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Ethical discussion about blood donation.

Nurses   (8,848 Views | 69 Replies)

Flare is a ASN, BSN and specializes in school nursing, ortho, trauma.

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You are reading page 5 of Ethical discussion about blood donation.. If you want to start from the beginning Go to First Page.

czyja is a MSN, RN and specializes in Critical Care, Progressive Care.

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Gay sex is undeniably higher risk than heterosexual sex due to the trauma endured by the anus which is not meant to stretch as much as a vagina. And unfotunately, if we decided to get more "PC" about it and deny blood donation by anyone who engages in sex in general, then well we'd all bleed out unless a whole lot of priests and nuns lined up for donation! :jester:

"Gay sex" as you call it, does not carry inherent risk. You are correct in noting that receptive anal intercourse is (much) riskier than receptive vaginal sex. But sex, in all its splendor, is varied thing. Many, many gay men do not have receptive anal sex and are therefore at no increased risk for HIV infection.

IMO, screening should be for sexual behavior, not orientation, if we even need to screen donors (as opposed to donated blood) at all. As it stands now a celibate gay priest is prohibited from donating. The current practice is not supported by evidence and must be changed in favor of an evidence based approach The current practice does not make our blood supply safer but it fosters the view of gay men as as "other" and as diseased.

Edited by czyja

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http://www.cdc.gov/hiv/

http://www.avert.org/aids-statistics.htm

Avert.org is a great resource for a demographic breakdown on HIV stat's and includes more context, IMO. I think stigmatizing high risk populations is a problem and breeds ignorance and bigotry.

"Gay sex" as you call it, does not carry inherent risk. You are correct in noting that receptive anal intercourse is (much) riskier than receptive vaginal sex. But sex, in all its splendor, is varied thing. Many, many gay men do not have receptive anal sex and are therefore at no increased risk for HIV infection.

IMO, screening should be for sexual behavior, not orientation. As it stands now a celibate gay priest is prohibited from donating. The current practice is not supported by evidence and must be changed. It fosters the view of gay men as as "other" and as diseased.

Well said!

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czyja is a MSN, RN and specializes in Critical Care, Progressive Care.

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Thank you.

And thank you for the excellent information about blood screening.

But back to original question- the ethics of the lie on the screening form. I think this depends on why the donor lied. If for example he lied in order to gain compensation, for a plasma donation for example, then his ethics are suspect. If he lied as a protest, then I think it might possibly be acceptable. I would however argue that a more effective protest might be found in not donating and working to change the policy.

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TiffyRN has 27 years experience as a ADN, BSN, PhD and specializes in NICU.

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In high school we have a blood drive. They ask us if we are homo. The only homos I went to high school with (who are still very close friends of mine) were virgins when we had the blood drive.

It sounds like the screening process was being done incorrectly. I also believe the original story regarding the donor who was rejected because he was suspected of being homosexual is wrong.

The screening for blood donation addresses behaviors not sexual preferences. The high schoolers written about above would not have been screened out because they were not males having sex with males. If one is a lesbian, one is not refused unless one fails d/t other factors on the questionnaire.

Sexual preference is not addressed anywhere on any form I've seen, risky behaviors or circumstances are. Should other risky behaviors be on the form? Maybe

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TiffyRN has 27 years experience as a ADN, BSN, PhD and specializes in NICU.

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I must not be reading the same screening forms as others. The ones I have read address males having sexual contact with other males, not whether one defines oneself as homosexual or not.

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czyja is a MSN, RN and specializes in Critical Care, Progressive Care.

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I must not be reading the same screening forms as others. The ones I have read address males having sexual contact with other males, not whether one defines oneself as homosexual or not.

I hear you- and you are right. My concern is that not all sexuall contact between all males is "high risk." What about a concordant seronegative monogamous male couple that have been together for 20 years? Their HIV risk is nil. They should be allowed to donate. What a about a single straight woman that has sex with multiple partners and has had anal intercourse without a condom? Her risk is relatively elevated, and she is permitted to donate. This is why we need to test donated blood, and not stigmatize potential donors.

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TiffyRN has 27 years experience as a ADN, BSN, PhD and specializes in NICU.

2,303 Posts; 16,243 Profile Views

I hear you- and you are right. My concern is that not all sexuall contact between all males is "high risk." What about a concordant seronegative monogamous male couple that have been together for 20 years? Their HIV risk is nil. They should be allowed to donate. What a about a single straight woman that has sex with multiple partners and has had anal intercourse without a condom? Her risk is relatively elevated, and she is permitted to donate. This is why we need to test donated blood, and not stigmatize potential donors.

