Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #106237

Charlene A. Galarneau, PhD, Community Health Program, Tufts University, 112 Packard Ave., Medford, MA 02155, (617) 627-5446, cgalarneau@post.harvard.edu

To the extent that public health policy fails to treat similar cases similarly, it unfairly discriminates and is unjust. Current FDA blood donation policy, initially established in 1985 by the Blood Products Advisory Committee, assumes that all men who have had sex with a man (MSM) since 1977 have equivalent and high risk for carrying the HIV virus. Based on that assumption, the FDA requires blood banks to permanently “defer” all MSM from blood donation. This overly-inclusive screening criterion combined with this overly-exclusive deferral practice rests on inadequate scientific evidence, fails to differentiate the risk levels of different behaviors, sets different deferral standards for potential donors with similar HIV risk levels, and does not support an ethical life-long exclusion of all MSM.

This policy creates “bad blood:” not only does the deferral of MSM donors unnecessarily restrict the donor pool, it stigmatizes MSM and excludes them from participating in this “gift relationship.” Blood is a gift of altruism: there is no right or civic obligation to give blood. Nonetheless, blood donation is a symbolically rich and materially important way of participating in and contributing to society.

A more just blood donation policy would assess subgroup levels of HIV risk and defer all potential donors of comparable risk equivalently. The federal government's responsibility for a safe and sufficient blood supply joins with its responsibility to treat all persons justly. From both ethical and scientific standpoints, the current blood donation policy warrants prompt reconsideration.

Learning Objectives: At the conclusion of this session, participants will be able to

• Describe the three central moral values at stake in the current FDA blood donation policy.
• Articulate the tensions among these values.
• Discern the public health and ethical consequences of the current policy.
• Assess several alternative blood donation policy options.

Keywords: Ethics, HIV Risk Behavior

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation