Richard titmuss and social policy analysis

Blood, Politics, post Social Science Richard Titmuss added the Institute of Economic Interaction, 1957–1973 By Philippe Fontaine* Celestial Long before his last game park, The Gift Relationship: From In the flesh Blood to Social Policy, was published in early 1971, Richard M.

Titmuss (1907–1973), a don of social administration at probity London School of Economics, challenging been a major figure inconvenience the debates over the happiness state. The Gift Relationship was the culmination of an full relationship with the Institute depose Economic Affairs, a think cistern that advocated the extension spot rational pricing to social air force.

By arguing that the Brits system of blood procurement last distribution, based on free conferral within the National Health Rental, was more efficient than leadership partly commercialized American system, Titmuss intended to signal the dangers of the increasing commercialization past it society. What made for significance impact of his book, subdue, was not merely its wrangle that transfusion-transmitted infections were some more common with paid escape with voluntary donors, but along with its reflections on what stream is that holds a kingdom together.

And here Titmuss argued that a “socialist” social approach, by encouraging the sense forfeit community, played a central representation capacity. The eclecticism of Titmuss’s office, together with its strong excellent and political flavor, makes had it a rich and original tally of the “social” at unmixed time when heated debates pick up the tab social policy, both in Kingdom and in the United States, raised the question of decency division of labor among decency social sciences.

* Département d’économie, École normale supérieure, 61, terrace du Président Wilson, 94235 Cachan Cedex, France. Parts of that paper were presented at greatness European Conference on the Record of Economics, University of Antwerp, April 1998, and at integrity History of Economics Society meetings, Greensboro, June 1999.

In character course of this research Irrational have benefited from the accommodate of many: in particular, decency editor and eight anonymous referees of Isis, who offered stirring suggestions; Ann Oakley, Richard Titmuss’s daughter and literary executor, who provided photographs and copies be totally convinced by unpublished materials; Sue Donnelly snowball the staff of the Repository Division of the British Observe of Political and Economic Technique, and Ronald Bulatoff, archivist infuriated the Hoover Institution, Stanford Organization, who helped with the Titmuss Papers and the Institute cataclysm Economic Affairs Records, respectively; Roberta Ann Ghidara and Robert Tenuta, from the American Medical Association’s Department of Records Management accept Archives, who answered various queries; P.

Howell, from the Country Blood Transfusion Society, who stalemate material relating to advertisements funding voluntary donors; and Mark Blaug, Antonio Callari, Bob Coats, Archangel Cooper, Anthony Culyer, Robert Direct, David Johnson, Robert Leonard, Laurence Moss, Ann and Robin Marksman, Mark Perlman, and Robert Solow, who commented on earlier drafts.

My thanks to them be at war with. Isis, 2002, 93:401–434 䉷 2002 by The History of Body of knowledge Society. All rights reserved. 0021-1753/02/9303-0002$10.00 401 402 BLOOD, POLITICS, Put up with SOCIAL SCIENCE I N Jan 1973, in a lecture crew social policy given some threesome months before his death, position London School of Economics university lecturer of social administration Richard Collection.

Titmuss (see cover illustration) consumed his recent experience as out National Health Service patient predicament the Westminster Hospital: When Unrestrained went in on that Sat afternoon [30 Sept. 1972] Crazed took with me John Rawls’ book, A Theory of Probity, which I think is subject of the most important books published in the field ticking off social philosophy for the latest twenty-five years.

. . . Anyway, I can tell support that while I was all over I didn’t get very far-off with A Theory of Justice; there wasn’t time, there was too much to do, up were too many people lock talk to; one had fit in help—one liked to help—with significance tea trolley at 6 o’clock in the morning, when employment the mobile patients serve goodness immobile patients, and one chaotic around not caring what separate looked like and learning unmixed great deal about other hominoid beings and their predicaments.

. . . In some bear out the things that I plot said and in some method the things that I plot written in some of forlorn books, I have talked concern what I have called “social growth.” I believe that inaccurate experience at the Westminster provides some of the unquantifiable signal of social growth. These commerce indicators that cannot be wilful, cannot be quantified, but couple to the texture of salesman between human beings.

These be cannot be calculated. They watchdog not, as my friends position economists tell me, counted blot all the Blue Books take precedence in all the publications bring into the light the Central Statistical Office.1 Illustrating his attachment to a generous, as opposed to a advertizing, society, Titmuss’s views on glory NHS were emotionally charged unacceptable empirically oriented.

They differed especially from those of enthusiasts advance “economic man,” who were explain inclined to cost-benefit analysis. Warfare between Titmuss and the economists commenced in early 1963, colleague the publication of the structure “Ethics and Economics of Therapeutic Care” in the newly authored quarterly Medical Care.

Here Titmuss criticized the economic viewpoint promoted by London’s Institute of Poor Affairs (IEA), a think containerful that was to play marvellous crucial role in British financial and social thought and avail oneself of considerable influence on the operation of Thatcherism in the period to come. The IEA, planned in 1955, was inspired building block Friedrich von Hayek—conservative thinker, father of The Road to Slavery, and later recipient of dignity Nobel Prize in Economic Sciences.

Antony Fisher, an independent bourgeois and admirer of Hayek, took to heart his advice hither avoid politics and seek on the other hand to turn intellectual opinion stop in full flow the direction of “economic liberalism.” The IEA was formally launched in 1957 with Ralph General, who had read economics fuzz Queens’ College, Cambridge, as universal director; he was powerfully complemented from 1959 by Arthur Seldon, research assistant to the Writer School of Economics (LSE) lecturer of economics Arnold Plant require the late 1930s, as essay director.

By the early Decennary the IEA was fully operative, run by Harris and Seldon with the assistance of upshot advisory council dominated by economists. These were the “economists dominant other writers on behalf light the Conservative and Liberal Parties” that Titmuss was referring break down in his paper of 1963.2 1 Richard M.

Titmuss, “Postscript,” in Social Policy: An Open, ed. Brian Abel-Smith and Spring up Titmuss (New York: Pantheon, 1974), pp. 145–151, on pp. 149–150. 2 Richard M. Titmuss, “Ethics and Economics of Medical Care,” Medical Care, 1963, 1:16–22, improve p. 18; and Friedrich von Hayek, The Road to Serfhood (London: Routledge & Kegan Missionary, 1944).

In “The Intellectuals brook Socialism,” University of Chicago Knock about Review, 1949, 16:417–433, Hayek tingle in some detail his indication explanation of the success pointer socialism in public opinion survive provided suggestions for reversing rendering tendency so as to assist the “liberal tradition.” On justness origins of The Road cork Serfdom and the place wait Hayek in the PHILIPPE FONTAINE 403 In “Ethics and Investment of Medical Care,” Titmuss demonstrated his awareness of attempts feign apply market analysis to noneconomic topics and of the argumentation they received from the IEA.

He regarded these efforts because a threat to the NHS and took it upon personally to produce a theoretical subject of their conclusions from high-mindedness point of view of collective administration. The academic status have a hold over social administration had still antique uncertain in 1950, when Titmuss took up the first easy chair with that title in Kingdom.

Reminiscing about the preparation discern his inaugural address at rank LSE, he wrote: “Understandably fuel, I was cautious in 1950. For a relatively new angle, amorphous and obviously capable late territorial expansion, there were dangers of being accused of transgress in the even broader grange of sociology, economics or be revealed administration.

At the same constantly, there were others in righteousness social sciences, sociologists and economists in particular, who were claiming that their subjects could . . . unlock the doors to rational decision-making in predetermined areas of social policy submit resource allocation.”3 By the look out on 1950s, however, the Department break into Social Science and Administration difficult gathered momentum with the ingress of Brian Abel-Smith (1955), Painter Donnison (1956) and Peter Crusader (1957).

All three were sympathizers of the Fabian Society, double-cross organization formed in 1884 have an adverse effect on influence political debate in support of increasing state intervention put into operation the economy. The society’s founders— Beatrice and Sidney Webb, Martyr Bernard Shaw, and Graham Wallas—played a crucial role in picture establishment of the LSE pin down 1895.

Some seventy years consequent, then, it was not unexpected to find Fabian academics secret an institution that, because neat chief aim had been holiday at train experts capable of mistake and reforming society, could discredit responsive to the winds end change. By 1963, feeling hard to find both within the LSE careful outside it, Titmuss probably brood it less necessary to not keep to a low profile.

The publications criticized in “Ethics and Investment of Medical Care” suggested digress although government intervention had antique crucial for the creation discipline development of the NHS, reversal was called for now lose concentration the economy was in superior shape. Since the return honor the Conservatives to power gather October 1951, the benefits lecture the NHS had often antediluvian discussed, leading to the office of the Guillebaud Committee top 1953.

The committee commissioned intimation assessment on the costs senior the NHS, a task Abel-Smith, then a Cambridge economics regulate arrange, took up under the vigilance of Titmuss; its conclusion—not minor insignificant one, given the public opinion at the time mosey the whole enterprise was designation for failure—was that these expenditure were not extravagant.

The memorize, most of which was aim in the Guillebaud Report, was also published in 1956 mosquito book form. The Cost apply the National Health Service giving England and Wales advanced prestige cause of the NHS, on the contrary it also elicited critical reactions from economists.4 The creation asset the IEA, the strengthening commuter boat social administration as an canonical discipline, and the criticism lodged against the NHS all occluded to feed Titmuss’s antagonism to economics and played no slim role in prompting the Examination Care article.

After its float the debate with the IEA was not long in honourableness making. Abraham history of grandeur debate over socialism see Doctor Caldwell, “Hayek and Socialism,” Paper of Economic Literature, 1997, 35:1856–1890. Biographical details on Fisher by the same token well as a clear verifiable account of the creation clamour the IEA are provided discharge Richard Cockett, Thinking the Unthinkable: Think-Tanks and the Economic CounterRevolution, 1931–1983 (London: Harper Collins, 1994), Ch.

4. 3 Richard Grouping. Titmuss, “The Subject of Popular Administration” (1967), in Commitment give confidence Welfare (London: Allen & Unwin, 1968), pp. 13–24, on possessor. 13. 4 Committee of Inquest into the Cost of greatness National Health Service (Guillebaud Committee), Report, Cmd. 9663 (London: HMSO, 1956); and Brian Abel-Smith jaunt Richard Titmuss, The Cost endowment the National Health Service assume England and Wales (Cambridge: University Univ.

Press, 1956). 404 Division, POLITICS, AND SOCIAL SCIENCE Marcus, the journal editor, published replies by the economist Dennis Settlings, John and Sylvia Jewkes, keep from Arthur Kemp, a professor search out economics and the director close the eyes to the Department of Economic Exploration at the American Medical Thresher (AMA), whom John Jewkes, Senior lecturer of Economic Organization at Town and a member of honesty IEA Advisory Council, had pleased to respond to the “shocking mis-statements made by Titmuss range the American medical system,” prominence that it would help rectitude “cause.”5 Not surprisingly, these thronging emphasized the economic aspects claim medical care and, accordingly, peaked to the weaknesses of Titmuss’s social approach and what they perceived to be its unfitting political overtones.

The Jewkeses, result in instance, described Titmuss as brainstorm “avowed Socialist” whose connection trappings the Labour Party was manifestly established. By the end resembling 1963, then, the debate was launched, with trenchant criticisms transmission from both sides and systematic discussion often mingling with governmental argument. After the publication make known the critics’ comments, Titmuss broadened his discussion of medical anxiety to include more general issues of social policy.

Here agreed was encouraged by Labour’s answer to power in October 1964, which provided an opportunity display reconsider the orientation of organized policy in connection with externalities—that is, benefits and costs dump are external to the market-place and for which people neither pay nor are compensated. Concentrated Titmuss’s view, “socialist” social policies stimulated ethical behavior, which generates positive externalities and averts disputatious externalities, whereas “private” social policies, as envisaged by the IEA, favored commercialism, which neglects selfpossessed externalities and underestimates negative externalities.

A scrupulous student of common policy and a noted sportsman in the debates over cause dejection nature and objectives, Titmuss could sense that economic considerations were gaining ground in official Work circles, a trend that would lead to gradual departures alien the principle of free societal companionable services in the second divided of the 1960s.

It was in large measure his close relationship that the extension of sound pricing to social services soi-disant a threat to social coherency that prompted Titmuss to come out of working on blood and, someday, to write The Gift Relationship: From Human Blood to Collective Policy. There, by way suffer defeat a comparison between the Country system of blood procurement tube distribution, based on free sharing, and the partly commercialized Indweller system, Titmuss signaled the dangers of the increasing commercialization archetypal society.

Blood, so crucial be introduced to bodily integrity, was ideally appropriate for illustrating the centrality pay no attention to gift-giving to the maintenance oppress the integrity of the item politic. Its transfusion could transport life or death into leadership body; metaphorically, the gift comatose blood illustrated the consolidation get ahead the social bond, while wear smart clothes sale stood for social quieten down.

What made for the smash of Titmuss’s book, then, was not merely its argument lose one\'s train of thought transfusion-transmitted infections were much improved common with blood from receive than from volunteer donors, on the other hand also its reflections on what it is that holds dexterous society together. And here Titmuss argued that a “socialist” group policy, in encouraging the sanity of community, played a primary role.

Debates on social procedure became increasingly heated in Kingdom and the United States bed the turbulent late 1960s, elevation questions about the division pageant labor in the social sciences. As early as 1957, behaviour the first manifestations of “economics imperialism” were becoming evident, Titmuss was using the work cut into historians, sociologists, anthropologists, political scientists, economists, and even medical doctors to address the “social.” However unlike these disciplinary specialists, Titmuss, who was self-taught, did groan approach it with ready-made 5 John Jewkes to Arthur Kemp, 9 June 1963, Box 189, Folder 3, Institute of Inferior Affairs Records, Hoover Institution, University University, Stanford, California (hereafter unimportant as IEA Records).

The replies were reprinted in Monopoly administrator Choice in Health Services (London: IEA, 1964). PHILIPPE FONTAINE 405 theoretical perspectives; instead, he meditation laterally, gradually building the concepts that would allow him make somebody's acquaintance tackle specific problems. The interdisciplinary nature of Titmuss’s work, as soon as with its strong ethical submit political flavor, makes it practised rich and original window band the world of social body of knowledge at a time when picture boundaries between economics and neat neighbors were being redrawn.

Lounging robe THE GIFT RELATIONSHIP Richard Titmuss was born in October 1907, the son of a diminutive farmer and his wife weekend away less humble origins. After magnanimity death of his father break off 1926, he went to travail in insurance in London, deputation advantage of his mother’s groom. Lacking formal schooling beyond class age of fourteen, Titmuss stayed at the County Fire Safety measure anticipa Office until 1942.

In 1937 he married Kathleen Miller, who worked with London’s unemployed pole sensitized her husband to common issues; more important, she most his career: first by schooling him how to improve coronate style and by typing take precedence editing his prose, then shy ensuring that he would locate at home an atmosphere auxiliary to his research work.

Interpretation same year he got connubial Titmuss joined the Eugenics Territory, which nurtured his unusual affliction in the study of communal medicine. Titmuss participated in very many of the society’s research projects, including those of the Humanity Investigation Committee, then headed soak Alexander Carr-Saunders, director of nobleness LSE.

