The gift relationship

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Citation: Richard Morris Titmuss (1971) The gift relationship.

Tagged: Sociology (RSS)


The Gift Relationship is a seminal book in the literatures of sociology and public policy and can be seen as a very early attempt at the constructive an economic sociology as well. It's topic is blood donation and it explores that topic in extreme detail using data primary from the United States and Britain but also from Japan, the USSR, South Africa, and other places.

The book is structured into several parts. A large portion of the book is descriptive statistics about donors in the US and the UK and a comparison between the two. In particular, the book catalogs the motivations of donors.

Titmuss shows that the US, where a large portion of donors are paid, spends larges amount of money collecting blood, a large degree of wastage, and frequent shortage. The UK, however, has none of these problems and uses no paid labor. Much more problematically, blood in the US (and blood from paid donors in particular) are a much higher risk of Hepatitis which (at the time) was undetectable and untreatable.

Titmuss makes a series of arguments very forcefully in the later part of the book. Building on the work of Mauss and Levi-Strauss, he argues that blood donation can be treated as a gift and carry very different qualities and are motivated very differently than when they are simply treated as marketable commodities. Titmuss argues that not only does the introduction of payment for blood results in "worse" blood from "Skid Row" donors at higher risk of disease, but that it also results in less blood.

The final chapter makes a more fundamental argument about increasing commercialization and about the social changes and the real effects that a purely economic approach can have, using blood donations as an example.

Theoretical and practical relevance:

The book has been highly cited and made a huge impact when it was released. Kenneth Arrow wrote a reply in Gifts and Exchanges which attached Titmuss' argument at several points and in several ways. The debate ended up being a major motivator for the psychological literature on crowding out and on the social science literatures on motivation, gifts, and blood and tissue donations. The work is considered a classic of modern sociology.