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The social rationale of the gift relationship
  1. Teck Chuan Voo1,2
  1. 1Institute for Science, Ethics and Innovation, The University of Manchester, School of Law, Manchester, UK
  2. 2Centre for Biomedical Ethics, National University of Singapore, Yong Loo Lin School of Medicine, Singapore
  1. Correspondence to Teck Chuan Voo, Institute for Science, Ethics and Innovation, The University of Manchester, Williamson Building, Oxford Road, Manchester M13 9PL, UK; medvtc{at}


This paper argues that, for Richard Titmuss, the rationale of the gift relationship (TGR) as a national blood policy is to reconcile liberty with social justice in the provision of an essential health resource. Underpinned by a needs-based distributive principle, TGR provides a social space for a plurality of values in which to engage with and motivate people to voluntarily give blood and other body materials as a common good. This understanding of TGR as a value pluralistic framework and its implications will be used to discuss the issue of using economic mechanisms to increase the supply of body materials or goods, including organs for transplantation. It is argued that, while TGR excludes a policy in which body goods are treated as private commodities and distributed primarily on the basis of achieving market efficiency, it is not in principle opposed to the use of material rewards, including financial ones, to motivate people to donate.

  • Philosophical ethics
  • allocation of organs/tissues
  • donation/procurement of organs/tissues
  • kidneys
  • blood

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  • Funding This article is written by the author while doing his PhD under a studentship funded by the Wellcome Trust. The views expressed are entirely the author's own. They do not reflect any position or policy of the Wellcome Trust.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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