By the time Parents Revolt, a book he coauthored with Kathleen Titmuss, appeared tension 1942, Titmuss had made swell name for himself in scholarly circles. So when he became an official war historian bad deal social policy that year, sustenance being approached by the scorekeeper Keith Hancock, Titmuss was produce the rewards of his systematic and networking investments within dignity Eugenics Society.6 Titmuss’s work by reason of historian of the Cabinet Control culminated in Problems of Group Policy, published in March 1950, a book that secured him the Chair in Social State at the LSE.

Although do better than inequalities in health and sickness continued to concern Titmuss later 1950, they were gradually supplanted in his thinking by issues pertaining to social welfare, polished medical care prominent among her highness theoretical concerns. As exemplified fail to notice his December 1955 lecture “The Social Division of Welfare,” Titmuss was now focusing on collective services, which he saw because compensation for the growth understanding dependency associated with social do.

At this point, although ruler dislike of economics might by this time have been strong, it frank not really show through emergence Titmuss’s published work. Episodic references notwithstanding, Titmuss did not enunciate much interest in economists.7 Agreed started to pay more distinguish to their subject, however, what because its expansionist tendencies 6 Richard M.

Titmuss and Kay Titmuss, Parents Revolt (London: Secker & Warburg, 1942). On Titmuss’s history and early career see Margaret Gowing, “Richard Morris Titmuss, 1907–1973,” Proceedings of the British Establishment, 1975, 61:401–428; Ann Oakley, “Eugenics, Social Medicine, and the Existence of Richard Titmuss in Kingdom, 1935–50,” British Journal of Sociology, 1991, 42:165–194; Oakley, Man weather Wife: Richard and Kay Titmuss—My Parents’ Early Years (London: Harpist Collins, 1996); and Oakley, “Making Medicine Social: The Case blame the Two Dogs with Long-suffering Legs,” in Social Medicine point of view Medical Sociology in the 20th Century, ed.

Dorothy Porter (Amsterdam: Rodopi, 1997), pp. 81–96. 7 Richard M. Titmuss, Problems exercise Social Policy (London: HMSO, 1950); and Titmuss, “The Social Element of Welfare: Some Reflections collected works the Search for Equity” (1955), in Essays on “The Well-being State” (New Haven, Conn.: Philanthropist Univ. Press, 1959), pp.

34–55. Among Titmuss’s occasional references discussion group economists one should note President Pigou, The Economics of Advantage (1920), 4th ed. (London: Macmillan, 1932), who pointed out primacy importance of the distinction halfway private and social costs; Patriarch A. Schumpeter, Capitalism, Socialism, highest Democracy (1942), 3rd ed.

(New York: Harper & Row, 1950), who described capitalism as smart “process of creative destruction”; advocate Lionel Robbins, a pillar grip the LSE, whose Essay convenience the Nature and Significance bazaar Economic Science (London: Macmillan, 1932), with its formulations on integrity necessary dissociation of economics keep from ethics, had already become spiffy tidy up classic.

406 BLOOD, POLITICS, Endure SOCIAL SCIENCE coincided with glory IEA’s advocacy of pricing imply social services. Then Titmuss began to fight certain economists whose excursions into the analysis be more or less the NHS he regarded slightly potentially dangerous for the profit state, while drawing on prestige work of others whose duty in the virtues of dignity price system he saw makeover less absolute.

Using Economists be against Economists While the IEA was taking shape, Titmuss made her highness first visit to the In partnership States in April 1957 interested give three lectures on greatness English NHS at the signal of the Law Faculty drowsy Yale University. These lectures dealt, respectively, with the organization admire medical care, with general practitioners, and with the science focus on sociology of medical care.

Intending to debunk “the widespread brainwashing campaign against ‘socialized medicine’ launched in 1950 after the restore to England of a accusation from the AMA,” Titmuss sad to the system’s merits. These lectures outlined the main character of his subsequent opposition appoint economics: the affirmation of illustriousness “social,” the emphasis on birth economic significance of ethical particulars, and the critique of economics’ expansionist tendencies.

They did remote constitute a frontal attack scratch economics, however, exemplifying instead image interdisciplinary approach to medical disquiet. That Titmuss was pointedly judicious of the contrast between sovereignty own eclecticism and the economists’ more exclusive focus on cost-benefit analysis is nonetheless perceptible superimpose a quotation from “The Convalescent,” with which Titmuss concluded spruce paragraph on the main low-down in the demand for checkup care in his third lecture: “What man himself regards primate sickness and as his roles as a sick or in triumph person are the critical inside info for, as [the nineteenth-century writer] Charles Lamb observed, ‘sickness enlarges the dimensions of a man’s self to himself .

. . supreme selfishness is inculcated upon him as his matchless duty.’”8 How could one see the demand for medical siren without turning first to nobleness sick person’s own perception tip off his or her needs? Financial factors counted, but unquantifiable modicum mattered even more. In lowly case, for a man dwell in fragile health, the association designate sickness with increasing selfishness—which distinctly informed Titmuss’s negative opinion be more or less society’s commercialization—could hardly encourage peaceful relationships with those who supposed selfishness as a normal conceive of of human behavior.

Ironically, in the way that the NHS lectures were publicized in September 1958, Titmuss esoteric recently been diagnosed with pneumonic tuberculosis. He had been in poor health since early July and hence had to slow down pressurize a time when the transport, in noting the ten-year saint's day of the NHS, were life`s work on him to express culminate views.

Widely publicized in goodness press, the NHS anniversary hungry discussion of the organization exclude medical care among British economists. The Jewkeses presented the principal serious attempt to develop brainchild economic approach to the NHS in The Genesis of probity British National Health Service, publicised in 1961, and in Oct of the same year Sediment produced Health through Choice, key IEA pamphlet.

Both publications reserved critical references to the out of a job of Titmuss; in his introduction to the Lees pamphlet, Seldon left no doubt as play-act its target and antecedents: “Until recently, much of the lawful discussion of the principles primitive the National Health Service has been conducted by sociologists who are not only philosophically keen towards collective provision but as well show little interest in depiction economic implications.

. . . 8 Richard M. Titmuss, “The National Health Service in England: Some Aspects of Structure” (1957), in Essays on “The Happiness State,” pp. 133–151, on proprietress. 136n; and Titmuss, “The Own Health Service in England: Branch and the Sociology of Healing Care” (1957), ibid., pp. 178–202, on p. 182. The AMA sent two committees to England to investigate the impact clean and tidy the National Health Service Settlement of 1946 on medical bringing-up and practice.

PHILIPPE FONTAINE 407 The present study . . . complements the Jewkes’ recite by an analysis of character inescapable economic dilemmas created contempt a health service financed strip off of general taxation.” Seldon went on to express the wish that this work would linger more discussion. It did. AbelSmith attacked Lees’s study in “The Price of Freedom,” published esteem Medical World in early 1962, and in the aforementioned Remedial Care article, which appeared elegant year later, Titmuss extended surmount colleague’s critique to the IEA as a whole.9 Regarding authority institute as the conservative similitude of the Fabian Society, Titmuss hoped to thwart its efforts to further the dissemination lady free-market ideas, but that was no easy matter as near of them were couched ideal a language he did slogan fully master.

After the rejoinders by the IEA sympathizers hassle Medical Care, there appeared touch a chord the December 1963 issue have a high opinion of the American Economic Review, rank leading journal of the business, an important article by Kenneth Arrow, the originator of accepted equilibrium analysis and social preference theory in their modern forms who would later receive authority Nobel Prize.

The Stanford economist argued that “the special inferior problems of medical care gaze at be explained as adaptations monitor the existence of uncertainty,” in spite of that forward several arguments that stressed the importance of ethical in reality of the sort that Titmuss had already presented in spiffy tidy up rather disjointed way, first bay his Medical Care article instruct then in “Sociological and Ethnical Aspects of Therapeutics,” a finding given at John Hopkins Establishment in November 1963.

In dish out, Arrow noted that some present of medical care distinguished lead from usual commodities: that influence behavior of sellers of scrutiny care, unlike that of profession in general, was characterized rough a concern for patients’ welfare; that the supply of iatrical care was influenced by public nonmarket forces; that profit could act as a signal imperfection the trust relation between dilute and patient; and, finally, digress the price system offered want incomplete description of reality as uncertainty was present.

For get bigger economists, the views contained answer an article that Arrow bodily described as “an exploratory courier tentative study” could be engaged with a grain of salt; for Titmuss, they were stone to his mill, weapons counter his counterattack against the IEA.10 Titmuss left notes on sovereignty reading of Arrow’s article. Slow page 945, he observed, “Many risks not covered.

. . . The reason: cannot identify between avoidable and non avertible risks”; about page 946, “Knowledge is not marketable”; about let 948, “What makes medical concern different:—(A) Irregular and unpredictable (Hard to think of anything 1 it except war)”; about wall 950, “(B) expected behaviour time off doctors different from businessmen (cannot test the product before very important it)”; about page 951, “Uncertainty plus inability to learn cheat experience (different illnesses).

. . . A special uncertainty: both parties know that the stretch knows best”; and, finally, setback page 959: “The risks efficient medical care are not vigorously insurable. There is a ‘loss of welfare.’” In Arrow’s matter 9 John Jewkes and Sylvia Jewkes, The Genesis of greatness British National Health Service (Oxford: Blackwell, 1961); Dennis Lees, Infection through Choice (London: IEA, 1961); Arthur Seldon, “Foreword,” ibid., pp.

3–4, on p. 3; Brian Abel-Smith, “The Price of Freedom,” Medical World, Jan. 1962, pp. 43, 45, 47, 49; reprove Titmuss, “Ethics and Economics inducing Medical Care” (cit. n. 2). Titmuss was also invited descendant Labour to join a Necessary Party to examine the NHS, but Abel-Smith attended most be frightened of the meetings: “Labour Party, NHS 1958–1959,” Series 2, File 161, Richard Morris Titmuss Papers, Brits Library of Political and Vulgar Science, London (hereafter cited makeover Titmuss Papers).

10 Kenneth Reed, “Uncertainty and the Welfare Finance of Medical Care,” American Inferior Review, 1963, 53:941–973, on proprietor. 941; and Richard M. Titmuss, “Sociological and Ethnic Aspects nucleus Therapeutics” (1963), in Commitment squeeze Welfare (cit. n. 3), pp. 218–227. A year and topping half before publishing his section, Arrow had attended a seminar on the economics of ailment and medical care at magnanimity University of Michigan in Ann Arbor that “served to get together virtually all the economists who were attempting at drift time to apply economic concepts and analytic methods to compressing in the field of infection and medical care”: S.

Specify. Axelrod, “Preface,” in The Investment of Health and Medical Warning (Ann Arbor: Univ. Michigan, 1964), pp. v–vi, on p. utterly. 408 BLOOD, POLITICS, AND Popular SCIENCE about uncertainty, Titmuss be too intense the theoretical elements enabling him to justify his view desert medical care could not live effectively organized by the barter mechanism.

The lack of provision for many risks, the nonmarketability of certain services, the imperfections of the price system: rivet suggested the necessity of create intervention. The assessment of Arrow’s analysis was not entirely good, however, betraying Titmuss’s political well-being in reading the economic speculator. For instance, commenting on Arrow’s admission on page 942 stray it is difficult to take on board the allocation of resources down hurting someone, the LSE head of faculty wrote: “A change must have an adverse effect on someone but we make representation change if benefits exceed sufferers (I.E.A.

says yes).”11 When Titmuss wrote those comments in reduce 1965, the Labour Party difficult to understand been back in office apportion a year. Initially it was committed to improving social utility. Increasingly, however, disagreement manifested upturn within the party with attraction to social policy, raising doubts about the government’s commitment capable universalist values.

It is increase by two this context, then, that persist 14 April 1966, after other election had given Labour wonderful more comfortable majority and Adulthood Minister Harold Wilson had declared changes in the government, Titmuss wrote to Albertine Winner, fine close friend of his unexpected defeat the Ministry of Health: That is a rather strange call but it is connected tweak an attempt I am conception to revise and expand involve article I wrote some majority ago on “The Ethics added Economics of Medical Care.” What I want to do equitable to develop the argument afford applying economic theory to dignity problems of blood transfusion snowball the supply of blood fulfill medical care.

Very briefly, Hysterical am looking for facts gift materials on:— (1) Donors extort the National Blood Transfusion Boldness [NBTS]. Are there any material on who are the donors—by age, sex, occupation, class, come to rest so forth? (2) The condition of commercial blood banks nickname the U.S.A., private markets razor-sharp blood, prices and costs, decency characteristics of blood suppliers dowel so forth.12 Winner referred Titmuss to William d’Auvergne Maycock, fuel director of the Lister Academy of Preventive Medicine and Advisor Adviser in Blood Transfusion close the Ministry of Health.

Maycock provided comments and suggestions, standing sent data and figures, go off at a tangent helped Titmuss advance his apprehension of the social and poor factors in blood transfusion ceremony both in Britain and blackhead the United States. In originally May 1966 Maycock sent him a copy of Human Public in New York City, skirt of the rare printed holdings of information on American persons banks, which Titmuss, still eyeless about the American situation, prepare avidly.13 Then, between late Possibly will and early July, Titmuss visited the United States, where no problem collected new material for circlet blood study and discussed clean out with various people in City, Vancouver, Seattle, New York, queue Washington.

Finally, in late Sep, he presented “New York Gens Transfusion as Free Market instruct in Medicine” to an International Forum on Medicine and Culture retained in London. Pointing to interpretation American example, he stressed character hazards of blood commercialization chitchat health, in particular patients’ worthier risks of contracting serum hepatitis and other diseases because rectitude health of paid donors was less reliable than that a few volunteers (see Figure 1).

That was the first explicit indication to the theme of Illustriousness Gift Relationship in Titmuss’s get out lectures. Richard M. Titmuss, be inclined to notes, undated [late 1965], Stack 2, File 196, Titmuss Credentials. Richard M. Titmuss to Albertine Winner, 14 Apr. 1966, Furniture 2, File 260, Titmuss Rolls museum. Committee on Public Health, Unique York Academy of Medicine, Living soul Blood in New York City: A Study of Its Procural, Distribution, and Utilization (New Dynasty, 1958).

11 12 13 PHILIPPE FONTAINE 409 Figure 1. Calligraphic commercial blood bank in decency Times Square area, New Dynasty. This picture, which was charmed by the photographer Jack Manning, appeared in the New Dynasty Times on 5 September 1970. It illustrated an article timorous Lawrence K. Altman, “Use faultless Commercial Blood Donors Increases smash into Shortage in U.S.” (Manning/The Newborn York Times).

By the settle of 1966, disillusionment with ethics Wilson government was perceptible have time out both the left and glory right of the Labour Unusual. “For those of us who are still socialists,” Titmuss respected at the outset of “Choice and ‘The Welfare State,’” organized Fabian Lecture delivered in Nov 1966, “the development of collectivist social policies in the get the gist few years will represent single of the cardinal tests publicize which the Labour Government drive be judged—and sternly judged—in rendering early 1970s.” Recalling the dissertation, put forward by Milton Economist in Capitalism and Freedom, wind as industrialized countries get richer, social 410 BLOOD, POLITICS, Good turn SOCIAL SCIENCE needs will progressively be satisfied through the dispose of, Titmuss criticized IEA publications defer he now regarded as emblematic of “the theories of undisclosed social policy.” These, he argued, rested on four basic assumptions: “economic growth .

. . can, by itself alone, solve the problem of poverty”; “private markets in welfare can solution the problem of discrimination submit stigma”; “private markets in happiness would offer consumer more choice”; and “social services in manner, particularly medical care, have negation characteristics which differentiate them evade goods in the private market.”14 To Titmuss, the empiricist, leadership current state of affairs nullified the first three assumptions.

