Blood and the public body: a study of UK blood donation and research participation

A scoping review of sociology of voluntary blood donation

BACKGROUND AND OBJECTIVES

Maintaining stable blood supplies presents an increasing challenge for blood collection agencies (BCAs). Novel and multidisciplinary approaches and research have been called for to understand the mechanisms underlying the trends. The current body of sociological research on blood donation is a potentially valuable resource, but it is dispersed over different publications and theoretical frameworks.

MATERIALS AND METHODS

We conducted a scoping review of sociological research on voluntary, non-remunerated blood donation to identify insights and practical applications for researchers and BCAs.

RESULTS

Four organizing themes were identified: donated blood, blood donors, organizations and blood service systems. Key challenges associated with the organization of voluntary blood donation exist at the institutional and systems levels, and they may not be readily resolved by interventions focussed solely on the individual donor level. We identified opportunities for organizations to build trust with donors and the public through communications and working with communities to promote inclusion in blood donation.

CONCLUSION

The results support a multidisciplinary approach and research for BCAs to move forward and find novel ways to ensure safe, resilient blood service systems.

Lived time and the affordances of clinical research participation

In this article, we address the problem of participation and the dominant focus on motivations in clinical research. We explore participation as a relational mode of 'being in time' in Alzheimer's dementia prevention-a field profoundly shaped by changing bodies through time, as well as promissory trends towards future-oriented preventative medicine. Analysis of interviews with older adults in a clinical trial platform demonstrates that what research 'does' or might (not) 'do' for participants emerges as temporalities of participants' everyday lives become entangled with the possibilities, constraints and demands of biomedical 'research time'. As well as consistent desires to help (future) others, we identify incidental possibilities for care that emerged from continued research participation. We argue that longitudinal research participation can productively be understood as a set of evolving affordances: whereby differing limits and possibilities for care and agency emerge in a world where dementia cannot be cured. Future trial participation is considered in terms of 'therapeutic affordances', which are likely to fluctuate as certain lived or imagined futures unfold. As such, we open up a conceptual space to think about why, how, and critically, when participation happens, as it emerges in relation to lived times of ageing and everyday life.

"Missing minorities" in blood donation: Rethinking blood procurement in Europe as a citizenship regime

Although European blood collection organizations are currently obtaining sufficient and safe blood from the majority population, they report having difficulty recruiting first and second-generation immigrants from non-European countries. Most existing studies on these underrepresented groups, who have been coined the "missing minorities" in blood donation, have adopted an instrumental approach that focuses on the development of targeted recruitment strategies to overcome specific barriers to donation faced by members of these minorities. Although this approach does offer several short-term benefits, our central argument is that it is one-sided in its questioning of the non-participation of ethnic minorities. The literature currently lacks research on how the blood procurement system is failing to include minorities. Drawing on recent social theory, we seek a broader sociological understanding of minority under-representation in blood donor populations by shifting the analytic focus toward a critical examination of the main pillars of the procurement system within the European context. This paper advances a novel analytical framework based on two general propositions. First, we apply the literature on "citizenship regimes" to argue that blood donation is part of one specific institutionalization of citizenship and solidarity. We then reconceptualize the "problem" of missing minorities in European blood donation as an application for social change, suggesting avenues related to blood collection as a way of renegotiating minority-majority relations of solidarity.

Gender dynamics in the donation field: human tissue donation for research, therapy and feeding

This paper examines how gender dynamics shape human tissue donation for research and for human health. Drawing on research investigating the donation of different types of bodily tissues including blood, plasma, breastmilk, cord blood, foetal tissue and placentae we consider how and why women and men are viewed as different kinds of donors. We situate these donation practices within a broader understanding of gender difference to explain why any sociology of donation needs to take account of gender. In so doing we explore how tissue derived from the bodies of women acquires value in distinctive ways and for distinctive purposes and reasons. Within these gendered bioeconomies of donation, the supply and demand for tissue is structured by social understandings of maternity, parental responsibility, and risk, which in turn affect the experiences of donors.

Blood’s ontologies-entangled: Qualitative inquiry into the enactment, representation, and organizational modes of coordination of blood’s multiplicity in a Belgian blood establishment

Since British sociologist Titmuss authoritatively conceived blood donation as an altruistic ‘gift relationship’, blood establishments have adopted blood’s highly symbolic status as a core professional belief. However, important developments since the 1970s have resulted in blood’s bio-objectification, making blood a renewed object of concern. Because different versions of this bio-object are simultaneously present and interfere with one another, we ask how the organization renders this multiplicity workable? Studying how ontological versions are enacted in a specific blood establishment and how the organizational model of a blood establishment functions as a mode of coordination, we develop a praxiographic appreciation of blood in the context of a specific Belgian blood establishment. We show how the organizational mode of coordination allocates versions of blood in specific departments along functional and chronological dimensions. Blood remains the object of a gift relationship but is accompanied by blood’s enactment and representation as the object of suspicion, management, research/biology, and a blood economy. Furthermore, the organizational mode of coordination also allocates personalized and depersonalized enactments according to the level of contact with the donor population. This reflects a third dimension: (de)personalization of blood. Whereas the organizational mode of coordination is successful in rendering blood’s multiplicity workable, at times, it causes suboptimal practices. Moreover, we showed how sometimes a focus on intra-departmental modes of coordination is necessary to understand how blood’s multiplicity complicates the practices of the blood establishment.

Blood donors' preferences for blood donation for biomedical research

BACKGROUND

Increasing numbers of blood donors are recruited to participate in biomedical research. As blood services depend on voluntary donors, successful recruitment calls for a better understanding of donors' expectations and attitudes toward the use of samples in research.

STUDY DESIGN AND METHODS

Sixty-one semistructured interviews were conducted with blood donors at eight Finnish Red Cross Blood Service donation sites in Finland. The 10- to 30-minute interviews included open-ended questions about donors' views on blood donation for patients and for biomedical research. Central motives to donate blood for patients were identified against which views on research use were compared to see how these reflections differed.

RESULTS

Six central motives for donating blood for patients were identified among donors. The interviewees were, in general, willing to donate blood for research, but considered research donation more likely if it could be easily integrated into their usual blood donation habits. Biomedical research was perceived as important but its social benefits were more abstract than a direct help to patients.

CONCLUSIONS

Familiarity and reciprocity were key to the relationship between the blood service and blood donors. Donation for research introduces a new, more complex context to blood donation. Challenge to recognize concrete outcomes and benefits of donation may affect willingness to donate for research. Transparent communication of the role of the blood service in research and of the beneficiaries of the research is essential in maintaining trust. These results will help blood services in their planning to recruit blood donors for research projects.