I agree with you. Sadly I think expense is going to keep things the way they are. It is cheaper to draw sweeping conclusions.

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Rob72 is a ASN, RN and specializes in Infectious Disease, Neuro, Research.

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I hear you- and you are right. My concern is that not all sexuall contact between all males is "high risk." What about a concordant seronegative monogamous male couple that have been together for 20 years? Their HIV risk is nil. They should be allowed to donate. What a about a single straight woman that has sex with multiple partners and has had anal intercourse without a condom? Her risk is relatively elevated, and she is permitted to donate. This is why we need to test donated blood, and not stigmatize potential donors.

True, but again, this is placing the "rights" of the donor to particiapte in a social function above the relative safety of the society as a whole.;) This is Lowest Common Denominator reasoning- because we may offend some in exclusion, we may exclude none until the criteria are PERFECT.

The AABB form is not the best, but is certainly not inappropriate. Local blood centers frequently have their own questionnaires, and I know that several regional facilities do ask about multiple sexual partners w/in the preceding 6 months.

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czyja is a MSN, RN and specializes in Critical Care, Progressive Care.

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True, but again, this is placing the "rights" of the donor to particiapte in a social function above the relative safety of the society as a whole.;) This is Lowest Common Denominator reasoning- because we may offend some in exclusion, we may exclude none until the criteria are PERFECT.

Nobody has a right to donate blood. If I implied this, I was most certainly in error.

Actually it is the current policy that uses lowest common denomonator reasoning. The reasoning is that if you you are a man and you have ever had sexual relations with a man then you are at elevated risk for HIV, no matter what sexual actions took place and how long ago they took place, and therefore you must be prohibited from donating blood.

Again, there is no evidence to show this policy makes our blood supply safer. It does, however, make our blood supply substantially smaller. This is foolish.

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Agree :)

And the initial article referred to someone the blood bank thought "looked" gay.... that's abhorrent to assume anything by appearance, and stigmatize someone because of prejudice. NOT actual facts...

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it is a statistical fact that the rate of hiv infections of homosexual males have been decreasing while that of heterosexuals have been increasing.

seems to be conflicting information about gay men being at higher risk for carrying the hiv virus. from yale university:

"new hiv infections have been declining among heterosexuals and injection drug users, but rates have been steadily rising among gay and bisexual men, a trend that is alarming public health officials in connecticut and beyond.

in a “call to action” to stem the tide of infections, the center for interdisciplinary research on aids at yale (a research group within the school of public health) partnered with the connecticut department of public health to sponsor a daylong hiv-prevention and educational conference in early june. nearly 200 hiv counselors, educators, outreach workers, researchers and others attended to learn about the current infection trends, innovative strategies to reach the gay community and some of the interventions that are being used to prevent the spread of the infection.

men who have sex with men are now 44 times more likely than others to become infected with the virus nationwide, and the rate of new infections is particularly pronounced among young, gay black males, said edward white, m.p.h., ph.d., an associate research scientist at the school of public health. current projections show that 59 percent of gay black males in the united states could become infected by the time they reach age 40, he said. this would be higher than the rate in sub-saharan africa."

http://publichealth.yale.edu/news/news/2010/hiv.aspx

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"Gay sex" as you call it, does not carry inherent risk. You are correct in noting that receptive anal intercourse is (much) riskier than receptive vaginal sex. But sex, in all its splendor, is varied thing. Many, many gay men do not have receptive anal sex and are therefore at no increased risk for HIV infection.

IMO, screening should be for sexual behavior, not orientation, if we even need to screen donors (as opposed to donated blood) at all. As it stands now a celibate gay priest is prohibited from donating. The current practice is not supported by evidence and must be changed in favor of an evidence based approach The current practice does not make our blood supply safer but it fosters the view of gay men as as "other" and as diseased.

I very much agree with your statement about screening for sexual behavior and not orientation! It's not about being "gay", it's about whether or not you have engaged in behavior that carries higher risk of acquiring blood born viral pathogens. I never meant to imply that sex is not a varied thing and that all homosexual men engage in anal sex. That is something I am in no way shape or form stereotypical about. But whatever. I agree with you, you just articulated it better.

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