Ethics of preventing infections in transfusion blood

An ethical analysis of moral responsibility and fairness in public health

The Philosophy group collaborates with the Netherlands blood services organization, Sanquin, to explore ethical issues in relation to blood safety.

Donor blood is screened for infectious agents to protect recipients against harmful infections. However, some screening measures may cost more than € 1,000,000  per life year gained.

There may be good reasons for aiming at very high safety levels in blood transfusion, but what costs are justified in times where public health care faces clear limits and basic health services are rationed? This question requires a better understanding of the scope of moral responsibility of blood services regarding precautions and prevention of infection via donated blood. This question is the background for several ethical substudies that aim to clarify and critically review the normative assumptions behind and arguments about current blood screening policies. Through review of arguments and concepts, taking into account the specific features of blood donation practice, this study will formulate practical criteria for deciding which tests should be included in blood donor screening. The study is led by philosopher Marcel Verweij and medical microbiologist Hans Zaaijer and is fully sponsored by Sanquin.

Recent results

PhD student Koen Kramer recently published his first paper in the journal Transfusion. It is a review of blood safety policies and procedures in 5 Western countries, exploring what concerns are driving current policies regarding the prevention of transfusion-transmittable infections. The study focuses on general policies and on the introduction of hepatitis B virus nucleic acid testing and selected measures against variant Creutzfeldt-Jakob disease, West Nile virus, and Q-fever. Analysis of policy documents show how blood services take a variety of ethical, scientific and societal considerations into account, but decision making processes are often not as transparent as one would expect in democratic societies. The paper was picket out by the journal editors for a special commentary.