title: Titmuss and the gift relationship: altruism revisited.
abstract: BACKGROUND
  This paper revisits Richard Titmuss' 1970s blood donation model in the light of its 1997 reprint in order to consider whether we are justified in continuing to accept that the main reason for blood donation (and other donation types) is an altruistic desire to help others.
  
  
  OBJECTIVE
  This paper explores how others have examined the notion of altruism, before concentrating on two major elements of Titmuss' work: blood donors' motives to donate and the social implications of gift-giving in relation to the uniqueness of blood donation.
  
  
  METHODS
  Donor motivation is discussed in detail with particular reference to questions 4 and 5 of Titmuss' blood donor survey and through a critical appraisal approach to his work.
  
  
  RESULTS
  Methodological inconsistencies are revealed in the design and implementation of the survey, as well as in Titmuss' list of blood donation's unique attributes, bringing into question the rigour of his findings. It may be that blood donors are altruistically motivated, but such conclusions cannot be drawn from this work. It is also unclear if 'altruism' can be shown in the example of blood donation or other donation types.
  
  
  CONCLUSIONS
  We should reconsider the motivation behind gifting in health care in the light of these findings and ensure that evidence-based practice is consistent with methodological rigour. Nurses and other health professionals need to have a clearer understanding of concepts such as altruism in order to appreciate why people seek to donate.
authors.affiliation: Research Consultant, Research and Development Support Unit, Swansea Clinical School, University of Wales Swansea, Singleton Park, Swansea, UK. f.l.maggs-rapport@swan.ac.uk
authors.forename: F L
authors.initials: FL
authors.lastname: Rapport
authors.forename: C J
authors.initials: CJ
authors.lastname: Maggs
mesh_terms: D000533:Altruism; D001782:Blood Donors / Q000266:history*; D003625:Data Collection / Q000266:history; D006379:Helping Behavior; D049673:History, 20th Century; D006801:Humans; D008960:Models, Psychological; D009042:Motivation; D012107:Research Design; D011795:Surveys and Questionnaires; D006113:United Kingdom; D014481:United States