Ethics in Blood Transfusion

Definitions

What is right/ good

Human duty/ logic of moral discourse

Examine troubling dilemmas

Ethics is a dynamic process

Making decisions

First do no harm

Respect/ Autonomy (patient’s) – wishes, dignity, privacy

Justice – treat cases alike, fairly distribute benefits, burdens

Principled approach to medical ethics

Goal of medicine

Heal, cure

Comfort, palliate

Preserve, promote health

Basic medico-ethical principles

Autonomy – dignity, integrity of human beings

Beneficence

Justice, equality

Medico-ethi cal guidelines/ Code in Transfusion medicine

International Society of Blood Transfusion (ISBT)

(Code of ethics for blood donation, transfusion)

Code adopted by WHO

Active participants in transfusion medicine

Guides in implementing basic princi ples

Goals for BTS (Blood Transfusion Services)

Acceptable mission of a BTS

Meet perceived needs of patient

Minimum cost

Minimum wastage

Maximum safety, effica cy

Ethical approach

Donors

Physicians

Recipients

Blood Transfusi on Form

Duty of Donor

Blood donation

Do no harm to donor’s health

No risk to health of recipient

Responsibilities

Voluntary/ No financial incentive

Made to understand – social obligations

Safety of blood supply – depend on retention of regular donors

Obligations to donors

Trained BTS staff in contact

No pressure/ discrimination

Assure/ educate donors – blood is handled, distributed with care

BTS use updated, authorized, detailed criteria for selection, deferral, exclusion

• Explained/ understood

• Informed consent

• Donor information - confidential

• Confidential matters – conveyed in private

Anonymous – donor, recipient

Plasmapheresis – handled by specifically trained personnel/ nurses

No wastage – clinician prescribing the blood

Duty of Physician

Indications

Most effective therapy with maximum safety

Transfusion practices review committee

Prescription procedure/ blood transfusion guideline

(prevent errors in requesting, supplying, administrating blood)

Duty of Recipient

Informed consent – explained/ understood

• capacity to understand

• adequate information

• obtained without coercion

Verify/ Identify – each blood unit pretransfusion

Investigate – reactions/ complications

Prescribed only with genuine therapeutic indication

No financial incentive

jslum.com | Medicine