The Development of Generosity
By Claire Andre and Manuel Velasquez
Out nation's blood supply is sustained entirely by voluntary
donations, yet fewer than 5% of Americans eligible to give blood
do so each year. Why so few? Among other reasons, donating blood
involves obvious costs time, some pain, and occasionally unpleasant
or physically harmful consequences ranging from nausea to blood
Perhaps the more interesting question is "why so many?" In
other words, why would anyone donate blood? This was the question
that intrigued Richard Titmuss, author of the widely-acclaimed
book, The Gift Relationship. In this book, Titmuss examines
the role of altruism in society as it's manifest in voluntary
blood supply systems, and highlights the characteristics of
voluntary blood donation that distinguish it as a unique form
of altruistic behavior, distinct from other forms of exchange
in a market-oriented society:
In the gift of blood . . . there is the absence of tangible
immediate rewards in monetary or non-monetary forms; the absence
of penalties, financial or otherwise, and the knowledge among
donors that their donations are for unnamed strangers without
distinctions of age, sex, medical condition, income, class,
religion, or ethnic group.... How can they and do they learn
to give to unnamed strangers?
How, indeed, do people learn to give? According to the philosopher
Aristotle, the generosity displayed by blood donors, like other
"virtues," is learned over time. That is, one becomes generous
or otherwise virtuous by repeatedly performing generous or virtuous
We acquire virtues first by acting, just as we do in the
case of acquiring crafts.... for example, by building we become
builders, by playing the Iyre, Iyre players. And so too, webecome
just by doing just actions, and temperate by doing temperate
actions and brave by doing brave actions.
Moreover, Aristotle argued, the motivation behind virtuous
acts changes over time. A young person, for example, acts virtuously
initially only because he or she is subjected to external pressures
or rewards, such as the praise of others. But as the person
acquires a virtue, the person develops a sense of ease and delight
in acting virtuously. The virtuous person is moved by an internal
motivation, engaging in virtue for its own sake.
Since Titmuss' book, several studies have explored the motives
behind commitment to regular blood donation, and these studies
have tended to confirm the traditional theories of Aristotle.
In one study, Ernie Lightman, a professor at the University
of Toronto, sent detailed questionnaires to nearly 2000 voluntary
blood donors. Lightman found that, initially, the decision to
donate blood was likely to be motivated by external factors,
such as the convenience of a clinic or an appeal from a blood
drive, as well as by internal factors, such as a general desire
to help others. But, he writes:
With the passage of time . . . the key motivators became
increasingly phrased in moral language. Ideas such as a sense
of duty and support for the work of the Red Cross, along with
a general desire to help„motives which may be described as
strongly internal to the respondent„assumed an increasingly
important role as motivators. Though the general location
of clinics remained important, other 'external' motivators„in
particular peer pressure„became relatively insignificant.
With repeated performance of a voluntary act over time, the
sense of personal, moral obligation assumed increasing importance.
Similar findings were reported by researchers at the University
of Wisconsin, who observed that the motivations of blood donors
developed and changed over time. The results of their studies
revealed that the greater the number of donations reported by
donors, the less likely donors were to say that they gave so
as not to disappoint others, and the more likely donors were
to report that they were motivated by a sense of moral obligation
and responsibility to the community. Whereas external motivations,
such as social pressure, were likely to prompt the initial decision
to donate, it was internal motivations, such as a sense of moral
obligation, that maintained the behavior over time.
While the motives of blood donors are admittedly complex,
these studies may suggest one answer to Titmuss' question, "how
do they learn to give?" Donors learn to give by giving. Moreover,
learning to give in one context may carry over into other contexts.
Several studies, for example, have found that active blood donors
are more likely to engage in volunteer work or to make charitable
contributions than non-donors. Perhaps Aristotle was right:
virtue is a learned habit.
Aristotle. The Nicomachean Ethics. (F. H. Peters, trans.)
London: Kegan Paul, Trench, Treubner & Co., Ltd., 1891.
Lightman, E. "Continuity in social policy behaviors: The case
of voluntary blood donorship." Journal of Social Policy,
1981,10 (1), pp. 53-79.
Piliavin, J. A., Evans, D. E., & Callero, P. "Learning to
'give to unnamed strangers': The process of commitment to regular
blood donation." In E. Staub, et al., (Eds.), Development
and maintenance of prosocial behavior: International perspectives
on positive morality. New York: Plenum Press, 1984.
Piliavin, J. "Why do they give the gift of life? A review
of research on blood donors since 1977." Transfusion,
1990, 30 (5), pp. 444-459.
Titmuss, R. M. The gift relationship: From human blood
to social policy. New York: Vintage Books, 1971.