donor…or even getting some sort of gift card for people who sign up on a donation registry.”

Tune in to Edmonton’s Global News Hour at 6 on Sunday, May 1 for the first video report in this series.