The Sunday Edition

The debate over paying Canadians for plasma

In recent years, paid plasma clinics run by a private company have been popping up across Canada, sparking a fierce debate.
Many Canadians rely on blood products derived from plasma for life-saving treatment. But Canadian blood donors can meet only a fraction of the growing demand. (CBC)
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Canada has a growing need for blood products made from plasma, the liquid left over once red and white blood cells and platelets have been removed. These products are used to treat burn victims, hemophiliacs and people with immune disorders or serious infections.

Right now, plasma collected from Canadian volunteers is only meeting a small fraction of the demand for these life-saving blood products. 
The largest component of blood is a clear, liquid gold known as plasma. (CBC)

The shortfall is made up from plasma obtained from paid donors in the United States. 

Canadian Blood Services does not compensate donors for blood or plasma. But in recent years, paid plasma clinics run by a private company called Canadian Plasma Resources, have been popping up across Canada. 

These clinics have sparked a fierce debate. Some say opposition to paying for plasma is hypocritical — given our dependence on paid American donors — and that a compensatory model could help increase our supply. 

Others argue paying for any kind of bodily material is exploitative and fundamentally un-Canadian. 

The Sunday Edition host Michael Enright spoke to three experts about the debate over paying for plasma.

Vida Panitch is a professor whose research focuses on political philosophy and bioethics. She says arguments about the dangers of commodifying the body can too easily spill over into other jurisdictions. (Lachlan Dennis)
Vida Panitch is an associate professor of philosophy and the director of the doctoral program in ethics and public affairs at Carleton University. Her research focuses on political philosophy and bioethics.

Panitch says it's misleading to oppose the sale of plasma on the grounds that it wrongfully commodifies the body. 

"These body parts already have a cash value," she says. "Other people are making money off the donation of various kinds of body parts, and we're paying donors in the United States for theirs. So it's not that money doesn't enter this picture at all."

"The only people who don't get compensated are the donors themselves."

Panitch adds that the commodification argument can also be a slippery slope.

"I worry that we've relied on these arguments too heavily in Canadian policy and legislature discourse to justify bans on everything from the sale of eggs and sperm to surrogacy to, until recently, sex work.

"Because of the spillover effect that these arguments have had into other domains pertaining to the human body — and specifically to women's bodies — I'm hesitant to get behind legislation that relies on these sorts of claims." 

Medical historian Jacalyn Duffin says she's wary of the potential contamination risks that may accompany this kind of collection. (Kas Roussy/CBC)
While she stresses that products that come from paid plasma clinics in the United States are rigorously tested and treated and are considered safe, Jacalyn Duffin says we still need to safeguard against the risk of infectious diseases that haven't been identified yet. 

Duffin is​ a hematologist and historian. She is also Professor Emerita in the Hannah Chair of the History of Medicine at Queen's University.

"I trained before we had AIDs, before we knew what Hepatitis C really was, and that experience made me very wary of the potential risks of this kind of collection," she says.

"Wise historians do not predict the future, but in the past, we saw that the contamination rate was influenced by people who were lured into selling their plasma, or their blood products, because they needed the money very badly," Duffin adds. 

"These people were vulnerable — people on the streets, drug users, people who were short of money. As it turned out with the particular situation of HIV/AIDs and also with Hepatitis C, these were people who had a higher rate of infection."

Dr. Graham Sher, CEO of Canadian Blood Services, says solutions are needed to guarantee the security of plasma supply for Canadians. (Canadian Blood Services/Canadian Press)
For Graham Sher, the greatest concern is around the security of supply.

Sher is the CEO of Canadian Blood Services. He is a hematologist by training, and has worked with Canadian Blood Services since it was founded in 1988.

"The demand for immune globulins is rising and we don't have enough to plasma to meet that demand," Sher says. 

"So the question is not should we or should we not rely on remunerated donors. We do today. Eighty-five per cent of the supply comes from the United States, where they pay their plasma donors. The issue in Canada is, how do we want to solve for the domestic security of supply concern?" 

"Do we want a public sector solution which guarantees security of supply for Canadians," Sher asks, "or do we welcome private sector players into the Canadian market who will sell the plasma anywhere on the international market to the highest bidder?"

Ontario, Quebec, and Alberta have all passed laws banning the sale of plasma, and Nova Scotia and British Columbia are considering similar legislation. 

To hear the full conversation, click 'listen' above.