As I discussed in the previous post, when my son needed platelets, we set up an account at the Red Cross where people could donate specifically to meet his needs.  In hindsight, it wasn’t such a good idea for him, or for anyone else really, except perhaps that it motivated people to donate thinking their blood products would actually be used by him.

This is not necessarily so, for a number of reasons.  First, the donation must match his needs.  Perhaps he needed red blood, but the donations were all of platelets.  Now the question is what to do with all the excess platelets?  They  only last about five days.  Should they be allowed to expire just because he didn’t need them?  Of course not, they should be released into the general stock of platelets, to be used by anyone that needs them.  In fact, we had several calls from the Red Cross asking for permission to do just that, to which we, of course, agreed.

Blood is a fungible, perishable commodity.  Red blood and plasma can last several months.  Platelets only a few days.   But aside from component longevity and blood typing that must be done with red blood infusions, it is all the same.  The best method of marrying demand with supply is to put all the blood in one collective pot (the blood bank) and disburse it according to need. 

Which is effectively what we told the Red Cross to do with directed donations for our son.  A directed donation sounds nice (I even saw them infuse a bag of my platelets one time–they had given me the identifying number so I could tell), but it really is more effective if the blood can be added to the blood stocks and disbursed in the normal manner, according to the needs of the total patient population.  

When people would make a directed donation and ask if my son had received it, I would just say there was no way to tell, because they only use identifying numbers, not names.  And then I would tell the Red Cross to use the blood however they saw fit.  I figured it meant that my son’s withdrawals from the blood bank maybe wouldn’t exceed deposits made into it on his behalf.  The blood made it to the places it was most needed.  Sometimes that was my son.  Sometimes it was someone else.  I figured it was a harmless lie that directed donors believed he alone received their blood.

There was a comment that my idea of compensation might actually yield fewer donors, because of the differences between extrinsic and intrinsic motivation for donating.  I acknowledge that people motivated intrinsically by their altruistic impulses might be put off by being offered money (perhaps a gift card instead?).  The question is whether enough of them would quit donating because of the insult to negate the increased donations because of the compensation.  It’s not clear.  Because blood donation is done locally, perhaps compensation could be tried in a few areas to see if it increases or decreases the total volume of blood being donated.

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