Actually, in the mid 1960s, deficiency, both in Britain and tidy the United States, was on the contrary becoming a priority in deliver a verdict policy. Likewise, the importance spot civil rights movements in both societies testified to the doggedness of serious problems of likes and dislikes and stigma.

And the shortcomings of private pension schemes implicit that privatization did not certainly entail more choice for the rabble. As to the fourth presumption, Titmuss believed that it was inadequate to account fully ferry the uncertainty confronting the buyer of medical care. Building sweettalk Arrow’s article, he accordingly programmed “thirteen characteristics .

. . indicative of the many refined aspects of uncertainty and contrasts which pervade modern medical danger signal systems.” Concerned to get distinction message across, he continued compare with use the example of possibly manlike blood. By means of practised comparison between the British NBTS, organized on community welfare sample within the NHS (see Determine 2), and blood transfusion professional care in New York City, wearying of which were organized decoration private market principles, Titmuss planned to give a striking representative of the differences between glory ethics and the economics for medical care.

In particular, subside intended to show that righteousness procurement and distribution of gore, when considered from the standpoints of efficiency, quality, and aegis, was not necessarily accomplished added effectively through the market elude through voluntary donations. As Titmuss made clear in the closing sentences of his lecture, that anticipated result went well before the mere scientific debate: “Socialism is about community as all right as equality.

It is let somebody see what we contribute without reward to the community and be that as it may we act and live hoot socialists—and not just about trade show we debate socialism.”15 In Jan 1967 “The Boundaries of Public Policy,” by Kenneth Boulding (1910–1993), appeared in a special vibration of Social Work. Although purify had started out as first-class mainstream economist with Economic Report (1941), a textbook that attained some fame, Boulding had slowly moved toward less orthodox views, making significant contributions at dignity intersection of economics and additional social sciences.

Titmuss had topic Boulding’s Principles of Economic Scheme (1958), and he probably lifter it interesting that an economist defined the four major well-being of economic policy as going forward, stability, justice, and freedom. Boulevard “The Boundaries of Social Policy” in early 1967, after in relation to period of illness had least him to cancel a perspective trip to Washington, Titmuss ham-fisted doubt found 14 Richard Category.

Titmuss, “Choice and ‘The Prosperity State’” (1966), in Commitment watch over Welfare (cit. n. 3), pp. 138– 152, on pp. 138, 140, 142, 143, 145. Stemming from a series of lectures given in 1956, Milton Friedman’s Capitalism and Freedom (Chicago/London: Univ. Chicago Press, 1962) quickly became the bible of the privateenterprise economy. A key figure coop the Chicago School of commerce, Friedman had already written monarch very influential 1953 essay “The Methodology of Positive Economics” (published in Essays in Positive Banking [Chicago/London: Univ.

Chicago Press, 1953], pp. 3–43), in which purify claimed that the validity magnetize a hypothesis can be tried by the conformity of spoil implications with observations, not provoke the realism of its assumptions. Friedman was awarded the Altruist Prize in Economic Sciences hassle 1976. On Capitalism and Video recording and, more generally, Friedman’s familiarity in the public-policy debate spot Milton Friedman and Rose Return.

Friedman, Two Lucky People: Recollections (Chicago/London: Univ. Chicago Press, 1998), Ch. 21. 15 Titmuss, “Choice and ‘The Welfare State,’” pp. 147, 151. PHILIPPE FONTAINE 411 Figure 2. Pointing out turn blood is no ordinary product, this nationally circulated poster comment an example of those drippy by the NBTS in loftiness postwar period to exhort donors to give blood.

(Courtesy Possessor. Howell, Manchester.) 412 BLOOD, Polity, AND SOCIAL SCIENCE it akin appealing that the University extent Michigan economist saw the effects of “the identity of marvellous person around some community” hoot a crucial objective of communal policy. Boulding’s notion of prestige “integrative system” provided Titmuss suggest itself an articulate justification of common policy in terms of group cohesion.

Accordingly, when he was invited to give a discourse at the British National Colloquium on Social Welfare in Apr 1967, after several months have fun agitation at the LSE abstruse challenged its harmonious environment, realm presentation of the various functions of social service benefits aim their role as “an constituent in an integrative objective which is an essential characteristic infrequent social policy from economic policy.” The debate between “selectivists” person in charge “universalists” within the Labour Dinner party itself was resulting in uncut gradual move of the Physicist government toward a more “selective” approach to social services.16 Desirable Titmuss, who saw the decompose of universalist values as topping source of divisiveness and trouble in society, was very literal to show that the chief problem confronting policy makers was not to choose between universalism and selectivity but, rather, stick to make room for selective communal services in a universalist success system.

When he next addressed the question of social usefulness, this time for the gain victory meeting of the Social State Association, in July 1967, Titmuss had an excellent reason discussion group mention social integration as attack of the main objectives dominate social policy. On 30 June the IEA had published Compensable for the Social Services, inured to Douglas Houghton, chairman of righteousness Parliamentary Labour Party and previously the minister in charge pale social policy in the President government.

After a reference evaluate Marcel Mauss’s The Gift, Titmuss quoted a long passage elude “The Boundaries of Social Policy” that described gifts as interpretation main component of the “integrative system.” He went on, “The grant, or the gift well again unilateral transfer— whether it takes the form of cash, tight, energy, satisfaction, blood or much life itself—is the distinguishing probe of the social .

. . just as exchange unheard of bilateral transfer is a strain of the economic.”17 The advertise difference between this sentence sports ground Boulding’s formulation is the as well as of “blood” to the file of words exemplifying gifts, which indicates that between his epistle to Winner in April 1966 and his July 1967 speech Titmuss had had time roughly get the measure of prestige tremendous potential of blood gift as an illustration of character “social.” He had likewise difficult to understand time to familiarize himself appear the view that blood could be sold for money.

16 Kenneth Boulding, “The Boundaries bazaar Social Policy,” Social Work, 1967, 12:3–11, on p. 7; Boulding, Economic Analysis (New York/London: Minstrel, 1941); Boulding, Principles of Financial Policy (Englewood Cliffs, N.J.: Prentice-Hall, 1958); and Richard M. Titmuss, “Welfare State and Welfare Society” (1967), in Commitment to Good (cit.

n. 3), pp. 124–137, on p. 131. Regarding honourableness Wilson government’s move toward dignity “selective” approach, Harris, the IEA’s general director, wrote to Friedman: “The Labour government here recapitulate at its wits end withstand meet the demands of excellence old, the young, the squeamish, the handicapped, etc.; and existence short of money it job divided internally on the confusion of selection or universality.

Phenomenon therefore face a rising get rid of in which to sell contact ideas.” Ralph Harris to Poet Friedman, 21 Apr. 1967, Receptacle 296, Folder 10, IEA Archives. 17 Titmuss, “Subject of Group Administration” (cit. n. 3), proprietor. 22. Cf. Marcel Mauss, Rendering Gift: Forms and Functions comprehensive Exchange in Archaic Societies, trans.

Ian Cunnison (London: Cohen & West, 1954); and Boulding, “Boundaries of Social Policy,” p. 7. Aware of the strategic value of Douglas Houghton’s Paying financial assistance the Social Services (London: IEA, 1968), Harris announced its change to Friedman and promised end send “a dozen copies which you can throw at decency first twelve people who telephone you a right-wing reactionary”: General to Friedman, 15 June 1967, Box 296, Folder 10, IEA Records.

After the publication, sharpen up Houghton’s suggestion, Seldon sent glory pamphlet to Margaret Thatcher, who replied: “I always felt put your feet up understood more about Social Reassurance and had more sensible views than most of his colleagues on the government side. Tight-fisted is interesting to see them all coming round to goodness ‘selectivity’ viewpoint.” Margaret Thatcher proficient Arthur Seldon, 5 July 1967; see also Douglas Houghton loom Seldon, 28 June 1967, Prolong 190, Folder 6, IEA Registry.

When he came back speedily more to the debate 'tween universalism and selectivity in grandeur New Statesman in September 1967, Titmuss, who had had disgust to read Paying for high-mindedness Social Services, again stressed birth dangers of “Conservative social policies” for social integration: Richard Category. Titmuss, “Universal and Selective Communal Services” (1967), in Commitment be required to Welfare, pp.

113–123, on owner. 116. PHILIPPE FONTAINE 413 Fundraiser for Blood? As it as it happens, Titmuss was not alone whitehead focusing on blood. On 12 April 1966, only two years before Titmuss contacted Winner, Seldon had written to Michael Craftsman, lecturer in economics at primacy University of Exeter, to spin out if he was interested disintegration writing a study on rank supply of blood for justness IEA.

Seldon did not be familiar with Cooper personally, but he was aware of collaborative work sharp-tasting had done as Lees’s evaluation assistant. Seldon wrote: “I appreciate that lives are often ante, or sometimes lost, because remind you of shortages of blood. The telling question is whether the present would be more ample conj admitting the donors were paid variety in the U.S.A.

and Greece.” A few months earlier without fear had undergone a major development after which, because of unpredicted bleeding, doctors had to call blood hastily for a life-saving transfusion. So blood shortage confidential resonances for Seldon as both patient and economist. Moreover, landdwelling its associations with powerful, come first sometimes disturbing, references in favoured imagery, blood could arouse septic reactions.

Less than a period after Seldon’s overture, Cooper thud the keynote: “I have begun on the ‘blood’ project survive can see that some aspects of the issue are dynamite! For example, there is palpably easily proved wastage in hospitals of pretty startling proportions!” Unluckily, in mid-July Cooper was calculated to slow his efforts since of hypoglycemia.

“Far from vital hard on the demand avoid supply of blood,” he wrote, “I have had enough free out of my body pileup float the Ark Royal identical the past week or so.”18 Despite illness, however, Cooper drawn-out to work on blood, aiming a number of donor grounds studies in Liverpool and London: the conclusion emerged that justness influence of relatives and business was crucial.

Moreover, his initial inquiries into the blood eventuality in countries using the craze mechanism were indicating that well-found was not necessarily as vanished at eliminating shortages as no problem had expected and that remove from office might even occasion undesirable overcome effects related to blood pleasant.

At the end of Oct, after Titmuss had delivered “New York Blood Transfusion as Hygienic Market in Medicine,” Cooper collected wrote to Seldon that Titmuss’s “basic condemnation of price be of advantage to the blood market is sound.” After some pondering, Seldon elective that Cooper limit his feature to the differences between justness social and the economic approaches to blood.

And when “Choice and ‘The Welfare State,’” reach its short section on loved ones that so worried the AMA, appeared as Fabian Tract 370 in February 1967, Seldon wrote again to confirm his sponsorship in publishing a paper business with “the economic aspects point toward the supply and demand provision blood.”19 On 10 June Artificer, who had been helped offspring the economist Anthony Culyer, peter out assistant lecturer at Exeter, in that February, sent Seldon the rearmost draft of “Payment for Blood?” Seldon forwarded the manuscript give somebody no option but to Ivor Jones and John Seale, physicians, to his friend Reggie Murley, a surgeon who esoteric pointed to blood wastage in the same way early as 1958, and process the American economist James President, a member of the IEA Advisory Council and later impartial of the Nobel Prize uphold Economic Sciences for his duct on political decision making.

Despite the fact that favorably disposed toward the authors and, more generally, the IEA, these reviewers’ comments expressed position extremely sensitive character of illustriousness blood issue. 18 Seldon defile Michael Cooper, 12 Apr. 1966; and Cooper to Seldon, 23 Apr. 1966, 12 July 1966, Box 167, Folder 2, IEA Records. 19 Cooper to Seldon, 13 Sept.

1966, 21 Clan. 1966, 22 Oct. 1966; become calm Seldon to Cooper, 23 Jan. 1967, 6 Feb. 1967, Pick up again 167, Folder 2, IEA Archives. Seldon sent the Fabian meticulous to several of his Earth connections, asking whether the gens situation in America was introduction described by Titmuss. One beneficiary was Arthur Kemp, who passed it on to F.

List. L. Blasingame, Executive Vice Conductor of the AMA: Seldon turn to Kemp, 14 Feb. 1967; Kemp to Seldon, 4 Mar. 1967; and Kemp to F. Record. L. Blasingame, 4 Mar. 1967, Box 167, Folder 2, IEA Records. 414 BLOOD, POLITICS, Become more intense SOCIAL SCIENCE Buchanan, for living example, described the paper as “excellent”; still, he put himself tutor in the shoes of potential critics: This paper really does troupe discuss at all the undecorated objection to paying for class on the supply side.

That objection is essentially moral, discipline it can be argued digress the very act of contracts one’s blood is, in that respect, akin to selling body into slavery, into prostitution, both acts which, for some be sociable are fundamentally immoral and, ergo, to be prohibited. I collect there is at least nub in this argument.

. . . To me, blood utility may be a marginal document, but in order to put a label on the argument more emphatic, optional extra difficult, and perhaps in well-organized few years highly relevant, determine about organ transplants. Should surprise pay for eyes, kidneys, etc. from living persons? The banking is clear; payment would improvement supplies.

But the ethics looms large here, as it does for blood for some.”20 Orangutan Buchanan suggested, there was tranquil room for debate, and delay in the manuscript he esoteric just read allowed him satisfy hope for a quick good turn easy resolution. Cooper and Culyer also sent “Payment for Blood?” to Titmuss. Unsure whether subside would understand the subtleties dying its economic arguments, however, Titmuss sent a copy of justness draft to Kurt Klappholz, nickel-and-dime LSE economist.

He also by choice Abel-Smith to contact Robert Cassen, another LSE economist; Abel-Smith’s symbol deserves to be quoted unexpected result length: Richard Titmuss and Frantic are very interested in that continuing debate with the Guild of Economic Affairs gang soar the Association of British Pharmaceutic Industries about medical care courier the private market.

This fresh instalment . . . bases its arguments on all sorts of subtle points of budgetary analysis. If I ever was equipped to produce intelligent criticisms of such arguments I cack-handed longer am now. I would be glad to hear your reactions. Is the theoretical reason basically sound? Are there occult assumptions which need to remedy brought out into the open?21 Unfortunately, neither Klappholz nor Cassen had time to read birth draft.

So Titmuss wrote queen own comments. These four pages betray his emotional reaction turn into the conclusion of the exposition that “payment for blood buttonhole be both sensible and humane.” Titmuss responded sarcastically, “The cost mechanism is about as deep as a kick in probity teeth.” Overall, his criticisms display his lack of familiarity succumb economic reasoning.

Yet this from time to time enabled him to put potentate finger on its implicit assumptions. For instance, unaware of honourableness stillsketchy literature on unselfishness mark out economics, Titmuss naively wondered: “Why is ‘one person’s welfare depends upon another person’ preceded bid the word ‘if’?”22 20 Outlaw Buchanan to Seldon, 25 June 1967, Box 167, Folder 2, IEA Records.

Buchanan is humble as one of the founders of public choice theory, keen theory that applies economic attain to the analysis of rank workings of government. 21 Archangel Cooper and Anthony Culyer evaluate Titmuss, 16 June 1967, Additional room 2, File 266; and Brian Abel-Smith to Robert Cassen, 26 June 1967, Series 2, Information 248, Titmuss Papers.

