Blood, society and the gift: An ethnography of change in the gift relationship

Abstract

Commentary about solid or whole body part transplantation, transfusion and donation is well documented and has added to discourse about who gives and receives and how. Commentary about another body part – blood – is, it is argued here, less well developed (Sanner, 2001; Lock, 2004; Scheper-Hughes and Wacquant, 2006; Shaw, 2009). Blood and its modern-day sociology and anthropology is understood and limited by its links with both Titmuss’ altruism and gift exchange theories. This thesis, using a qualitative ethnographic approach, re-examines and introduces new discourse about blood, challenging the orthodoxy of altruism and seeking new understanding and justification for blood donation. It uses testimony from 80 blood donors to elicit real-time ideas about blood as a source of risk rather than a gift from strangers. It also argues that donors “give to get back” their donations rather than give as a form of altruistic behaviour, thus introducing the concept that blood donating is a form of covenant between society and the individual or a form of deposit. Issues of trust are examined via the lens of deferment as increasingly it is not good enough to just donate blood without stringent societal, as well as techno-medical, surveillance. Donating blood is shown to be a form of active citizenship, and to be deferred from doing so has a direct impact on individuals’ freedom to donate and thus community membership. The emotional labour of giving is revealed by the testimonies of “able” donors, which evidence that not only do donors perceive their blood to be special, but also the act of giving is a labour carried out by the few who can do it for the majority, in contrast to those donors who regard giving blood to be a mundane, functional practice. Lastly, an emerging hierarchy of self in relation to the body is uncovered here revealing hints at its’ inalienable status. The thesis charts the journey of blood from being a mystical part of the body, linked to goodness, to blood being the new “master tool” of modern society, imbued with risk and therefore entrusted to society via scrutinising blood management systems. The methodological framework is centred on an interpretative approach, using data gathered from interviews and questionnaires from active blood donors in sessions at the National Blood Service (NHSBT) as well as testimony gathered from individual one-to-one interviews. It refers to theories by Foucault, Mauss and Douglas to interpret the qualitative data revealing blood as a target of bio-power, risk management and social exchange and a shifting dislocated new body part, and it sets out to challenge the orthodoxy of altruism as the rationale and justification for blood donation in modern Britain.