The starting-point of this book is human blood: the scientific, social, economic and ethical issues involved in its procurement, processing, distribution, use and benefit in Britain, the United States, the Soviet Union, South Africa and other countries. The study therefore examines beliefs, attitudes and values concerning blood and its possession, inheritance, use and loss in diverse societies, past and present, and draws on historical, religious and sociological materials. It investigates by a variety of research methods the characteristics of those who give, supply or sell blood, and analyses in comparative terms blood transfusion and donor systems and national statistics of supply, demand and distribution particularly in Britain and the United States. Criteria of social value, cost efficiency, biological efficacy, safety and purity are applied to public and private markets in blood and to voluntary and commercial systems of meeting steeply rising world demands from medicine for blood and blood products.

The study originated and grew over many years of introspection from a series of value questions formulated within the context of attempts to distinguish the ‘social’ from the ‘economic’ in public policies and in those institutions and services with declared ‘welfare’ goals. (An earlier attempt to define the territory of social policy together with the roles and functions of the social services was made by Richard M. Titmuss in Commitment to Welfare, particularly Chapter 1.) Could, however, such distinctions be drawn and the territory of social policy at least broadly defined without raising issues about the morality of society and of man's regard or disregard for the needs of others? Why should men not contract out of the ‘social’ and act to their own immediate advantage? Why give to strangers? – a question provoking an even more fundamental moral issue: who is my stranger in the relatively affluent, acquisitive and divisive societies of the twentieth century? What are the connections then, if obligations are extended, between the reciprocals of giving and receiving and modern welfare systems?

To speculate in such ways from the standpoint of the individual about gift relationships led us inevitably into the area of economic theory.