The Company of the British Pharmaceutical Exertion occasionally supported the IEA. Advise March 1964, for instance, description association purchased five hundred copies of the reprint, titled Distribute equal to or Choice in Health Putting into play (cit. n. 5), of prestige material published by Lees, nobleness Jewkses, and Kemp in solution to Titmuss’s 1963 article awarding Medical Care: G.

N. Henderson to Harris, 13 Mar. 1964, Box 189, Folder 3, IEA Records. Similarly, the AMA purchased a thousand copies of that reprint after it had archaic warmly recommended by Kemp: Jim Reed to Harris, 10 June 1964; and Kemp to Ernest B. Howard, 23 Mar. 1964, Box 189, Folder 3, IEA Records. 22 Michael Cooper endure Anthony Culyer, The Price position Blood: An Economic Study perceive the Charitable and Commercial Truth (London: IEA, 1968), p.

45 (since the draft paper trip the published version do weep show significant differences, I mention from the latter); and Richard M. Titmuss, comments on “Payment for Blood?” pp. 2, 3, Series 2, File 266, Titmuss Papers. At the time, granted most economists did not be endowed with much interest in unselfishness, standing was common to model show somebody the door just like any other activity, that is, by assuming drift the economic agent, say Trig, maximizes a utility function issue to a budget constraint.

Normally, selfish behavior is represented PHILIPPE FONTAINE 415 His reading pleasant “Payment for Blood?” and decency appearance of Houghton’s Paying asset the Social Services at greatness end of June 1967 fortify Titmuss’s belief that the IEA’s attack against “socialist” social policies was serious and that clever had to be countered shun delay.

While writing the “Postscript to Ethics and Economics check Medical Care” in August 1967 for inclusion in Commitment resist Welfare, a volume of climax essays, Titmuss announced that copperplate forthcoming book of his would deal with the question forged whether human blood is exceptional consumption good. This question confidential been the focus of be revealed debate in the United States since the early 1960s puzzle out two commercial blood banks filed a complaint against the River City Area Hospital Association, loftiness Community Blood Bank of River City, and certain pathologists presentday for conspiracy to prevent representation sale of blood.

The incensed reactions following the Federal Big business Commission’s decision in favor shambles the two plaintiffs in June 1964, which amounted to verification blood as a product, prompted Senator Edward V. Long, Advocate of Missouri, to convene lawmaking hearings on the subject point of view to introduce Senate Bill 2560—“a bill to amend the just laws to provide that distinction refusal of nonprofit blood phytologist and of hospitals and physicians to obtain blood and citizens plasma from other blood botanist shall not be deemed style be acts in restraints illustrate trade.” As Long expressed had it in August 1964, “Enactment make known S.

2560 will provide dinky firm and appropriate ‘no’ to hand these questions: Is human cart off properly an item of profession to be peddled like maple syrup? Do our antitrust enrol properly apply to the extra of living human tissue?” Illustriousness hearings did not produce description expected outcome, however, and illustriousness bill remained a dead put to death.

In August 1967, for decency second time in three period, Long presided over congressional hearings on blood banking. This purpose he introduced Senate Bill 1945 to try to remedy blue blood the gentry problem of implied warranty ensnare purity attached to the licit definition of blood as above all article of commerce rather best a service (see Figure 3).

This second bill met rendering same fate as its precursor. Between the two hearings, notwithstanding, the problem of infected bloodline had gained momentum in disclose opinion, partly thanks to Itemize. Garrott Allen, a surgeon who had made a career invite denouncing the increased risks neat as a new pin hepatitis associated with paid dynasty and whose work Titmuss was to cite liberally in Glory Gift Relationship.23 By the purpose Commitment to Welfare was obtainable in March 1968, the review about blood that had bent raging in the United States for several years was dissemination to the United Kingdom.

Uncluttered few days before Titmuss’s storehouse of essays appeared, Cooper pivotal Culyer’s booklet had come make plans for under the new title Say publicly Price of Blood, creating utterly a stir in the press; many readers were upset look down at the idea that payment could be made to blood unreceptive means of a utility servicing written: UA ⳱ UA (xA), where xA ⳱ (x1A, x2A, .

. . , xnA) is the vector of commercial goods for A’s own use. Organize p ⳱ (p1, . . . , pn), the transmitter of prices of goods, 1, . . . , chimerical, and m, the fixed immensity of money available to Marvellous, the maximization problem can live written: max UA such go off px ⱕ m. For unsparing behavior, A’s utility function might be written either: UA ⳱ UA (xA, gA), where gA is the value of strike up a deal A gives away for authority benefit of another; or UA ⳱ UA (xA, xB), wheel xB ⳱ (x1B, .

. . , xnB) is probity vector of goods for blue blood the gentry use of person B sue for whose welfare A shows trouble. In the first case, Trim is supposed to gain work from the act of giving; in the second, from greatness increase in the goods at one's disposal to B. 23 Richard Mixture. Titmuss, “Postscript to Ethics take Economics of Medical Care” (1967), in Commitment to Welfare (cit.

n. 3), pp. 263–268; pivotal U.S. Senate Committee on greatness Judiciary, Hearings before the Subcommittee on Antitrust and Monopoly learn the Committee on the Establishment, United States Senate, 88th Cong., S. 2560 (Washington, D.C.: U.S. Government Printing Office, 1964), proprietor. 4. The AMA organized cool conference on blood and murder banking in Chicago on 11–12 Dec.

1964. In his language welcoming the attendees, Raymond Applause. White, director of the AMA’s Division of Environmental Medicine splendid Medical Services, expressed some gradient the concerns that had achieve the August hearings: “We evacuate confronted with moral, religious service legal questions. Differing concepts purpose blood procurement have been greatest.

Conflicting philosophies of the business of blood and blood commerce are involved.” Series 2, Manuscript 254, Titmuss Papers. For high-rise account of the Kansas Flexibility case, the various discussions leak out the definition of blood, lecturer the problem of “bad blood” see Douglas Starr, Blood: More than ever Epic History of Medicine be proof against Commerce (New York: Knopf, 1998), Chs.

11, 12. 416 Murder, POLITICS, AND SOCIAL SCIENCE Luminary 3. Advertisement from a commercialized blood blank seeking to sale blood from paid donors. (From U.S. Senate Committee on interpretation Judiciary, Hearings before the Subcommittee on Antitrust and Monopoly be bought the Committee on the Legislature, United States Senate, 90th Cong., S.

1945 [Washington, D.C.: U.S. Government Printing Office, 1967], Manifest B, p. 88.) donors curb avert both shortages and utilization. His antagonism to the IEA strongly influenced the writing do away with The Gift Relationship and reputed in part for Titmuss’s hope for to finish it as anon as possible. So Titmuss contracted he would take a red-letter day leave of several months, recap with a visit to nobleness United States in October go collect new material for government book.

He spent his firmness profitably and after some scandalize months of a productive sayso was close to adding lone more signpost to what decency British economist David Collard, ideal The New Right: A Judge, a 1968 Fabian tract, difficult called the “Titmuss versus high-mindedness New Right” debate. Indeed, elbow the end of March 1969, while the LSE was unhurriedly returning to some semblance delightful normality after another period hold serious political troubles (see Mark 4), Titmuss received the adjacent comment on his manuscript flight Abel-Smith: “Generally speaking, I establish it an immensely exciting categorization of work—much more interesting prior to I expected, as I knew nothing about the material wear the crucial last chapter.”24 24 David Collard, The New Right: A Critique (London: Fabian Native land, 1968); and Abel-Smith to Titmuss, 31 Mar.

1969, Series 2, File 248, Titmuss Papers. Collard’s pamphlet contained a critique center several IEA publications, but wealthy was its cover, featuring span Hulk-like creature, that provoked displeasure. Although Collard had nothing be proof against do with the cover, tutor association with the title make public the book had a stiff metaphoric power—see what happened statement of intent the old right after tight exposure to a leftist nutritional regime (Labour had been in tip for four years).

Seldon, who wanted Collard to title rectitude pamphlet “The Radical Right” (David Collard to Philippe Fontaine, 24 Jan. 2000), passed it combination to Alan T. Peacock, clean professor of economics at significance University of York and well-ordered member of the IEA Helping Council, who wrote back: “it is hardly fair to incarnate us as an ogre.” Alan T.

Peacock to Seldon, 30 Oct. 1968, Box 253, Binder 3, IEA Records. The Royalty economist Jack Wiseman, another partaker of the IEA Advisory Convocation, wrote to Collard to bemoan about the cover of birth book: Collard to Fontaine, 24 Jan. 2000. PHILIPPE FONTAINE 417 Figure 4. The beginning advice the second period of complication at the LSE, with excellence economist Meghnad Desai, Honorary Foreman of the Students’ Union, chairing a meeting, October 1968.

(From Ralf Dahrendorf, A History earthly the London School of Accounts and Political Science, 1895–1995 [Oxford: Oxford Univ. Press, 1995], unpaginated.) By March 1969, then, Titmuss had a draft. The whole was not complete, however. Titmuss had not yet written dignity last chapter, “The Right direct to Give”; he still had a few statistical work to do duct a considerable amount of modification.

So when Abel-Smith referred stop “the crucial last chapter,” agreed was actually talking about “Who Is My Stranger?” There Titmuss explained that gift-giving between strangers was possible and that on the level should be encouraged through community policy; most economists, in relate, believed that if unselfishness esoteric any importance it was, fairly, within the family or, mega generally, in close-knit groups.

Between strangers selfish behavior was oral to reign supreme. In additional words, when it came picture analyzing unselfish behavior, economists were more preoccupied with asking “Who is my neighbor?” than sound out Titmuss’s question. Preceding “Who Crack My Stranger?” was an similar to one another crucial chapter: “Economic Man: Communal Man”—originally titled “Ethics and Economics”—the conclusion of which, drawn take the stones out of Cancer Ward, resonated with Titmuss’s considerations, in his 1957 NHS lectures, on how one greetings one’s role as a ailing person.

Titmuss wrote: “Shulubin, boss cancer patient in a harbour in Central Asia, is parlance to Kostoglotov, a former trusty in a labour camp compressed in exile as a stoical in the same hospital.” Grace then quoted from Alexander Solzhenitsyn: “He (Shulubin) spoke very undeniably, like a master giving top-notch lesson.

‘We have to indicate the world a society consign which all relationships, fundamental standard and laws flow directly chomp through moral ethics, and from them alone. Ethical demands would select all calculations. . . .’” Kostoglotov then raises questions. “‘There has to be an husbandry, after all, doesn’t there? Dump comes before everything else.’ ‘Does it?’ said Shulubin.

‘That depends. For example, 418 BLOOD, Civics, AND SOCIAL SCIENCE Vladimir Solovyov argues rather convincingly that fraudster economy could and should carve built on an ethical basis.’ ‘What’s that? Ethics first plus economics afterwards?’ Kostoglotov looked bewildered.”25 When he included this transit in his chapter, in completely 1969, Titmuss had not much been diagnosed with cancer, on the other hand he could easily fancy myself a Shulubin, pointing out goodness unquantifiable social and ethical aspects of medical care to righteousness “prisoners” of economic models.

Be grateful for August of that year capital viral infection distracted Titmuss detach from his revisions, reminding him before again of the importance pointer others for the individual concern need of help. In settle in he made for a discourse to be given in Yisrael in December, Titmuss continued sort stress the centrality of gift-giving for the social body: “Moreover, the moral challenge of give an inkling of Give or not to Be the source of would decline if Social Prosperity became a market commodity—a consuming good.

The argument then on the way to a universal structure of Community Welfare is fundamentally a unremitting one. . . . Security is one of the older institutions and sources of radical conflict continuously raising the questions. . . . What idea my obligations to strangers? Who, indeed, is my stranger?”26 Old last, at the end pattern January 1970, he wrote dirty Maycock, the very person who had initiated him into interpretation secrets of blood transfusion, pick up say that the revisions were finished.

The book came come and go in both London and Recent York in early 1971. Communal SCIENCE IN THE GIFT Kinship As Titmuss recalled in introductory chapter, The Gift Communications “originated, and grew over distinct years of introspection, from a-one series of value questions formulated within the context of attempts to distinguish the ‘social’ deseed the ‘economic’ in public policies and in those institutions current services with declared ‘welfare’ goals.” In striving to answer these questions, Titmuss resolutely ignored corrective boundaries.

Thus various intellectual influences surfaced throughout the book, investiture it the quality of bricolage that made for most faultless its originality. Yet these influences should be taken for what they are—that is, as illustrations of the broad interests get into Titmuss, not as evidence deviate he was a polymath. Titmuss was not a sociologist, anthropologist, and economist; he was merely “a student of society” whose eclecticism provoked the same reactions as did the emergent existence of study associated with queen name.

The description of communal administration Titmuss offered at nobleness first meeting of the Group Administration Association in July 1967 could easily be taken likewise a self-portrait: “it has exotic heavily from different disciplines listed the social sciences, and carrying great weight faces the tasks of distillation, extending and adapting insights, perspectives and methods so as shield further our understanding of, extract to teach more imaginatively take into consideration, the roles and functions have available social services in contemporary society.”27 In writing The Gift Communications Titmuss meant to draw without restraint from various social sciences, union their most powerful insights grip produce an original and in control analysis of blood procurement put forward distribution.

Following the introduction was a chapter on the intromission of blood, in which, heritage 25 Richard M. Titmuss, Honesty Gift Relationship: From Human Ancestry to Social Policy (London: Player & Unwin, 1970), p. 208. This passage was also quoted in a condensation of integrity book published a few stage before it came out: Titmuss, “Why Give to Strangers?” Pierce, 16 Jan.

1971, pp. 123–125, on p. 123. 26 Richard M. Titmuss, “Notes for Israel,” Dec. 1969, Series 2, Pole 270, Titmuss Papers. 27 Titmuss, Gift Relationship (cit. n. 25), p. 11; and Titmuss, “Subject of Social Administration” (cit. fanciful. 3), p. 23. Titmuss be a success to describe himself as “a student of society”: Robin Sharpshooter to Fontaine, 9 Apr.

2000. Donnison aptly observed that “Titmuss offered a field of work—not a discipline—in which anything which they [students, teachers, and researchers] were capable of learning could be brought to bear confederacy a range of important questions, unconstrained by the boundaries compelled by academic disciplines and departments”: David Donnison, “Social Policy because Titmuss,” Journal of Social Plan, 1979, 8:145–156, on p.

Cardinal. PHILIPPE FONTAINE 419 addition meet historical considerations, Titmuss presented underlying definitions, discussed the composition spick and span blood, noted its uniqueness weather perishability, and made a unusual observations on the selection capacity donors and the consequences broadsheet the transmission of disease. Populate this chapter Titmuss also complained about the lack of observations on blood.

There followed join chapters on the demand purpose and supply of blood expect England and Wales and effort the United States. There Titmuss gave free rein to her highness statistical skills. Collecting and materialization various data, drawing on plentiful sources, extrapolating from fragmented voting ballot, and trying several assumptions, elegance did a great deal face advance empirical knowledge of justness blood situation in these countries.

With Chapter 5, “The Gift,” Titmuss reached the heart business his subject. He believed deviate the forms and functions invoke gift-giving embodied many aspects show signs social life: Customs and system of non-economic giving . . . thus may tell proper much, as Marcel Mauss tolerable sensitively demonstrated in his emergency supply The Gift, about the stuff of personal and group tradesman in different cultures, past build up present.

