This Article Is Going to Suck… Your Blood!

How to give blood if you have a needle phobia.

I recently learned that due to a (probably long overdue) policy change under the Biden administration, I’m now eligible to donate blood for the first time. Huge win for equality, I guess. As you might surmise from what I’ve written before about charity and altruism, I think more people should donate blood. And now that the government finally wants my blood, I guess I should give it away. Right?

The only problem is that I’m extremely averse to needles — like really badly, extremely averse.¹ Whenever I get blood work done, the nurse has to tell me multiple times to unclench my fists and stop shaking. When I got the COVID shot, I started to tear up, and not for any of the stupid political reasons. One of the reasons I work out so much is to have more prominent vasculature so I never have to be stabbed multiple times while getting blood drawn because a medical professional can’t find a vein. I’ll willfully admit that this is irrational, but that doesn’t make it any less real.

I used to be able to pass up blood drives guilt-free because ought implies can. What you might call systemic discrimination, I called a Get Out of Moral Responsibility Free card. Leave it to the Democrats to mess up the last good thing about structural heterosexism.

Now I have to reckon with the fact that I could potentially save people’s lives, but I really don’t want to. So what are my options?

First is that I could just keep doing nothing. But this would be wrong, of course. Donating blood presumably does a lot of good on the margin, since blood banks are almost perpetually running dry (because our idiotic government and namby-pamby bioethicists would rather let sick people die than allow blood donors to be compensated). If you take the blood banks at their word, a typical donation has a 1-in-30 chance of saving a human life, and it’s not like someone else will just take your place if you don’t donate.

The 1-in-30 estimate is almost certainly too high, but even if it’s just 1-in-300, that’s still high enough that I don’t want to take the risk of doing nothing. Besides, I might have a very useful blood type. I don’t actually know what my blood type is, but as long as I can’t foreclose the possibility, I feel a rather strong obligation to give.

Second, I could just suck it up and give blood. But again, this is something I really don’t want to do. When you donate, they stick a needle in your arm for 10 minutes. I can confidently say I would pay at least $100 to avoid this (and that’s a very conservative estimate).

Third, I could indirectly cause an equal or greater amount of blood to be donated by other people as if I had donated myself. For one, I could convince friends, family, or Substack readers, who otherwise wouldn’t have donated, to donate blood. I could also give enough money to an organization that runs blood drives such that the expected marginal return to my donation exceeds the amount of blood I would have given personally. In an ideal moral world, I’d of course both give money and donate blood, but in an ideal world, I wouldn’t hate needles so much and I wouldn’t face this dilemma in the first place.

So how do I decide what to do?

The obvious solution is to determine how much money I’d have to give to make up for my hematic stinginess, then compare that to how much I’d pay to avoid having to give blood, then go with whichever option is cheaper. The same amount of blood would get donated no matter what I do. The critical difference would be that in one situation, I’d personally give up less than I would in the other. Or, if I’m feeling generous, I could hold constant some baseline level of discomfort I’m willing to accept, and then choose whichever method results in the greatest amount of blood being donated.

I already said I’d pay at least $100 to avoid having to give a unit of blood (typically a pint). So the operative question is whether it costs a charity more or less than $100 on the margin to get a single person to give a pint of blood.

According to the American Red Cross, it costs $3,900 to put on a blood drive. The Red Cross holds 520 blood drives per day and collects 4.6 million units of blood per year. That amounts to 24.2 units per drive, or $161 per unit. This is in line with the approximately $200 per unit that hospitals pay for blood.

Wait, what? I thought for sure that offsetting my refusal to part with my precious bodily fluids would be a lot cheaper than sticking a needle in my arm. Maybe it is, since $100 is the absolute lower bound. But there’s at least room for ambiguity.

Literally me.

It’s possible that the marginal cost of a single blood donation is less than the average, since it’s cheaper to accommodate the 25th person at a blood drive than it is to set up a blood drive for the first person to give. But most of the cost of a blood donation consists in testing, processing, typing, and matching the individual sample to a recipient, which probably doesn’t have a very good economy of scale. Also, the cost of outreach and recruitment for a marginal donor is almost certainly greater than for a donor who gives in the status quo. So $161 is probably a fair estimate.

I’m probably not going to give directly, but I’m certainly not going to do nothing. You can give blood every 8 weeks, or 6.5 times per year. Now that I’m eligible — damn you, Biden — that means I owe the universe either one hour with a needle in my arm and 6.5 pints of blood, or $1,047 per year on top of my current giving, or some combination thereof. If I opt for the money, I’ll give it to some charity that does more good on the margin than the Red Cross, like GiveWell.² I suppose at that point I’m not giving blood anymore, but if it does more good anyway, what’s the big deal?

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1. Yes, I’ve seen the Aella article.

2. Despite my previous objections to donating to human charities based on the meat-eater problem and longtermist effects of climate change, Bentham’s Bulldog has tentatively convinced me that human beings have a positive impact on longtermist global net welfare because human activity likely reduces long-run invertebrate populations, and invertebrates in toto likely have extremely net negative lives.