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Chris Selley: Why shouldn't Canadians get paid to donate blood or plasma?

The queasiness is understandable — but banning it leaves no one better off

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A sad story from Manitoba proposes an interesting ethical dilemma, and provides some insight into how Canadians, and Canadian media, think about health-care policy. The story: In recent months, two people have passed away in Winnipeg after donating plasma at private clinics run by the Spanish biopharmaceutical colossus Grifols, which trades on both the Madrid Stock Exchange and NASDAQ. (You can already see where this story is going, in part.)

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Grifols claims to have “no reason to believe that there is a correlation between the donors’ passing and plasma donation.” And two doesn’t make a pattern — especially since the deaths occurred at different labs in Winnipeg, neither of which has recently failed a Health Canada inspection — but it’s certainly unusual and worthy of inquiry.

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Deaths related to plasma or blood donation are vanishingly rare. From 2016 to 2020, the U.S. Food and Drug Administration (FDA) reports 19 fatalities were “definite(ly), probabl(y), or possibl(y)” attributable to complications from blood or plasma donation. That’s fewer than four per year in a country of 340 million. Canadian Blood Services latest report, from 2024, lists the most common serious complications from donations as fainting, causing a fall and injury. It records a very small number of cardiac events that may or may not have been related to the procedure.

Beyond the deaths themselves, media coverage has generally focused on two larger points. One, as parenthetically alluded to above: the deaths were related to private “for-profit” clinics, meaning the usual suspects are glomming onto it as evidence all medical services must be provided by government employees; and two, Manitoba pays people to donate plasma. That’s the ethical dilemma: Is it fair to invite desperate people to sell their precious bodily fluids?

The private health-care argument is basically pro-forma. “Once you have a private company coming into Canada, you lose control over much of the industry,” Curtis Brandell, president of Canadian Hemophilia Society’s British Columbia chapter, told The Guardian. “I fear the first thing we’re losing is public accountability and oversight.”

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“Building more profit motive into health-care delivery is never something, I think, that ends well for patients,” Noah Schulz of the Manitoba Health Care Coalition told the Winnipeg Free Press.

Except, of course, you don’t lose control. That’s what inspections are for. Health Canada inspectors have deemed four of Grifols’ 17 facilities “non-compliant” since 2023 for various transgressions, before certifying them “compliant” on follow-up inspections. They were in Regina, Saskatoon, Calgary and Saint John, N.B. None were in Manitoba.

The Guardian spoke to “one inspector with Health Canada, who asked not to be named, (and said) he felt the non-compliance reports were ‘very troubling’ and believed they reflected a ‘deeper set of concerns’ about the facilities and how they were run.”

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What I didn’t see reported was that Health Canada inspectors have failed just as many publicly run labs in recent years as private, namely the McGill University Health Centre, Jewish General Hospital in Montreal, Mount Sinai Hospital in Toronto and a Provincial Laboratory Medicine Services facility in Abbotsford, B.C.

Deficient oversight can lead to terrible outcomes in the private and public health-care systems alike, as we have seen to devastating effect over and over in this country. Ontario’s privately run long-term care homes were harder hit as a group during the pandemic than publicly run homes — but the vast majority of long-term care homes in Quebec are public, and they fared no better. Motherisk, the discredited, disgraced and since-shuttered hair-analysis lab at Toronto’s Hospital for Sick Children, helped the government steal untold numbers of kids from their parents on pretences that can only now be considered false. Disgraced pathologist Charles Smith’s incompetent autopsies sent innocent people to prison for killing their children. He also worked out of Sick Kids.

The former Miramichi Regional Health Authority in New Brunswick employed pathologist Rajgopal Menon for 12 years before it emerged his cancer diagnoses, and lack of diagnoses, were in many cases rubbish. A similar scandal unfolded in Newfoundland on the watch of a regional provincial health authority. I’m not telling anyone anything they don’t already know here: “Canadian public hospital” is not a byword for “reasonable guarantee of excellence.”

That brings us to the issue of paying for plasma and blood donations. Quebec and British Columbia do not. Ontarians can only get paid for donations at Grifols labs, via an agreement with Canadian Blood Services. And it’s perfectly understandable to feel a bit queasy about it. But it’s a sort of luxury queasiness, not to say self-interested.

I notice that prominent “no paid plasma” advocates include at least three huge public-sector unions. And even those who have nothing obvious to gain from their opposition seem somewhat detached from the issue.

“I think (it’s) a pretty sad reflection of our society,” Schulz told the Free Press, that people might feel duress in considering whether to donate. A Free Press reporter found no such qualms in a Grifols waiting room in Winnipeg, however, but rather concerns that the government might cut off a crucial source of income.

“First do no harm” is as good a principle in a legislature as it is in an examination room. Canadians with bills to pay can’t wait for society to be perfected.

National Post cselley@postmedia.com

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