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In 1946, Britain launched its National Blood Transfusion Service (BTS), an early and famous component of its National Health Service.2 The National BTS’s reliance on unpaid, voluntary donors who made their blood a ‘gift’ to dying strangers contrasted strikingly — and often favourably — with the American tendency to pay ‘donors’ for blood. The sociologist Richard Titmuss seized on this contrast, turning it into an eloquent defence of altruism in his classic study, The Gift Relationship (1970). Here, social conscience played hero to self-interest’s villain. The National BTS, Titmuss argued, could ‘only be understood within the context of the Health Service’. The NHS, an exemplar of ‘socialized medical care’, was ‘the most unsordid act of British social policy in the twentieth century’, encouraging ‘sentiments of altruism, reciprocity and social duty … [in] all social groups and classes’.3 For Titmuss, the NHS extended the communitarian spirit and material responsibilities generated in wartime. The National BTS exemplified this spirit. Titmuss made no mention of blood donation’s pre-NHS history, so freeing the reader to conclude that the system of voluntary donation arose de novo from this post-war movement. It did not. It was, instead, the product of interwar Britain, shaped by its much older tradition of medical charity.
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