As the province’s first for-profit blood plasma donation clinic awaits its license to open in Toronto, local sentiments are split. Some say that as long as they’re properly regulated, for-profit clinics could provide a new source of much-needed donations. Others are concerned that turning a profit may put the public at risk. Below, two perspectives on this contentious issue.
For paid plasma:
David Page, executive director at Canadian Hemophilia Society
The Canadian Hemophilia Society recognizes the essential nature of paid plasma donations in Canada and on a global level. It also recognizes that products made from paid plasma donations are of equal quality and safety as compared to those made from unpaid donations, as long as the for-profit clinics are properly regulated.
There are many, many diseases and conditions that require plasma-derived products, and people rely on them for their very survival. Around the world, 80 per cent of plasma-derived products are already made from paid donations.
Fresh blood components, such as those collected by Canadian Blood Services and American blood centres, are collected using voluntary donors. However, they rely on only two levels of safety: donor screening, where you choose healthy donors, and donor testing, where you test each donation for pathogens.
For plasma products, you have three levels: donor screening, donor testing and a third level for viral activation. The combination of these is what really gives these products a very good safety record.
In a perfect world, we’d all love plasma donations to be voluntary and non-remunerated. But that’s not the case. In fact, we’re going the opposite way. Medical science is finding new uses for these plasma proteins, and our only source is from paid American donors. It’s hypocritical for us to say we can forbid those in Canada and think that it really changes anything. All it does is make us rely on donors from the U.S.
Unless we are willing to invest a massive amount of money to attract volunteers, it’s hard to argue against paid donations on ethical grounds. I think the opposite is true: it would be unethical to restrict access by prohibiting this practice and denying patients medicines essential to their well-being.
Against paid plasma:
Dr. Danielle Martin, chair of Canadian Doctors for Medicare
For-profit blood or plasma clinics undermine the safety of our blood system and pose a real threat to the ability of the Canadian blood system to take care of Canadians’ health when they need it the most.
As patients and providers, we rely upon the standards set by our government to protect us. That these clinics need to turn a profit for their shareholders — their obligation as for-profits — presents substantial concerns.
Paying for donations has been extremely problematic in Canada and internationally. Paid donations were linked to the tainted blood tragedy in the early ’80s. [Editor’s note: the Krever Commission ruled that inadequate screening and testing were leading causes of the tainted blood tragedy in Canada.]
Canadian Blood Services has already been very successful, and one of the reasons for that is because it was founded on the necessity of maintaining a voluntary donation model as opposed to for-profit.
That’s not to say that we couldn’t use more donors, but the solution, when there is an undersupply, is to increase public education, do more drives, find ways to encourage donations and make it easy for Canadians to donate — not to pay vulnerable people for whom $20 makes a difference between eating and not eating.
I think the clinic opening near Toronto’s Scott Mission illustrates my point perfectly. Many of the American blood donations that led to the tainted blood scandal came from prisons and inner-city communities. I really don’t think that is a direction anyone wants to see our system head in.
Given this move’s significance, I think that public debate should have occurred earlier. Both the public as well as experts in the field of blood services would tell the government that this is a bad idea.