Thousands of Low-Income Americans 'Donate' Blood Plasma to For-Profit Centers

First of all, we're talking about plasma and not whole blood - the difference is important.

> An adequate and reliable supply of safe blood can be assured by a stable base of regular, voluntary, unpaid blood donors.

An adequate and reliable supply of plasma cannot be assured by a stable base of unpaid plasma donors - countries that pay for donations run a surplus and end up supplying it to countries that don't, because the latter don't produce enough.

> if the screenings were totally reliable why would we bother asking for risky behaviours ?

Because it saves time (and money) to be able to rule out people who are ineligible for blood donation before they ever get their blood drawn. You might think, "how could a person who has had Hepatitis A not know that they are ineligible to give blood?", but the answer is that this happens all the time.

Screening questions are there as a cost-saving measure; they're not intended to catch anything that blood testing wouldn't, and they're already arguably overly conservative in the screening stage as it is.

> What about the window between an infection by the HIV and the production of antibodies ? >

(A) For plasma, you don't test for antibodies - you test for viral load.

(B) The window is incredibly short. The chance of someone donating plasma within a few days of being infected with HIV and having a viral load high enough to transmit HIV but also not test positive is minuscule. At that point, there are far bigger risks to worry about, like the many things that you can't test for (and which the patient may not know they have). Risk management isn't about eliminating risk; it's about systematically and contextually evaluating the appropriate levels of risk.

Trades of goods are equivalent to currency.

I was acquainted with a couple from Ohio somewhere. At times the husband would 'donate' blood in order to afford gas money to be able to drive to an entry level job at some warehouse or something. It was a pretty sad sounding story. On the other hand, I can admire their will to do what it takes to earn some money the hard way.

> The "donations" in this case aren't really donations. They're being paid in exchange for their blood plasma.

Which gets back to the question - what's wrong with that?

The alternative is not to pay people for donating plasma, and we can see quite clearly that that doesn't work - every country that does not pay for blood plasma donations runs a shortage, and most of them end up importing plasma from the US.

So, we have to pay for plasma, or else we won't have enough, which means people will literally die. Given that we have to pay for plasma, what's wrong with letting anyone who's medically eligible to donate do so?

Most of the common arguments against tissue donation (safety, incentive to lie, etc.) either don't apply to plasma donation or are no longer relevant thanks to the cost and accuracy of modern testing methods. There is no medical or financial reason not to permit the practice, and I'm struggling to see a moral one that doesn't eventually result in people dying because we refuse to collect the life-saving tissue that people are perfectly capable of providing and willing to provide.

I donate blood now and then, and am an organ donor. I suppose technically I'm being exploited, but I don't mind.