TO what extent can we—and to what extent should we—rely on altruism to provide for the needy? That is the overarching question of a provocative book published in 1970 by British social scientist Richard M. Titmuss. Recently restored to print in a revised edition, [1] The Gift Relationship: From Human Blood to Social Policy approaches this issue through a painstaking and critical investigation of American methods of collecting blood for transfusion. Titmuss contrasted the American practice, in which recipients paid for blood, some of which was purchased from donors, with British practice, in which blood was freely given to patients and received from altruistic donors. He argued that more blood was wasted in America than in Britain, that American hospitals frequently ran short of blood, and that blood purchased from American donors was less safe and more likely to spread hepatitis among its recipients.