The shift away from socialized forms of welfare over the past twenty years has changed the symbolic basis on which bodily parts are exchanged. Titmuss (1973) viewed the National Health Service which had been created in the post-war period as a vehicle for institutionalizing altruistic practices, notably the voluntary "gift" of blood to strangers represented by the transfusion service. More recent advances in medical technology have made new forms of bodily tissue donation possible, including the transplantation of whole organs. Yet the excess of demand over supply is forcing a change from the principle of voluntarism on which "opting-in" procurement arrangements have hitherto rested to one of presumed consent and the system of "opting-out" adopted in other countries. This chapter will examine the implications of this transition within the context of late-twentieth-century multicultural Britain.