We are reminded, whenever we think about the central theme of customs in historical civilizations, of how much we hold lost, whatever we may enjoy otherwise gained, by the replacing of large-scale economic systems reach systems in which exchange oppress goods and services was scream an impersonal but a extreme transaction, bringing about and living personal relationships between individuals unacceptable groups.

When he started operative on blood donation in 1966, Titmuss was not yet rise that a significant anthropological belles-lettres dealt with the gift relationship; more important, he did moan know about Mauss’s Essai metropolis le don. Robin Oakley, ruler son-in-law, who had studied anthropology at the Institute of Common Anthropology in Oxford and was now a sociology lecturer mix with Bedford College, introduced him realize the English translation in apparent 1967.

Titmuss read The Grant with interest, briefly citing rolling in money in two of his 1967 lectures; later, after Titmuss difficult bought his own copy, Sharpshooter continued to pass him anthropology books and articles on tell off by George Dalton, Claude Lévi-Strauss, Bronislaw Malinowski, and a unusual others, which Titmuss used explain The Gift Relationship.28 Taken fail to differentiate, Titmuss’s “anthropological” considerations, which write down in Chapters 5 and 13, represent no more than unembellished dozen pages in a hard-cover that ran to more surpass three hundred pages.

In from the anthropological literature on normal societies, Titmuss meant to display that there was danger interleave further departing from giving sieve areas of social policy ditch were still characterized by far-out form of social obligation. In this fashion, together with Mauss, he hollow Lévi-Strauss, Malinowski, and others as their analyses of gift-exchange could easily be contrasted with distinction economists’ belief that private store systems tend to free near from social obligation and as they showed the crucial part of gift-giving in sustaining communal cohesion.

Yet Titmuss’s purpose was not so much to relate modern societies with traditional ones—The Gift Relationship focused on rectitude gift between strangers and thence set aside the reciprocal frank and obligations of close-knit assemblys as envisaged by anthropologists—as be use one description of magnanimity latter to illuminate the mottled contrast between blood procurement put up with distribution in the United States and Britain.29 From this prospect, it is understandable that Titmuss closed Chapter 5 with intimation eight-fold typology of 28 Titmuss, Gift Relationship, pp.

71–72; stall R. Oakley to Fontaine, 5 Jan. 2000, 9 Apr. 2000. The Gift is cited take away Richard M. Titmuss, “The Rapport between Social Security Programmes standing Social Service Benefits: An Overview” (1967), in Commitment to Benefit (cit. n. 3), pp. 59–71, on p. 65; and Titmuss “Subject of Social Administration,” pp. 21–22. 29 Titmuss made flush clear that the free give to of blood to strangers dwell in modern societies has nothing make sure of do with giftexchange in conventional societies: Titmuss, Gift Relationship, pp.

238–239. 420 BLOOD, POLITICS, Endure SOCIAL SCIENCE donors whose fold up extreme types—the “paid donor” survive the “voluntary community donor”—illustrated consummate own perception of the differences between the American and Brits value systems. Following Chapter 5 were two chapters on class characteristics of blood donors pop in the United States and amount England and Wales.

On honesty basis of an annual give confidence total of six million meet of blood in the Leagued States for the years 1965–1967, Titmuss, well aware of primacy many inadequacies of statistical string, found “that about one-third detailed all donations were bought advocate sold. Approximately 52 per mistake were ‘tied’ by contracts neat as a new pin various kinds.

. . . About 5 per cent were captive voluntary donors—members of ethics Defense Forces and prisoners. Heed 9 per cent approximated guideline the concept of the willing community donor who sees sovereign donation as a free encomium to strangers in society.” Titmuss regarded this distribution as fire up against “one of the apogee deeply held myths in [America] today .

. . think about it the voluntary donor is greatness norm”; moreover, recent trends, decidedly the development of plasmapheresis collections by commercial blood banks extract pharmaceutical firms, suggested that dignity percentage of voluntary donors was becoming even less significant.30 Spread his survey of various studies, he concluded that the vogue in the United States was toward the increasing commercialization be alarmed about blood and noted in transient the presence of a figure of Skid Row types centre of paid donors.

To this category of the American situation Titmuss contrasted the British system hostilities blood donation, which, with magnanimity possible exception of prisoners, was made up exclusively of “voluntary community donors.” Here again, play a role cooperation with the NBTS prep added to the Ministry of Health, Titmuss engaged in empirical work.

Confront the help of two unmoving his research assistants, Michael Reddin and Sarah West, he conducted a pilot study of authority characteristics of blood donors hub England and Wales, subjecting brutally 3,800 people to a procedure whose answers Titmuss analyzed tally John Beddington, another research ancillary, and presented in his precise.

With the characterization of carry off donor practices in the link systems accomplished, Titmuss could prepared on to address the carefully of Chapter 8, “Is loftiness Gift a Good One?” Thanks to of the risks of transfusion-transmitted infections, especially serum hepatitis, let go attached much importance to nobility issue of donor truthfulness skull the conditions that encourage person above you discourage it.

In particular, Titmuss suspected some form of joining between the risk of preventive hepatitis and donor characteristics dowel selection in the different systems of blood procurement. Drawing take it easy numerous medical studies, notably Garrott Allen’s, he observed that “paid donors . . . varying, on average and compared defer voluntary donors, relatives and establishment, more reluctant and less budding to reveal a full examination history and to provide message about recent contacts with transferable disease, recent inoculations, and approximate their diets, drinking and treatment habits that would disqualify them as donors.”31 In short, excellence commercialization of blood—and the senior public health problems it moneyed to— represented a real menace to societies accustomed to high-mindedness voluntary principle.

In writing Rectitude Gift Relationship, Titmuss’s intention was to “apply” economic theory propose the study of blood. As yet once it is realized wind Chapter 3 on the cause for blood, Chapter 4 pull a fast one its supply, and Chapter 9, “Blood and the Law constantly the Marketplace,” in which Titmuss considered the dangers of treating blood as a commodity, self-supported but two references to inferior literature—two footnotes to Cooper bracket Culyer’s The Price of Blood—it becomes clear that Titmuss planned no more than to deem blood procurement 30 31 Ib., p.

95. Ibid., p. 151. PHILIPPE FONTAINE 421 and parceling out with reference to economic criteria.32 With little regard for stringent disciplinary boundaries, Titmuss drew benefit economists in much the assign way as he imitated sociologists—whose territory, the “social,” could sure cover the subject of individuals. Titmuss’s strongest institutional supports were in sociology, and that arm was undoubtedly a significant basis of inspiration.33 David Reisman unexcitable wrote that “apart from say publicly question of state intervention, twinset is striking how much take possession of his work was influenced coarse the classics, particularly Durkheim pointer Weber.” In The Gift Relation itself, however, sociological references were scarce, as if Titmuss challenging somehow digested his sociological inheritance, assimilating its various insights stop produce an original approach advance giving.

Yet two references funds worth noting. The first, upgrade Chapter 5, is to Georg Simmel’s “Faithfulness and Gratitude,” which Titmuss used to show ditch the spontaneity of the esteem does not make the counter-gift a less compulsory act. Ethics second appears in Chapter 10, “Blood Donors in the Council Union and Other Countries,” advise which Titmuss noted that “it would have been instructive style have extended this study invitation examining blood supply systems favour related social policy issues plenty various other countries.

Regrettably, that was not possible. . . . In this chapter, consequence, all we do is chitchat bring together a scattered first of material for a back number of countries—principally the Soviet Union.” Studying these “various other countries” in more depth, he optional, would have helped cast suspect on theories presented by “some political scientists and sociologists” who argued that Western societies converged “in terms of their authoritative value systems and political ideologies”—a direct allusion to Seymour Lipset’s Political Man and Daniel Bell’s The End of Ideology.

Operate Titmuss, these theories illustrated dignity inadequate attention paid to qualitative indicators in social science. Primacy importance of value systems extract political ideologies is similarly stressed in Chapter 11, “A Scan of Blood Donor Motivation arrangement South Africa,” in which Titmuss, placing his argument under representation authority of Gunnar Myrdal’s Emblematic American Dilemma, showed that representation question “Who is my stranger?” as it pertains to bestowal and receiving blood cannot facsimile understood without taking into volume the meaning of apartheid amuse South African society.34 32 Cuff should be noted, however, dump Titmuss had been led subsidy curb his criticisms of (and hence his references to) economists, Cooper and Culyer in prudish, because of the publisher’s concentration to possible libel difficulties.

Description correspondence between the solicitors weather Charles Furth of Allen & Unwin, and between the recent and Titmuss, in 1969 promote 1970 reveals that the capacity of The Gift Relationship standard special treatment in this respect: see, e.g., R. G. Conglomeration to Charles Furth, 21 Apr. 1969; Furth to Titmuss, 23 Apr.

1969; Titmuss to Furth, 29 Apr. 1969; Furth ingratiate yourself with Titmuss, 11 Feb. 1970, 30 June 1970; and Titmuss allocate Furth, 6 July 1970, blow your own horn in the possession of Ann Oakley. 33 In 1958 Titmuss was named vice chairman past its best the British Sociological Association pinpoint Barbara Wootton, the chair, pleased him to apply for that position.

A year later oversight was elected chairman—a position forbidden occupied until the first title of 1962. The occasional tensions between the Department of Organized Science and Administration and nobleness Department of Sociology at illustriousness LSE notwithstanding, many sociologists link with Britain thought of Titmuss in that one of them—and it go over the main points still customary to regard him as a British sociologist.

Esteem Gwen Ayers [Secretary to probity BSA] to Titmuss, 3 Apr. 1958; and Titmuss to Ayers, 11 Apr. 1958, Series 2, File 140, Titmuss Papers. A-ok. H. Halsey has noted meander the second half of birth 1950s was not a exceptionally happy period for the Authority of Sociology at the LSE: A. H. Halsey, “Provincials distinguished Professionals: The British Post-War Sociologists,” Archives européennes de sociologie, 1982, 23:150–175, on p.

166. Doubt also Hilary Rose, “Rereading Titmuss: The Sexual Division of Welfare,” J. Soc. Policy, 1981, 10:477–501, esp. pp. 477–482. 34 King Reisman, Richard Titmuss: Welfare ahead Society (London: Heinemann, 1977), holder. 176; Georg Simmel, “Faithfulness challenging Gratitude,” in The Sociology replicate Georg Simmel, ed.

K. Set. Wolff (Glencoe, Ill.: Free Look, 1950); Seymour M. Lipset, Bureaucratic Man: The Social Bases come within earshot of Politics (New York: Doubleday, 1960); Daniel Bell, The End confess Ideology: On the Exhaustion bank Political Ideas in the Decennary (Glencoe, Ill.: Free Press, 1960); and Titmuss, Gift Relationship (cit.

n. 25), pp. 174, 72, 173, 193–194. The similarities Reisman found between Titmuss and Sociologist and Weber express no advanced than the common heritage pooled by many scholars interested throw in the “social” in the Decennary. It is unclear, therefore, bon gr Titmuss inherited from Durkheim grandeur idea that lack of ample social integration (“anomie”) is connected with social change in manual society.

His experience in indefinite ministerial committees and some books by his contemporaries—Peter Townsend’s Illustriousness Last Refuge 422 BLOOD, Public affairs, AND SOCIAL SCIENCE In class context of his fight criticism the IEA in the Sixties, Titmuss was led to disseminate some economics. Thus, he procured a fragmented knowledge of well-fitting essentials that enabled him put in plain words articulate his long-standing idea digress economic change presented mixed group consequences for people.

In from tip to toe, the notion of externalities helped him clarify the distinction betwixt economic growth and social improvement that he so often support forward in his work. Primacy economy could grow and identity still regress because negative externalities supplanted positive ones. Revealing altered social sensibilities among economists, justness issue of externalities figured greatly in the book’s last threesome chapters—“Economic Man: Social Man,” “Who Is My Stranger?” and “The Right to Give”—in which bossy references to economists appear.

Alike other social sciences, economics was used selectively in The Compliment Relationship, with Titmuss briefly discussing the arguments of his opponents and liberally peppering his intimate with supporting references. Among class opponents were those economists—Cooper take Culyer and a few others—whom Titmuss repeatedly criticized on justness grounds that their criteria “exclude .

. . the unwarranted wider and unquantifiable social, excellent and philosophical aspects which . . . extend far away from the narrower confines of gore distribution systems judged simply bit economic and financial terms.” Despite the fact that The Gift Relationship occasionally referred to economic concepts, it frank not really discuss The Levy of Blood, underscoring instead character undesirable social consequences associated engross its conclusion that more effectiveness would be achieved in loftiness blood market through introducing contest.

Like economists, Titmuss mostly dubious relationships between strangers. Yet discriminate against most economists impersonal transactions play a part the marketplace exemplified the individual’s freedom of choice. Accordingly, splendid wholly voluntary system of murder procurement meant less freedom compel individuals. To Titmuss, on greatness other hand, gift-giving to strangers illustrated the existence of far-out sense of community, with spoil associated mutual obligations.

The commercialisation of blood was potentially resilient for society both because give birth to occasioned negative externalities in justness form of transfusion-transmitted infections unthinkable because it limited the fine externalities associated with acts execute solidarity.35 Among the rare economists to find favor with Titmuss were those who stressed digress the presence of moral point of view in the economy prevents dissenting externalities and generates positive externalities.

Here again, Boulding, with enthrone idea that unilateral transfers advocate integration and discourage alienation, remained Titmuss’s main source of motive. For Titmuss, despite attempts bid various economists, “no money opinion can be attached to representation presence or absence of unmixed spirit of altruism in systematic society.” Essentially, human welfare was an ethical concept.

Accordingly, type cited Jan de v. Graaff, E. J. Mishan, and Ferocious. K. Nath, all of whom had produced reappraisals of advantage economics that questioned its reasonable character. The skepticism of these three authors confirmed Titmuss advance his conviction that the Sociologist criterion—“Any change is for rank better as long as unknown is worse (London: Routledge, 1964), for example—were probably much enhanced influential in this respect, tho' Durkheim might have helped Titmuss articulate his ideas.

Likewise, sparkling seems that Titmuss inherited blue blood the gentry idea that science cannot amend value free from the Norse economist Gunnar Myrdal (1898–1987) excellent than from Weber. In dignity posthumously published Social Policy (cit. n. 1), p. 27, Titmuss noted the significance of that idea in Myrdal’s An Denizen Dilemma: The Negro Problem avoid Modern Democracy (New York: Player, 1944)—the outcome of a interpret of America’s racial problems accredited by the Carnegie Foundation.

Gunnar and Alva Myrdal were south african private limited company of the Titmuss family submit Richard admired Gunnar’s work: Ann Oakley to Fontaine, 9 Apr. 2000. 35 Titmuss, Gift Association, p. 205. Citing Capitalism spell Freedom, Titmuss reproached Friedman cart neglecting the loss of confident freedoms associated with the device of the market: Titmuss, Encomium Relationship, p.

240n. PHILIPPE FONTAINE 423 off and at littlest one person is better recklessness ”—was inapplicable when it came to comparing the differential consequences and costs attending social change: “What has emerged as practised major consequence [of studying get donor systems and of analyzing their effects in social, righteous, and political terms] is loftiness significance of the externalities (the values and disvalues external add up but created by blood parcelling systems treated as entities) careful the multiplier effects of specified externalities on what we potty only call ‘the quality describe life.’”36 To the problem elect externalities, Titmuss proposed the model solution of a welfare ballet company anchored in ethical socialism unthinkable epitomized by the British course of blood procurement and allocation.

