How can healthcare systems gain self-sufficiency in their procurement and distribution of blood and blood products efficiently while maintaining a degree of relatively equitable access for patients? This is a question that, at first look, the World Health Organization (WHO) has answered in detail by advocating for self-sufficiency through non-remunerated blood donation. This essay serves two purposes. First, it illustrates key differences between the WHO's policy recommendations and the realities of healthcare. For example, it can be readily demonstrated that the WHO has no empirical foundation for their claim that blood and blood products from unpaid donors is safer or more efficient than other, more commercial, avenues of procurement. Indeed, the WHO appears to take an ideological stand against compensation for blood products, which the empirical data does not support. Whether donation for blood and blood products should be compensated is a pressing ethical issue of practical import, especially if it can be shown that more market-oriented procedures leads to greater self-sufficiency, as well as safer and easier access to blood products than other alternatives. Such policy decisions should be based on the best available empirical data and ethical argumentation, rather than on political ideological grounds. Second, this essay serves as an Introduction to a special thematic issue of HEC Forum, which aims critically to explore ethical arguments in light of the best available empirical data so as to orient the blood industry towards more efficient and effective, and morally honest, procurement procedures.
Keywords: Blood; Blood products; Markets; Remunerated donation; World Health Organization.