Are there ethical differences between stopping and not starting blood safety measures?

Background and Objectives Concern with the costs of blood safety is growing, which raises the question whether safety measures that reduce risk only marginally should be discontinued. Withdrawing such safety measures would allow reallocating resources to more efficient health care interventions, but...

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Bibliographic Details
Published in:Vox sanguinis 2017-07, Vol.112 (5), p.417-424
Main Authors: Kramer, K., Verweij, M. F., Zaaijer, H. L.
Format: Article
Language:English
Subjects:
Blood
Blood Safety - economics
Blood Safety - ethics
Blood Safety - methods
Blood Transfusion - economics
Blood Transfusion - ethics
Cost-effectiveness
Donor blood safety
Ethics
Health care
Historical account
Humans
Operators
Patients
Primary Prevention
Regulators
Risk reduction
Safety
Safety measures
Studies
Transfusion
Transfusion-transmissible infections
Withdrawing vs. withholding
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Summary:Background and Objectives Concern with the costs of blood safety is growing, which raises the question whether safety measures that reduce risk only marginally should be discontinued. Withdrawing such safety measures would allow reallocating resources to more efficient health care interventions, but it might raise moral objections. Materials and Methods This study evaluates two ethical arguments why discontinuing blood safety measures would be more objectionable than not implementing them. The first argument is that whereas withdrawing protective measures causes harm to patients, not starting protective measures ‘merely’ omits to prevent harm. The second argument is that patients who benefit from protective measures are historically entitled to the continuation of those protective measures. Results Both arguments are unconvincing. There is only a weak causal connection between removing blood safety measures and harms that transfusion recipients suffer. Moreover, patients are not entitled to the continuation of protective measures that prove very inefficient, unless applying these protective measures rectifies past injustice towards them. Conclusion Unless stronger ethical objections can be found, blood system operators and regulators should be more willing to withdraw inefficient safety measures.
ISSN:0042-9007
1423-0410
DOI:10.1111/vox.12525