救國、助人、顧自己：台灣捐血運動的歷史初探，1950-1989

Abstract

本研究核心主旨在於考察1950 年至1989 年間，台灣醫療用血來源的歷史變遷，藉由檔案資料耙梳與深度訪談，釐清捐血體制的建立、發展，進而取代賣血體制的歷程。研究著重探討賣血組織、捐血協會、國家衛生單位、醫療專業社群及其他社會組織如何形構出血液的社會意義、捐血勸募論述以及捐血動員方式，最後將捐血設定為唯一合法的血液供應管道。 本文圍繞著血液的社會意義鋪陳，指出台灣經歷了三個階段的捐血運動，不同階段的醫療用血面臨不同的問題，而作為風險的解決辦法，捐血的勸募論述與動員管道不斷變遷，捐血行為因此有了新的意涵。在1950 年代與1960 年代，捐血運動作為應對戰爭、社會救助等緊急危難的管道。血液買賣是醫療用血的主要來源，然而賣血制度的運作卻導致醫療用血的嚴重短缺。第二階段的捐血運動作為解決缺血風險的方式，於1970 年代尋找新血源，捐血協會以相對龐大的論述能力重新定調失血行為的價值，藉由重新描述身體與人血，動員特定人群的血液。1980 年代，兩場重大流行病導致的輸血風險，使得更多行動者介入醫療用血的檢驗與分配，最後導致賣血制度的終結。整體而言，捐血運動的歷史進程是取代排擠、取代賣血制度的結果，國家與不同社會組織透過血液來源的管制，界定出正常與偏差、健康與疾病的界線。 本研究以台灣案例貢獻利他行為、身體商品化與開發中國家的捐血研究，一方面看見利他行為的組織性與多元性，亦從文化、知識、身體的角度看見血液去商品化的多元歷程，藉此釐清國家與醫療專業如何透過血液交換，打造理想的國民身體。

This study primarily aims to examine the historical change in the source of medical usage blood in Taiwan between 1950 and 1989. By reconstructing historical documents and interviewing, I clarify the establishment and development of Taiwan blood donation system, and show how it replaced the blood-selling system during 1950s to 1980s. This study focus on the process that several organizations such as blood-selling group, Blood Donation Association R.O.C., Ministry of Health and medical professional groups shape the social meaning of blood transfusion, discourse of donation and the mobilization strategy, then finally set blood donation system as the only legitimate blood collection regime. By elaborating the historical changes of the multiple social meanings of blood bank and human blood transfusion, I argue that Taiwan went through three steps of blood donation movement. Each steps of movement located in specific social context and the risk of transfusion; therefore, blood donation became the solution to the risk and then created the new meaning of transfusion, discourse of donation and the mobilization strategy. To sum up, the success of blood donation movement in Taiwan came from the exclusion and substitution of blood selling system. The government and other organizations have drawn the boundary between normal and deviation, health and unhygienic through the regulation on blood collection. This study can contribute to the research of altruism behavior, body commodification and the blood donation research in developing country. Presenting the case of blood donation movement in Taiwan, this article not only clarifies the multiple motives of altruism behavior, but also elaborates the anti- commodification progress that combines culture, medical knowledge and the meaning of body.