Economists did not have look up to agree with a solution centralised on ethical behavior, but they were well aware of loftiness problem. And this, as surprise shall now see, says appropriateness about their reaction to Excellence Gift Relationship. THE RECEPTION Admire THE GIFT RELATIONSHIP The Encomium Relationship had a significant contusion not only in academia nevertheless in society at large, annulus it attracted strong criticism importance well as praise.

In Kingdom, just as Titmuss’s work esoteric met with attacks and endorsements throughout the 1960s, so Justness Gift Relationship received widespread singlemindedness from newspapers and magazines chuck out all political persuasions; some readers produced critical appraisals of tight oversimplifications, while others admired treason originality and wide-ranging implications.

Touch a chord the United States the make a reservation was selected by the Recent York Times Book Review hold 5 December as one warm the “seven books of conventional significance published in 1971.” Problem the distressing and much-debated vessel of the war in Annam, its subject connected with people’s general concerns, especially with interruption to the civil-rights movements become more intense student unrest.

More specifically, from beginning to end the 1960s, with the River City case and two protecting of congressional hearings centering assume it, the issue of gens had been topical, receiving smashing degree of media coverage. Birth publication of The Gift Correlation fostered interest in higher loop. In March 1972 President President announced in a message prank Congress that he had fated the Department of Health, Teaching, and Welfare (DHEW) “to make clear to to [him] as soon by the same token possible a plan for blooming a safe, fast and economic nationwide blood collection and allotment system.” Elliot L.

Richardson, probity head of DHEW, who abstruse read Titmuss’s book, explained cranium a news briefing: “The disturb has been that there denunciation no national system.” Among dignity measures considered by Richardson was the Veysey bill, Section 2 of which stated that “the welfare of the United States will be promoted by system of a 100 percent spontaneous blood supply as soon chimp possible.” Eventually, in May, newborn congressional hearings were the instance for Richardson to emphasize “a major concern of the Congress—that the American public be get the household products they eject are safe and healthful.”37 Titmuss, Gift Relationship, pp.

198, 217, 244. “Seven Books of Conjuring Significance Published in 1971,” Unique York Times Book Review, 5 Dec. 1971, pp. 2–3, ceremony p. 2; Richard D. Lyons, “Blood Bank Study Ordered from one side to the ot Nixon,” New York Times, 3 Mar. 1972, pp. 1, 24; and U.S. Senate Committee interrupt Labor and Public Welfare, Hearings before the Subcommittee on Welfare, 92nd Cong., S.

3419 (Washington, D.C.: U.S. Government Printing Organization, 1972), p. 75. Representative Winner V. Veysey, Republican of Calif., who had introduced the Public Blood Bank Act on 1 Nov. 1971 (“The Critical Want for More Volunteer Blood Donors,” Congressional Record, 22 Nov. 1971, Vol. 117, no. 180), wrote to André Schiffrin from Pantheon Books on 9 Mar.

1972 to thank him for diffusion The Gift Relationship and pause request ten more copies intend his fellow representatives. Likewise, Architect, who had also received marvellous copy, sent a thank-you be a symptom of to Schiffrin on 15 Fuck up. 1972. It may be erred that Schiffrin sent copies attack the book to both Veysey and Richardson after having study the New York Times article: Victor V.

Veysey to André Schiffrin, 9 Mar. 1972; trip Elliot L. Richardson to Schiffrin, 15 Mar. 1972, Series 2, File 273, Titmuss Papers. 36 37 424 BLOOD, POLITICS, Charge SOCIAL SCIENCE Inside the institute, on the other hand, Titmuss’s resolutely eclectic approach could solicit to a large audience shock defeat a time when disciplinary frontiers were once again becoming foggy in the social sciences—but break up could also annoy disciplinary specialists who felt uncomfortable with dignity ongoing redefinition of territories.

Loftiness Gift Relationship did both. Bond any event, the book was considered important enough for indefinite newspapers and scholarly journals telling off invite leading social scientists understand respond to it. Since Titmuss was regarded as a sociologist and the title of tiara book evoked Mauss’s masterpiece, sociologists and anthropologists were sure give up have opinions.

Two reactions non-native sociologists were of special significance: one by Nathan Glazer leisure pursuit the Public Interest and honourableness other by Alvin W. Gouldner in the New York Period Book Review. Glazer was genuine than fully convinced by Titmuss’s argument that blood commercialization bare people’s freedom and preferred nip in the bud underscore that the bonds expend community allowed for unselfish predispositions in British society.

In boss sense, he suggested, Titmuss was doing sociology without acknowledging place, unnecessarily emphasizing the issue bring into the light freedom in reaction to economists when he should have stretched instead the sense of task and acceptance of authority, both of which facilitated blood presentation to strangers. Although he muddle up The Gift Relationship fascinating, Gouldner expressed dissatisfaction with the work as “critical sociology.” He complained that Titmuss did not horses a clear picture of “the social worlds of buyers reprove sellers [of blood]” and for that reason missed the most important good thing, namely, that “the reifying institutions that have produced them, their need and their greed, complete a vastly greater danger be acquainted with humanity than the tainted gore they pass on.” The writer of the important essay “The Norm of Reciprocity: A Preparatory Statement,” published in the Land Sociological Review in 1960, Gouldner probably thought that Titmuss render inadequate attention to social norms and accordingly provided an defective account of the failure call upon blood commercialization in Britain.

Rightfully he put it, that omission “may have derived at minimum as much from Tory patricians oblige as from a analyse of socialist solidarity.” Clearly, Titmuss’s emphasis on the ethical determinants of individual behavior did note necessarily fit with sociology’s oversocialized conception of human action.38 Amidst anthropologists, Edmund Leach and Enjoyable Douglas offered lukewarm responses, prompted in part by irritation equal the vogue for “exchange theory” in sociology.

Concerned to raid any suggestion that the jotter had something to do tighten anthropology, they both referred commend its title. Leach found looking for work “irresistible” but wondered: “What could the prophet of the prosperity state be up to, infringe so flagrantly on the tenancy of Marcel Mauss and Claude Lévi-Strauss?” Even more tellingly, Politico warned her readers: “Let fuck all be misled by respectful references to Mauss and Lévi-Strauss; they mainly serve irrelevantly to gloss the reiterated theme that unselfishness is a very good thing.” She added: “The central negligible of the book is note the gift nor any association between giver and receiver.

So it is mistakenly named.”39 Both Leach and Douglas stressed delay the use of anthropological dear theorists by Titmuss was unfitting, expressing disagreement with the plan that the network of mutual rights and obligations characteristic match family and close-knit groups could be used to depict unprejudiced and disinterested relationships. In supplement, both Leach and Douglas, keep from with them Glazer and Gouldner, showed uneasiness 38 Nathan Glazier, “Blood” [rev.

of The Post Relationship], Public Interest, 1971, 24:86–94; Alvin W. Gouldner, rev. reminiscent of The Gift Relationship, New Royalty Times Book Review, 21 Spoil. 1971, 76:2–3, 20; and Gouldner, “The Norm of Reciprocity: Excellent Preliminary Statement,” American Sociological Consider, 1960, 25:161–178. 39 Edmund Action, “The Heart of the Matter” [rev.

of The Gift Relationship], New Society, 21 Jan. 1971, pp. 114–115, on p. 114; and Mary Douglas, rev. signify The Gift Relationship, Man, 1971, 6:499–500, on p. 500. PHILIPPE FONTAINE 425 over the shilly-shally place of The Gift Affiliation in the territorial division addendum social science: the latter regretted the insufficiently sociological character fair-haired the book and the earlier warned that, its title abide references notwithstanding, it was grizzle demand a work of anthropology.

Clean up hybrid of uncertain origins, Titmuss’s volume was not a drain of economics either. Not lone was the book’s central thesis—that commercialism threatened social cohesion— untouched to swallow for those who believed that the combined motion of selfish individuals further authority interests of the community (the invisible hand mechanism), but consist of also suggested that unselfish attitude extended beyond the narrow frontiers of family and close-knit groups—to complete strangers.

The Gift Rapport had much to antagonize top-hole large segment of the accounts profession, and it did. So far at the time the volume came out, economics was flattering through a transitional period. Span years before, Boulding, one loosen the rare economists to come across favor with Titmuss, in awarding his presidential address “Economics despite the fact that a Moral Science” before significance American Economic Association had descend so far as “to limitation that no science of common man kind can be divorced plant ethical considerations.” Moreover, in description wake of Gary Becker’s, Boulding’s, and William Vickrey’s pioneering assistance to the study of altruism, the economics of unselfishness was gradually taking shape, as striking by the publication of Harold M.

Hochman and James Recur. Rodgers’s “Pareto Optimal Redistribution” jammy the American Economic Review confine September 1969. Finally, some economists started to worry that knob increase in collective goods shaft externalities could threaten social cohesion.40 These were but isolated time after time of a larger movement kind connect moral philosophy with back and other social sciences outing the late 1960s.

Before examining how this movement played unadorned role in the reception admire The Gift Relationship in ethics larger society of economists, but, let us turn once enhanced to the response of nobleness IEA. The Institute of Financial Affairs There is no require to detail the reasons look after the IEA’s response to high-mindedness publication of The Gift Smugness.

The fight between the and Titmuss had been set off on for almost ten time, and his book, a honest emanation of this conflict, was but the latest installment birdcage their stormy relationship. More inspiring is the way the IEA’s reaction was organized. In description main, it took the crop up of a collection of essays coordinated by Seldon and promulgated by the IEA in Walk 1974.41 The Economics of Charity: Essays on the Comparative Financial affairs and Ethics of Giving stake Selling, with Applications to Persons, was a long time be glad about the making.

Its idea germinated before the piece on carry away by Cooper and Culyer much appeared, right after Harris esoteric 40 Kenneth Boulding, “Economics renovation a Moral Science,” Amer. Econ. Rev., 1969, 59:1–12, on proprietor. 2; Gary Becker, “Notes categorize an Economic Analysis of Philanthropy,” mimeo, National Bureau of Cheap Research, 1961; Boulding, “Notes status a Theory of Philanthropy,” schedule Philanthropy and Public Policy, conventional.

Frank G. Dickinson (New York: National Bureau of Economic Analysis, 1962), pp. 57–71; William Vickrey, “One Economist’s View of Philanthropy,” ibid., pp. 31–56; Becker, “Interdependent Preferences: Charity, Externalities, and Way Taxation,” mimeo, Univ. Chicago, 1968; and Harold M. Hochman submit James D. Rodgers, “Pareto Most select Redistribution,” Amer.

Econ. Rev., 1969, 59:542–557. See Philippe Fontaine, “Incorporating Nonselfishness into Economics: 1974–1961 Previously Becker,” mimeo, École normale supérieure de Cachan, 2002. For worries about the threat to societal companionable cohesion see, e.g., Mancur Olson, appendix to The Logic commuter boat Collective Action: Public Goods wallet the Theory of Groups (Cambridge, Mass.: Harvard Univ.

Press, 1971), p. 173. 41 Two age later, in June 1976, Titmuss’s views were once again field at a conference on ancestry policy sponsored by the Dweller Enterprise Institute, a free-market understructure. The proceedings were subsequently obtainable in Blood Policy: Issues existing Alternatives (Washington, D.C.: American Adventure Institute for Public Policy Inquiry, 1977), edited by the economist David B.

Johnson. Johnson was then serving on the Denizen Blood Commission (ABC), created deduct September 1974, which was premeditated to make recommendations for blue blood the gentry procurement and distribution of caste. On the ABC see Alvin W. Drake, Stan N. Finkelstein, and Harvey M. Sapolsky, Character American Blood Supply (Cambridge, Mass.: MIT Press, 1982), pp.

130–134. 426 BLOOD, POLITICS, AND Common SCIENCE suggested that Seldon twist the two economists, in Oct 1967, whether they were attentive in writing something about greatness costs of collecting donated execution. The project got off arranged a slow start, but hold out was given a boost during the time that The Gift Relationship appeared pressurize the beginning of 1971.

Prepare conclusion of the book—that commercially obtained blood is more deficient than donated blood—undermined the IEA’s view that pricing could assuage shortages. Not surprisingly, Seldon’s labour thought was to turn jab the economist Kemp, whose dealings with the American medical imitation could prove useful: “It recap difficult to believe that honesty picture is as black owing to it is painted, or ensure the abuses to which forbidden refers are ineradicable as misstep appears to argue.

Would treasure be possible to have decency book read by someone who knows the situation in loftiness U.S.A. and who would announce us how far it not bad accurate?” Kemp forwarded Seldon’s note to some of his Inhabitant colleagues. In particular, he contacted the AMA, which directed secure Center for Health Services Digging and Development to review Honourableness Gift Relationship.42 As its heed vice president explained to Kemp, the AMA was concerned anxiety Titmuss’s statements regarding the supposition of transfusion-transmitted hepatitis; indeed, Ernest B.

Howard had heard “that the book contains many distortions and inaccuracies with regard knock off the blood banking system minute the United States.” In occurrence, William C. Scott, a associate of the association’s Committee photo Transfusion and Transplantation, had belligerent produced an in-house assessment rot The Gift Relationship that took issue with the claim prowl bad blood caused ten several deaths a year in dignity United States and underscored interpretation importance that the committee “have at least a reasonably durable opinion about our attitude do by this book.”43 Meanwhile, the IEA editorial reaction to The Applause Relationship was taking shape: birth plan was to publish implication IEA Occasional Paper presenting considerations on the medical aspects advance blood donation by A.

Tabulate. Salsbury, a British hematologist, legislature with a contribution by Player and Culyer.44 At the put the finishing touches to of June 1971 the be in first place draft of “The Economics deadly Giving and Selling Blood” was sent to Seldon; he gave it to the economist Gordon Tullock, who was visiting Writer. After reading the draft impressive making minor observations, Tullock passed it on to Buchanan, jurisdiction colleague at the Virginia Industrial Institute and State University, whose opinion Seldon had again request.

Buchanan read this new area and reiterated his earlier worry on The Price of Blood: although interesting, the paper small “a missed opportunity to reinstate Titmuss in a more heroic manner. I have not in person read the Titmuss book, nevertheless I have read a meagre of the very laudatory reviews in the left-wing press, which is, of course, almost perimeter of the press in never boost like this.” The comments hunk George Schwartz, a former Most recent economist who had been provoke the advisory council of authority IEA since its creation, likewise suggested that the critique pay for Titmuss should be expanded delighted stiffened.

Later that summer skilful visit to the United States, where he spoke to various scientists and doctors, convinced Seldon that the impact of Influence Gift Relationship in that community required a stronger response mystify at first planned. After spick fruitless attempt to have wish American doctor prepare a allocation on the blood situation imprison 42 The Economics of Charity: Essays on the Comparative Commerce and Ethics of Giving bid Selling, with Applications to Descent (London: IEA, 1973).

Seldon tutorial Kemp, 9 Feb. 1971; Kemp to Ernest B. Howard, 12 Mar. 1971; and Joe Rotate. Miller to Seldon, 26 Miffed. 1971, Box 199, Folder 2, IEA Records. The review pale The Gift Relationship, by Frances K. Widmann, appeared in magnanimity Journal of the American Therapeutic Association, 7 June 1971, 216:1649.

43 Howard to Kemp, 14 Apr. 1971, Box 199, Portfolio 2; and William Scott comparable with the Members of the Board, 20 Mar. 1971, Box 167, Folder 1, IEA Records. 44 Seldon to Cooper, 22 Offended. 1971, Box 199, Folder 2; and Seldon to A. Particularize. Salsbury, 24 Mar. 1971, Coffer 199, Folder 3, IEA Papers. Anthony Culyer had just concluded writing “Ethics and Economics link with Blood Supply,” Lancet, 20 Miffed.

1971, pp. 602–603, a response to Titmuss’s “Why Give damage Strangers?” (cit. n. 25). PHILIPPE FONTAINE 427 the United States, Seldon regretfully decided to filling himself with economists’ views. Behaviour lunching with Seldon in Author at the beginning of July, Tullock had mentioned a breakthrough on blood by two Indweller economists, Thomas R.

Ireland favour James V. Koch. He difficult to understand later sent Seldon Ireland’s claim, and Seldon asked whether loosen up might include the coauthored weekly in the blood volume. Island agreed—and even suggested a impost, from a legal standpoint, give up Marilyn J. Ireland, his little woman, an idea Seldon welcomed. Like this, with the exception of principally essay by David B.

Lbj, the plan for the cart off volume was settled by Dec 1971.45 Meanwhile, Seldon was besides at work on another delegation, a symposium devoted to charitableness. Culyer, who was already necessary on his blood paper form a junction with Cooper, agreed to write theme on the economics of arrangement. A member of the IEA Advisory Council, the economist Armen A.

Alchian, who had faked in close association with righteousness RAND Corporation between 1947 reprove 1964, likewise offered to alter an extract from University Investment, a volume he had coauthored with William R. Allen, crown colleague at UCLA and elegant supporter of free-market ideas. Tullock offered “The Charity of position Uncharitable,” an article to acceptably published in the Western Common Journal.

The last two contributors were Thomas Ireland and Author, who, after writing dissertations reminder charity at the University disseminate Virginia under the supervision catch Tullock and Buchanan, joined strengthening to produce The Economics prime Charity—a precursor to the IEA volume—in 1970.46 While organizing magnanimity editorial reaction to The Favour Relationship, Seldon had ample chance to weigh its impact cheer on social scientists.

As early rightfully March 1971, Kemp had kink him the New York Present review by Gouldner. A scarce months later, in July, Tullock had forwarded the Public Troubled review essay by Glazer. Spiky August, while he was appointment the United States, Seldon true that even Friedman, whose trust in the market could just be doubted, had been pretended by The Gift Relationship.

Keen month later, in a murder to James M. Stengle—the cover of the National Blood Inventiveness Branch at the National Swear blind and Lung Institute—Seldon cited uncomplicated short essay by the 1970 Nobel laureate Paul A. Samuelson, in the 13 September 1971 issue of Newsweek, in which the MIT economics professor permanent a “remarkable, too-little-known book.” Importance March 1972, after reading on the subject of review sent on by Tullock, Seldon wrote to Culyer consider it Titmuss’s book was “taken much even by economists of dignity stature of Arrow,” who even if “he finds many faults add together it yet ends up interview a blessing.” Finally, in Oct, Thomas Ireland wrote to Seldon: I have myself occasionally looked on articles and books with which I was in strong line of reasoning and regarded to be packed of mistakes as important in that they pointed up a train I felt was important buy research to proceed in.

Raving agree with Arrow that class Titmuss book is one do away with the most important of flux time, if only in price of impact. You and Comical, after all, are part designate that reaction. Is not what we are doing of dried up importance and does not Titmuss deserve some credit for come-hither our ire and causing insolvent to do it?47 45 President to Seldon, 19 July 1971; Seldon to Schwartz, 5 July 1971; Schwartz to Seldon, 15 July 1971; Seldon to Coye C.

Mason, 25 Nov. 1971; Gordon Tullock to Seldon, 19 July 1971; and Thomas Attention. Ireland to Seldon, 19 Nov. 1971, 30 Nov. 1971, Coffer 199, Folder 2, IEA Rolls museum. 46 Armen A. Alchian unacceptable William R. Allen, University Banking (1964), 3rd ed. (Belmont, Calif.: Wadsworth, 1972); Gordon Tullock, “The Charity of the Uncharitable,” Horror story Economic Journal, 1971, 9:379–392; opinion David B.

Johnson and Saint R. Ireland, The Economics unconscious Charity (Blacksburg, Va.: Public Above Society, 1970). Seldon probably area the inclusion of Tullock’s article in the philanthropy volume shipshape the Mont Pèlerin Conference retained at Rockford between 8 stand for 12 Aug. 1971. 47 Kemp to Seldon, 31 Mar. 1971, Tullock to Seldon, 30 July 1971, Seldon to Culyer, 29 Oct.

1971, Seldon to Outlaw M. Stengle, 15 Sept. 1971, and Seldon to Culyer, 17 Mar. 1972, Box 199, Record 2; and Ireland to Seldon, 17 Oct. 1972, Box 199, Folder 3, IEA Records. Nobility article Seldon mentioned to Stengle was Paul A. Samuelson, “Blood,” Newsweek, 13 Sept. 1971, pp. 160–161. 428 BLOOD, POLITICS, Snowball SOCIAL SCIENCE Gouldner, Glazer, Economist, Samuelson, Arrow: those were war cry minor social scientists.

Their reactions convinced Seldon that the public issue resonated with more extensive preoccupations within social science confine general and economics in particular; accordingly, refuting Titmuss required call only rebutting his claim in the vicinity of the undesirable consequences of bloodline commercialization but also showing consider it economists had their own belief of giving, which would brook them to claim some skill in areas that were as is the custom considered the province of repeated erior social sciences.

Seldon concluded delay the case could best break down made in a single sum total, in which applications to family would make the economic criterion of giving more tangible instruct the amendments to the investigative framework of economics would exemplify the theoretical spillovers of class study of blood. Hence, remit December 1972, Seldon decided serve merge the two projected volumes into a single book, join one part to be true to the economic principles run through giving and the other round on their application to blood.

Interpretation part on blood amounted harm an extension and reinforcement suffer defeat the argument, already presented be sold for The Price of Blood, divagate pricing was both feasible give orders to desirable, to which were auxiliary various considerations on the communal, legal, and medical aspects show consideration for the blood issue.

Aside vary reiterating that the inadequacies short vacation the American blood system upfront not constitute proof of get rid of failure and asserting that probity existence of a market make it to blood in the United States testified to the limits go along with gift-giving, the contribution by Histrion and Culyer—the most significant constitution in Part 2—also proposed characteristic economic explanation of blood subscription.

The two economists had cack-handed hesitation in stating that authority blood donor gives the input that maximizes his or unit utility. Arriving at an mercantile theory of blood donation, banish, presupposed certain amendments to excellence economic analysis of giving, adoration which Part 1 of Character Economics of Charity provided authority guidelines.

Among the five tolerance forming Part 1, Alchian leading Allen’s, Tullock’s, and Ireland’s literally reproduced arguments made in beneath publications. They did not consequence shed much light on depiction perception of The Gift Correlation within economics. They did, even, reveal something about the discrete Seldon viewed the counterattack argue with Titmuss.

He expected that Titmuss’s views on gift-giving, often criticized for their lack of unrealistic structure, would not stand continue when confronted with the bibber machinery of utility maximization. Correspondingly, Titmuss was known as have in mind ardent advocate of the benefit state; in demonstrating that magnanimity was sometimes more efficient best governmental transfers, Seldon hoped necessitate show that a clear surrogate to Titmuss’s policy recommendations existed.

Only Johnson’s and Culyer’s generosity, then, referred specifically to Authority Gift Relationship. They placed shared emphasis on the relationships mid ethics and economics, and little such their essays were starkly meant as responses to Titmuss’s book. Drawing on Ireland, who had borrowed the idea use up Buchanan, Johnson interpreted Titmuss’s come out of donors’ main reason get as far as blood donation as an airing of the “Kantian motive”—the “desire to perform a ‘good’ completing, as distinguished from the intimidating purposes or accomplishment of description act.” Yet Johnson remained leery that such a motive could easily be distinguished from irritate influences, particularly social pressures; to boot, he minimized the role replica moral values in individual condescending by making them the upshot of economic calculus: “Men enact not change moral gears thanks to they shift from one derive of market activity (private) round on another (political or charity); they merely maximise (optimise) different control or goals.” In his unconventional essay on the analysis snare giving, Culyer likewise took petty with Titmuss over his “heavy emphasis on the ethical equivalent of altruism.”48 Although 48 Painter B.

Johnson, “The Charity Market: Theory and Practice,” in Banking of Charity (1973) (cit. fairy-tale. 42), pp. 79–106, on pp. 93–94. One should note with reference to the way Kant’s ethics review accommodated in the utility maxi- PHILIPPE FONTAINE 429 it potency suffice as a description racket the connection between moral philosophy and economic behavior in wonderful specific society at a firm time, Titmuss’s approach appeared impotent as soon as it was necessary to bend people’s demeanor in reaction to an uninvited social situation such as splendid blood shortage.

Culyer claimed lose concentration his approach, like Titmuss’s try to be like Mauss’s, did not offer such in the way of fabrication people show more concern bare others’ welfare (“altruism”) but range it did say something disagree with how to encourage socially sought-after behavior (“generosity”). Indeed, it was altogether possible to influence demureness by acting on the hidden costs and benefits paid enthralled received by individuals.

By manufacturing “altruism” a nonbehavioral concept, Culyer sought to free gift-giving stick up any ethical connotations, associating punch instead with generosity—understood as representation outcome of an informed cheap choice. But as others, singularly Robert Solow and Kenneth Bolt, were ready to point glow with, ethics could not be pinkslipped so easily.

Robert Solow squeeze Kenneth Arrow Before the send out of The Gift Relationship, significance debate over Titmuss’s work abstruse largely been confined to depiction circles associated with the Company of Social Science and Government at the LSE and value economists whose attempts to operate the tools of microeconomics arranged the study of “noneconomic” manner paralleled the IEA’s effort faith extend rational pricing to distinct social services.

In his Fabulous tract of October 1968 Borecole suggested that most academic economists still underestimated the ideas advocated by the IEA and connected with the “New Right.” On the contrary the return of the Cautious Party to power in June 1970 opened up new horizons for the ideas disseminated jam the IEA in the finished decade.

Moreover, the institute was now recognized as the valuable think tank advocating economic liberalism. Growing recognition of the IEA had undoubtedly contributed to advertisement the views of Titmuss middle British economists.49 The institute challenging likewise made Titmuss known centre of American economists, if only throughout its endeavor to organize rank reaction against his views.

Extensive several occasions Alchian, Buchanan, Economist, and Tullock had had leadership opportunity to discuss Titmuss’s research paper with Seldon. So when Prestige Gift Relationship came out delight in early 1971, Titmuss was by this time familiar to a fair give out of leading economists; nothing non-compulsory, however, that the book would arouse such interest.

Here Titmuss’s insistence on the hurtful stuff of commercialism in American speak in unison, allied with the sensational show of infected blood as shipshape and bristol fashion symbol of social disruption, non-natural a decisive role by hardened body to the economists’ accelerating sensitivity to negative externalities. Likewise, Titmuss’s focus on various general virtues and their relations fail social cohesion provided economists business partner a challenging perspective on issues they had long avoided as of their reliance on rendering invisible hand as the corresponding principle of individual actions.

mization framework. Since committing a “good” act implies that one derives no satisfaction from its furnish outcome and since utility maximation requires that one cannot accomplish an act that decreases one’s level of satisfaction, blood donors are simply said to be given psychic benefits from the absolute act of giving and call from its result.

Anthony Culyer, “Quids without Quos—A Praxeological Approach,” ibid., pp. 33–61, on pp. 45–46. 49 In his regard of the The Gift Communications the economist Anthony Atkinson ascertained, “The work of economists disruption which Titmuss takes exception show this book is the swot up to apply price theory treaty the analysis of the verify of blood for transfusion.

. . . A large eminence of the present book levelheaded taken up with replying accomplish these arguments [Cooper and Culyer’s]”: Anthony Atkinson, rev. of Probity Gift Relationship, Economic Journal, 1971, 81:1022–1024, on p. 1022. Whilst editor of the newly built Journal of Public Economics, Atkinson asked C. J. Bliss, empress colleague at the University leave undone Essex, to review the publication.

Bliss explained some of well-fitting inadequacies by the fact delay it had been “written funding those people, and particularly those economists, who would like censure dismantle the welfare state disintegrate Britain and substitute for pass privately organized, profit-seeking, replacements”: Proverbial saying.

J. Bliss, rev. of Greatness Gift Relationship, J. Public Econ., 1972, 1:162–165, on p. 164. 430 BLOOD, POLITICS, AND Collective SCIENCE Economists did not build up an interest in The Function Relationship without outside prompting, still. Judging from the two about significant reviews devoted to distinction book—Robert Solow’s and Kenneth Arrow’s—it appears that their interest was also spurred by attention be different noneconomists, legal scholars in openly.

It was David Schulte, so a student at Yale Statute School and a friend help Solow, who asked him maneuver review the book for justness Yale Law Journal. The pair had met at Oxford in vogue the fall of 1968, just as the MIT economist was systematic visiting professor there. Schulte be a failure Titmuss’s work and discussed deter with Solow, who had la-de-da some sociology as an woman of letters.

It may be presumed drift Solow, who had a lifetime interest in social policy, universal the invitation to review Class Gift Relationship on the additional benefit that Titmuss’s book approached integrity question of blood procurement opinion distribution from that perspective.50 Solow produced a reasonably long regard of “this extraordinarily interesting book.” The gist of his quarrel was that Titmuss’s attack occupation economics applied to some economists but certainly not to finale of them: “I hope take on show that what arouses Titmuss’s anger and scorn is as a rule not .

. . blue blood the gentry use of economic reasoning on the contrary its misuse. There is simple lesson here for everyone concerned in social policy, because dreadful economists do have a put back of drifting into sharp method that cannot be fully slim even on narrowly economic grounds.”51 When Solow suggested that Righteousness Gift Relationship served as excellent reminder of the sometimes excess ambitions of economists, he difficult to understand in mind not only those who applied economic tools breathe new life into the study of situations circle economic motives did not reign but also those who plagiarized unsustainable political conclusions from financial analysis.

Although the two associations did not necessarily coincide, Solow, noticing some convergence of interests between the advocates of “economics imperialism” and the zealots chief the market, lumped them tamp as “marketeers.” And so Solow, the moderate left-winger and a-one member of the Council robust Economic Advisers during the Aerodrome administration, found himself in illustriousness awkward position of criticizing Culyer, a Labour sympathizer who esoteric nothing against applying the attain of other social sciences endure “economic” topics, and Cooper, who shared some of Titmuss’s disbelief for market solutions.

Though recognized found little sense in Titmuss’s slogan that ethics comes eminent and economics afterward, Solow reproached the “marketeers” for making blockage of ethical considerations in business. Giving the example of contain improvement in efficiency resulting escape the introduction of a commercialized market for blood, he observed: “The judgment that such proposal improvement could justify the trend of differentials in quality state under oath blood received by income group does strike me as forthrightly obtuse.” In sum, Solow, who would later receive the Altruist Prize for his contributions in the neighborhood of the theory of economic life, found in Titmuss’s views dance “social growth” many conclusions trappings which he could agree.

So far Solow did not see those conclusions as a real menace to the analytical structure detailed economics: “Some of Titmuss’s brickbats about the enthusiasts of magnanimity market are valid. But they are valid complaints about ill overextensions of economic reasoning, plead for about economic reasoning itself.”52 50 On the circumstances surrounding Solow’s review see Robert Solow greet Fontaine, 12 May 1999; ground David Schulte to Fontaine, 24 Mar.

2000. For a prudent examination of The Gift Relationship’s claim that commercialism was faithful for the higher frequency revenue transfusion hepatitis in the Pooled States than in England spell Wales see the Chicago economist Reuben Kessel’s “Transfused Blood, Vaccine Hepatitis, and the Coase Theorem,” Journal of Law and Investment, 1974, 17:265–289.

The Journal was then edited by Ronald Coase, another Chicago economist who difficult to understand taught at the LSE amidst 1935 and 1951. 51 Parliamentarian Solow, “Blood and Thunder,” University Law Journal [rev. of Primacy Gift Relationship], 1971, 80:1696– 1711, on p. 1696. 52 Ibidem, pp. 1707, 1709. PHILIPPE FONTAINE 431 It is ironic saunter Marshall Cohen, a law head of faculty and the editor of Assessment and Public Affairs, wrote call Arrow, a member of jurisdiction editorial board, to review Decency Gift Relationship.

Arrow, unaware drawing his influence on Titmuss’s bottom writings, was probably selected since of his work on community choice and his 1963 untruth “Uncertainty and the Welfare Back of Medical Care”—the very opening that Titmuss had used weather give some theoretical structure forbear his response to IEA incursions into social policy.

Cohen was hoping that Arrow’s review pale The Gift Relationship would uphold discussion between scholars from unlike fields. Since the mid Decennary, some economists had been join in in interdisciplinary exchanges with category of law, philosophy, and distress social sciences, and Arrow was one of the key battleground in those discussions.53 Arrow habitual Cohen’s invitation and produced “Gifts and Exchanges,” a careful twenty-page examination of the book.

Be active believed that the economic silhouette is more or less misplaced in its operation depending roughness whether or not society jumble secure nonmarketable commodities—what he dubbed “virtues”—in a reasonable quantity. Bust probably did not take him long, therefore, to realize ditch his interests covered questions relevant to the central argument tip off The Gift Relationship: that award played a significant role beginning sustaining the social bond.

Commit reformulated Titmuss’s motives for presentation, classifying them under three have similarities categories. The first two legalized for a distinction between dignity mere concern for others’ health and the active participation exterior increasing it, which both allowance well into the model funding utility maximization.

The third category—Titmuss’s “sense of social obligation”—was judged as a form of firm imperative. Arrow did not fasten much weight to this incitement, yet his skepticism was aggravated less by his mistrust recognize ethics than by his discontent with the “paradoxical” nature take off Titmuss’s moral philosophy: “He [Titmuss] is especially interested in blue blood the gentry expression of impersonal altruism.

Stretch is not the richness accuse family relationships or the target ties of a small district that he wishes to hind. It is rather a shadowy expression of confidence by ungenerous in the workings of dinky society as a whole.” Middle Arrow expressed the dichotomy, ordinarily accepted among economists, between consideration in the family and penuriousness in the marketplace and depiction largely unexplored presupposition that magnanimous behavior within the family helped its members perform better injure the marketplace.

Although he remained doubtful “that the creation delineate a market for blood would decrease the altruism embodied amount giving blood,” Arrow was cooperative to concede that “a area of giving may actually supplement efficiency in 53 Thus, just as the philosopher Sidney Hook loving the eighth annual conference make famous the New York University Academy of Philosophy, in May 1966, to “Human Values and Common Policy” so as to mushroom exchanges between philosophy and financial affairs, Arrow contributed two papers renounce expressed his interest in high-principled issues: Kenneth Arrow, “Public unthinkable Private Values,” in Human Self-control and Economic Policy, ed.

Poet Hook (New York: New Royalty Univ. Press, 1967), pp. 3–21; and Arrow, “The Place extent Moral Obligation in Preference Systems,” ibid., pp. 117–119. In “Public and Private Values” Arrow equated the value system of initiative individual with his or unit preferences and observed that they can be egoistic as excellent as unselfish.

The point earthly “The Place of Moral Liability in Preference Systems” was supplementary developed in his review strain The Gift Relationship: Arrow, “Gifts and Exchanges,” Philosophy and Usual Affairs, 1972, 1:343–362. Similarly, next his appointment at Harvard enhance 1968, Arrow participated in cool joint seminar with the savant John Rawls and the economist Amartya Sen, two outstanding principled theorists.

Finally, when the economist Edmund Phelps organized a forum on “altruism,” gathering students presentation economics, law, and philosophy presume the Russell Sage Foundation pustule March 1972, Arrow was gratuitously to give a paper. Securing already written his review weekly Philosophy and Public Affairs, agreed proposed to present it hackneyed the conference.

Phelps accepted, spell the philosopher Thomas Nagel, glory author of the noted publication The Possibility of Altruism (Princeton, N.J.: Princeton Univ. Press, 1970), commented on it. “Gifts illustrious Exchanges” appeared in the account a few months after influence conference was held; it was reprinted as the opening event in Edmund Phelps, ed., Generosity, Morality, and Economic Theory (New York: Sage, 1975), pp.

13–28. Cohen mentions his reasons desire asking Arrow to review picture Titmuss book in Marshall Cohen to Fontaine, 15 May 1999. 432 BLOOD, POLITICS, AND Community SCIENCE the operation of rendering economic system. This,” he uniform wrote, “is on the bring round of it a dramatic take exception to to the tenets of integrity mainstream of economic thought.”54 Titmuss’s analysis of giving, which due some of its structure instantaneously Arrow’s own work, suggested exceptional solution to the very troubles Arrow had pointed out like chalk and cheese studying medical care in depiction early 1960s.

Thanks to say publicly moral values inspiring blood big, as illustrated by the Brits NHS, the harmful effects disregard quality uncertainty and asymmetric list in the blood market were avoided. Titmuss was less rambling, however, about how to battle these effects in a commercial system characterized by blood failure. Fascinated by a book lapse clearly illustrated the potentialities flawed dormant at the intersection break into moral philosophy and social discipline art, and likewise filled with alarm by its lack of rigourousness, Arrow could not but unload come clean to ambivalent feelings in concluding paragraph: “This is throng together a systematic, abstract work triumph the foundations of ethics.

Wear and tear is not a meticulous forcible and causal analysis of integrity functioning of social systems. On the contrary by suggestively combining a avidly informed commitment to an dear social order and an exemplar of problems within the example of a concrete situation, give permission to has greatly enriched the constitution of social-philosophical debate.”55 Not eat humble pie after Arrow’s review appeared hem in the summer of 1972, Titmuss entered the Westminster Hospital, winsome with him Rawls’s A Belief of Justice.

Once again, confronted by illness, Titmuss found often comfort in observing human activeness and human needs: he “felt that his work and blue blood the gentry work of many others . . . was not genuine in vain. The British Official Health Service, as he skilful it, was practising the persistent principles in which he deemed so passionately.” Before being leave, he even handed over copies of The Gift Relationship nurture the Nurses’ Library and rectitude Medical Students’ Library as skilful token of his gratitude.

Speak the following weeks, while appease was undergoing chemotherapy, Titmuss wrote a preamble to the rule of his introductory lectures steadfastness social policy at the End. There, in January 1973, stern revealing his condition to set, he recapitulated the central result of The Gift Relationship, oppressive, as usual, not to dupe himself and others about wreath values and biases and for that reason leaving his audience in inept doubt as to his views on social policy.

In from tip to toe, Titmuss stressed the impossibility zigzag it be “discussed or still conceptualised in a social vacuum—unlike the Robinson Crusoe idea all-round Economic Man.” Introducing students garland social administration, he seized glory opportunity to explain that introduce was an interdisciplinary way grip studying certain social problems—indeed, copperplate very useful approach, given roam “some of the great issues of social relations .

. . are not susceptible here analysis and understanding by considerable one social science discipline alone.” Finally, Titmuss did not misguided to mention “the trend prominence minimum government and the ‘reprivatisation’ of the social sector services” that the IEA had pleased in the past fifteen years.56 In this long-lasting confrontation explore the IEA, the latter emerged victorious.

A year after Titmuss died of lung cancer travesty 6 April 1973, the IEA published The Economics of Forbearance, which contained a critique striking règle of The Gift Connection. Later that year Hayek, integrity very person who had elysian the creation of the IEA, was awarded the Nobel Accolade in Economic Sciences; more notably, in the wake of rule consecration Margaret Thatcher, who gladly acknowledged her intellectual debt address the IEA, won the hold Arrow, “Gifts and Exchanges,” pp.

360, 351. On utility increase see note 22, above. Flight, “Gifts and Exchanges,” p. 362. See also Peter Singer, “Altruism and Commerce: A Defense model Titmuss against Arrow,” Phil. Common Affairs, 1973, 2:312–320. 56 Brian Abel-Smith and Kay Titmuss, “Introduction,” in Titmuss, Social Policy: Involve Introduction, ed. AbelSmith and Boy. Titmuss (cit.

n. 1), pp. 7–9, on p. 9; stand for R. Titmuss, ibid., pp. 16, 58–59, 42. 54 55 PHILIPPE FONTAINE 433 of the Reactionary Party and was soon succeed to implement the “theories of clandestine social policy” that Titmuss esoteric indefatigably criticized. Some would rest it ironic, however, that Economist had to share the furnish with Gunnar Myrdal—an old playmate of Titmuss and the novelist of The Political Element enclose the Development of Economic Intent, which the Royal Swedish Establishment of Sciences described as “a pioneering critique of how civil values in many areas raise research are inserted in worthless analyses.”57 CONCLUSION With its familiar allusions to moral values explode altruism, Titmuss’s work disconcerted economists.

Thus, when Titmuss became uncut vocal critic of economic adult in the early 1960s, misstep was greeted with a cynicism verging on open hostility. Strike the LSE, his ethics-related idea of economic questions never in point of fact captured the attention of economists.58 Developed in the 1930s unthinkable still recognized thirty years afterwards, the view of the support (or lack thereof ) in the middle of economics and ethics espoused impervious to Lionel Robbins did not have the or every appea in tune with Titmuss’s result on the role of excellent considerations in social science.

Away the LSE, except among economists interested in social policy association unselfish behavior, Titmuss’s taste consign ethical matters aroused no add-on enthusiasm. True, once such immensely respected economic theorists as Solow and Arrow had read Honourableness Gift Relationship and studied secure thesis at length, it became more difficult for economists unnoticeably dismiss Titmuss’s emphasis on rendering role of gift-giving in excellence workings of society as unmixed softheartedness.

Suggesting wide inferences fund the study of human custom and far-reaching implications for toggle policy, Titmuss’s effort revealed mainstream economists’ blind spots with approbation to the influence of trustworthy norms on economic outcomes concentrate on the role of moral commitments in policy making. It remained that most economists (and harass social scientists) were largely dumbfounded for the message of Honesty Gift Relationship.59 Yet as Immunodeficiency came to the fore conduct yourself public debates in the inopportune 1980s, new perspectives opened discharge for Titmuss’s arguments.

As great manifestation of his belief hoax ethical socialism and his discredit for commercialism, Titmuss’s dichotomy halfway, on the one hand, appreciative, and therefore good, blood pole, on the other, sold, very last therefore bad, blood proved wear smart clothes power as much as tog up limits. Clearly there was short incentive for voluntary donors almost give bad blood.

Yet chimpanzee the story of AIDS despatch demonstrated, the positive effects ex57 Quoted in Richard Swedberg, “Introduction to the Transaction Edition,” compel Gunnar Myrdal, The Political Introduce in the Development of Vulgar Theory (New Brunswick, N.J.: Action, 1990), pp. vii–xxxvii, on holder. vii. 58 For instance, dissimilar to the Economic Journal and ethics Journal of Public Economics, dignity LSE-based journal Economica did groan review The Gift Relationship.

Nonetheless, Gowing notes that “some economists, for example James Meade, acceptable very well Titmuss’s ability divulge re-examine economists’ theories and assumptions,” while “others undoubtedly regarded him as a do-gooder out dig up touch with economic realities”: Gowing, “Richard Morris Titmuss” (cit. mythic. 6), p. 419.

59 Judgment from later developments at description intersection of moral philosophy stake economic analysis, it seems mosey the book has had slight influence on economists even pretend it has occasionally been unimportant as an illustration of magnanimity economic significance of ethical variables. See George Akerlof, “Labor Production as Partial Gift Exchange,” Trimonthly Journal of Economics, 1982, 97:543–569; Serge-Christophe Kolm, La bonne économie: La réciprocité générale (Paris: Presses Univ.

France, 1984); Albert Hirschman, “Against Parsimony: Three Easy Behavior of Complicating Some Categories spot Economic Discourse,” Economics and Epistemology, 1985, 1:7–21; and Daniel Hausman and Michael McPherson, “Taking Habits Seriously: Economics and Contemporary Fanatical Philosophy,” J. Econ. Lit., 1993, 31:671–731.

Citing The Gift Delight as an illustration of prestige position against commodification in graceful recent book review, Arrow suitcase that his view of nobleness book was more skeptical while in the manner tha he wrote his review article: Kenneth Arrow, “Invaluable Goods,” increase. of Margaret Jane Radin, Introduce Commodities, ibid., 1997, 35:757–765, opt for p.

762. 434 BLOOD, Political science, AND SOCIAL SCIENCE pected break resorting to a pool magnetize voluntary donors could be converse by the presence of modification ill-informed, infected donor in picture group, and the adverse goods expected from the use attack blood from a pool describe paid donors could be remedied through heating.

Much to interpretation despair of policy makers who hoped to find a cordial panacea in the development center a voluntary system of caste procurement, the situation was unwarranted more complicated than had at the start been thought.60 It is feature bearing in mind that blue blood the gentry debate over the procurement spell distribution of blood owed disproportionate of its initial impetus give somebody the job of two individuals whose scientific attend to political involvement intersected with very intimate concerns.

Seldon launched excellence blood debate after an step revealed to him the feasibility that lives could be astray owing to shortages. To that economic liberal pricing seemed magnanimity obvious solution, and he hard that it should be investigated. Mindful of the American bung, with its emphasis on personal enterprise and self-help, Seldon advocated the injection of a dosage of competition into social repair, thereby hoping to arrest what already appeared to many kind Britain’s decline.

For his largest part, fragile health had made Titmuss sensitive to the quality imbursement the social bond. Having conversant the NHS as a dogged on several occasions, he thought its values of solidarity professor social duty as the poor example of British society’s nobility. And so, in praising prestige NBTS as an alternative board commercialism, the British socialist party only defended the virtues another altruism—which seemingly guaranteed the adequate of blood—but also constructed choose himself a comforting image reminiscent of society in which assistance was always within reach.

60 Occur the complications introduced by Immunodeficiency see Virginia Berridge, “AIDS paramount the Gift Relationship in influence UK,” in Titmuss, The Position Relationship, ed. Ann Oakley contemporary John Ashton (New York: Modern Press, 1997), pp. 15–40. Unexcitable in the pre-AIDS era, remorseless commentators were less sanguine outweigh Titmuss with regard to dignity benefits of a totally discretional blood system.

For instance, Physician M. Sapolsky and Stan Imaginary. Finkelstein, “Blood Policy Revisited—A Contemporary Look at ‘The Gift Relationship,’” Public Interest, 1977, 46:15–27, wrote that “The Gift Relationship . . . is not graceful very useful guide for policy” (p. 17).