Донорство крови как социальная практика: российская специфика

Abstract

This article considers the meanings behind blood donation practice in Russia. More than 95 % of blood donors in Russia are considered to be voluntary and are non-remunerated. According to Russian legislation, however, non-remunerated donors are entitled to two days-off and a free meal, the latter usually being replaced by a equivalent cash payment. In 2013 an attempt was made to remove this compensation and thus bring the blood donation system into accordance with requirements of the World Health Organization. However, this attempt resulted in a decrease in the number of blood donors. This raises questions around the appropriateness of the commonly encountered language of altruism and the ideal of the selfless donor. In order to explore this question, we reviewed the current research on motivation among blood donors and conducted an analysis of the institutional aspects of blood donation. Based on this evidence, it seems that altruism is not the only logic driving donor behaviour and system characteristics. The motivation of donors is complex; it combines prosocial, normocentric and individualistic elements, as well as the important role of financial compensation. Incentives provided by the state, such as compensation and days-off, are an indispensable element of blood donation practice as all non-remunerated donors receive them. Contrary to Western Europe and the USA, in Russia paid donors must undergo a regular medical examination. As a result, remunerated blood donation is not criticized and is not considered to be risky for patients. Another specific feature of Russian blood donation system is the encouragement of family ‘replacement’ donations. In hospitals there is an unwritten rule that all patients who might need a transfusion have to provide the hospital with several blood donors. If the patient is unable to provide enough donors, this could mean the postponement of the treatment, thereby endangering the patient’s health. Thus, blood donation is embedded into a network of family or friends duties and is no longer a voluntary act but a necessity. Blood donation practice in Russia occurs in an environment where overlapping meanings intersect, those of altruism, interest, justice and family duty. This has to be taken into consideration both in academic reflections on this problem and in developing communication strategies for blood donors.