The body as medicine: a bio-cultural approach

This inter-team project will focus on a specific case where the patient's body is treated using the resources of another's body. In this case, the body is not only the receptacle of treatments but becomes itself a means of treatment available to patients in a situation of vital peril (leukemia, sickle cell disease, etc.). During the second half of the 20th century, blood transfusion was at the forefront of the development of biomedicine. Its progress continues today through the use of human biomaterials which occupy an increasing place in the therapeutic arsenal of the physician. Blood is becoming an essential element in complex therapeutics such as grafting, transplantation or the implementation of chemotherapies. Because of its strong transversal nature, blood is omnipresent in a wide range of care strategies, to the point that medical specialties that never resort to transfusion are becoming the exception rather than the rule. The therapeutic efficiency of blood-based products is based on the use of human biomaterials that combine two fields of research:
- The "biological" component, whose objective is to describe and understand the genetic polymorphism of markers involved in the immunological safety of transfusions, transplants or transplants
- The "cultural" component, whose objective is to understand the cultural determinants of the donation of body parts in order to ensure the availability and supply of blood products.
The immunological compatibility between "donor body" and "recipient body" takes into account research data from the "genetic diversity of blood groups and its medico-anthropological impacts" axis of the "GENGLOBE" team, which describes the geography of these polymorphisms in different populations around the world, making it possible to identify potential populations that must be converted into donor populations.
The supply of compatible blood products depends on the motivation to donate blood, which calls on socio-anthropological approaches On an ethical and legal level, blood collection raises the question of the trade-off between incentive (for the good of waiting patients) and respect for voluntariness (which protects donors from social pressure). The collection of blood is the object of an acute questioning which the researchers of this project intend to seize in order to question the relevance of the "ethical" model of donation, with regard to the current context. The problems will concern the values of gratuity and reciprocity in blood donation, the commodification

of blood derivatives, the availability of blood, and the particularities of donation related to rare blood groups. The ethical reflection will include a section dedicated to the modes of donor recognition (symbolic gratifications, indirect advantages, etc.).
Health anthropologists will also be mobilized to analyze the representations of the body as biomaterial. In its anthropological aspect, the research on blood donation will be materialized through the study of the impact of cultural affiliations and contemporary sociological evolutions on donors' behaviors. The productions resulting from this project aim, on the one hand, to enrich knowledge in bioethics law (in a field relatively little explored by the SHS) and, on the other hand, to feed the databases of the French Blood Establishment (EFS) through the "Social-Lab" structure. This recently established public institution is a think tank whose aim is to integrate data from the human and social sciences into the development of communication policies and the organization of blood collections. This partnership between UMR ADES and Social-Lab will be built on the basis of a pilot research project already carried out during the previous contract on the sociological profile of new generations of blood donors. The team intends to develop available knowledge on current blood donation practices in France and elsewhere, and on the processes of donor retention within an ethically acceptable institutional framework.
In order to be successful, this project will benefit from the support of a researcher in health anthropology, a health sociologist and, within the framework of an agreement currently being signed, researchers in health anthropology, including Yannick Jaffré (UMI Environnement, santé, sociétés, Institut de France, Académie des sciences) as well as Dr. Hélène Kane, lecturer in health anthropology (UFR de Rouen, department of "Anthropology and Social Inequalities in Health
").