Ethical Aspects of Blood Donors and the Recipients of Their Blood

To date medical care is inextricable based on blood donors and blood products. The continuing increase and intensification of tests and guidelines also results in a change in deferral and abnormal test results. Donors and recipients of their blood are faced with this information and are confronted with a kaleidoscope of thoughts and emotions. The discussion with respect to paid versus nonpaid donation is not new, but other aspects are less often discussed. We describe these other aspects for donors and recipients of their blood and hope to open the ethical discussion; if and to what extent we should have limits? 1. Introduction Blood transfusion has developed for about 100 years from “simple” whole blood infusion to advanced targeted therapy with specific parts of donor blood. In the same period enormous innovations were made in production techniques, laboratory techniques, and communication. The field of blood donation and transfusion nowadays plays in a rapidly growing global world with increasing needs for continuous monitoring of new threats and challenges. Simultaneously necessary ethical discussions rise on medical, financial, and political aspects. A number of ethical issues are more often discussed and published, for example, remunerated versus nonremunerated blood donation, and will not be discussed here. In this paper attention is paid towards ethical aspects of donor deferral and donor and recipient information, with focus on the donation of blood, blood products, and stem cells. These topics are less often discussed and published. 2. Donor Deferral, Good Intentions with Unwanted Adverse Effects For optimal safety of blood donation and transfusion to recipients, guidelines for donor examination are in place. In general donors are voluntary and healthy but may, however, be confronted with deferral. This often unexpected deferral can have several unintended adverse effects as follows. Feelings of Rejection In general donors feel healthy, have the intention to help a patient, take their time to come to a donor centre, and may not be allowed to donate their blood. A common reason is that the haemoglobin level is just below the lower limit. The donor is informed that, although the haemoglobin level is normal, it is too low do donate. A number of these donors are frustrated and disappointed and leave the donor centre feeling that they are not good enough to help a patient [1, 2]. Most likely this has an impact since it is known that deferrals due to low hemoglobin have a strong effect on return rates of both first-time and repeat donors [3].