Epilogue
In lieu of an abstract, here is a brief excerpt of the content:

253 The line can form as early as 5:30 A.M. outside the Interstate Blood Bank on Broad Street in North Philadelphia, even though it doesn’t open for another hour. The center, which pays its donors, is located in a rundown, what you might call in-between section of the city: too far north to be part of fashionable Center City, home of the law firm of Shrager, Spivey & Sachs, and too far south to be affected by the gentrification wrought by Temple University’s expansion. Its near neighbors include several vacant storefronts ; a few blocks in either direction, you’ll find the Salvation Army, YMCA, homeless shelters, churches, and other social services. Donors must be at least eighteen years old, weigh at least 110 pounds, and be in good health and well hydrated, according to the center’s recorded telephone message. You also need a valid Social Security card, a photo ID, and proof of address that’s within 125 miles of the center. No appointment is required. Interstate’s Memphis-based parent company owns thirty whole-blood and plasma collection centers, and was a founding member of the Plasma Protein Therapeutics Association (PPTA), an industry trade association. Its members operate more than 450 collection centers in the United States and Europe and manufacture about 80 percent of the plasma therapies used in the United States, and 60 percent of those manufactured in Europe. The PPTA has voluntary standards that require routine, independent , third-party auditing of its members’ collection centers.1 EPILOGUE BLOOD ON THEIR HANDS 254 On the bloodbanker.com website, Interstate’s Philadelphia patrons offer a variety of comments, ranging from “very professional workers, clean environment” to “the staff is not very polite and talk to people ill mannered.” A visitor can’t help but notice, though, that most of the people standing in that line, or sitting inside on the long rows of chairs in the waiting room, appear poor. And paid donors, especially poor ones, continue to be enormously controversial, because they are more likely to be ill and desperate enough for money to lie about their medical history. As recently as 2007, for example, one of the major plasma-products manufacturers called for collections along the U.S.-Mexican border to end, saying they “compromised the fundamental ethics of our business,” according to a story in the New York Times. “But the other companies defended the practice and the matter was dropped,” the Times noted.2 During the U.S. litigation, Judge Grady once commented on the broader issue in rejecting the companies’ argument that they should not have to produce photos and other records about their blood plasma donors. Grady noted that “we are dealing here with paid if not professional donors” and said he thought that the companies’ arguments for preserving privacy were “almost totally disconnected from any genuine concern about confidentiality.” He seemed sure there was some other reason. “The photographs do not show whether these people have infections,” he said. “They do not show whether their ears are pierced or whether they are toothless or have gum disease or anything of the kind, or if they do, it would be a rare photograph that does. Most of them do not. . . . They wouldn’t help me determine whether that person was a victim of hepatitis, or was a drug user, or was otherwise a person who engaged in the kind of conduct that might cause problems should he donate blood.”3 So why, the judge wondered, was industry so intent on not giving them to the plaintiffs? At this point, Judge Grady handed a number of what he said were randomly selected photos to David Shrager, the plaintiffs’ lead attorney, and called a ten-minute recess so the lawyer and his colleagues could look at them. When they returned to the courtroom, it became clear why the lawyers saw them as valuable. At least ten of the first handful, Shrager EPILOGUE 255 informed the judge, had listed their home addresses as General Delivery, Salvation Army, Salvation Army Mission, or “blank motel.” Also, Shrager said, “Perhaps every single one but two had additionally tattoo marks or scar marks,” and “without exception, references to some sort of a medical history.” Is this system of blood and plasma collection the best that industry and governments can provide, for recipients and donors? The World Health Organization doesn’t think so. In 2010 it proposed a global policy of blood self-suf...


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