Blood and blood-associated symbols beyond medicine and transfusion: far more complex than first appears.

Abstract

In medical care, blood transfusion has neither alternative nor equivalent. It saves lives under numerous circumstances and helps many patients undergoing treatment. However, transfusions continue only because generous individuals give their blood. Despite such a gesture of altruism, certain patients remain reluctant to receive blood components from other individuals, claiming a fear of blood-borne pathogens1-the stated part - but also likely a perceived threat from something more spiritual that accompanies blood - the unstated part2. While the majority of the population in industrialised countries say that they are willing to donate blood, most people when matching medical conditions refrain from presenting themselves for donation3; some think that it may be dangerous for themselves4, but many more have irrational feelings about blood and/or are embarrassed to present medically valid arguments to not give or attempt to give blood. What is blood? A red blood cell pack comprises more than 40 g haemoglobin, 200 mg iron, and many additional products contained in the residual plasma, parameters measured during the quality control of blood components. Meanwhile, blood donation has a time component - taken from other activities - which can also be measured, and shows altruism, generosity, and compassion for anonymous patients in need of a transfusion. Therapeutic blood is also special because cell components are largely donated and rarely sold in contrast to plasma derivatives obtained through fractionation5. Why are there such differences between these equally life-saving therapeutic products? Is this because one is visible (erythrocytes) whereas the other is simply a substratum for “drugs”? This essay revisits the image of blood in the humanities, from which medicine derived its origin, to gain an understanding of why blood cannot be simply restricted to its therapeutic value within medicine, at a time when medicine is embedded within science and a specific branch of medicine oversees blood and blood transfusion.

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