ABSTRACT The late Richard Titmuss made a persuasive case against allowing the sale of human blood in his book, The Gift Relationship. His arguments have been developed further by Peter Singer in recent articles. While the issues of quantity and quality of blood under market and non‐market systems have received much attention, the moral and political aspects of the Titmuss‐Singer case have gone relatively unexamined. First, I question their claim that a donation‐only system promotes greater freedom, which rests on a (...) confusion of liberty and opportunity. Next, I consider reasons for doubting their view that altruism is fostered significantly more under the non‐market approach. Finally, I survey recent developments in the quantity‐quality debate and possible implications of the blood controversy for national health care. (shrink)