No Surgery Without a License? Biopolitical Governance and Blood Donation Certificates in China

This article analyzes China's blood donation certificate system-whereby patients must present proof of donation for surgical priority-as a biopolitical technology of governance. Drawing on Foucault's framework, we examine how this informal practice operates through three mechanisms: temporal discipline that leverages medical urgency for compliance, territorial fragmentation that binds biological citizenship to local jurisdictions, and the paradox of anti-commodification that generates quasi-markets despite legal prohibitions on blood selling. The 2018 ban on mutual-aid donation eliminated legal mobilization pathways while institutional pressures persisted, transforming certificate requirements from biological exchange into administrative conditioning. We argue that the system's power lies precisely in the gap between formal voluntariness and practical compulsion-a space where biopower operates below legal accountability while extracting biological resources and cultivating civic complicity. This analysis illuminates how contemporary governance increasingly functions through administrative mechanisms that transform healthcare access from universal right into contribution-contingent privilege.