PBL 7 - blood donation

Question 1

what are moral arguments in favour of blood donation?

Answer 1

• as a society, we strongly encourage donation
• we have a moral obligation to help others if we can
• donating blood can truly save a life
• cost of helping minimal
• unfair/wrong to take from a system you don’t contribute to

Question 2

what are reasons against paying people for blood supplies to get rid of the shortage?

Answer 2

• society should encourage people to be altruistic
• voluntary donations will fail, people will opt for payment, extra financial burden
• voluntary donors may be reluctant to donate if their blood is sold commercially
• commodification — humans area not things that we should buy and sell
• exploitation of the vulnerable
• financial motivation will result in failure to disclose
• medical need will be disregarded
• standards will drop as commercial interests are pushed

Question 3

what are reasons in favour of paying people for blood supplies to get rid of the shortage?

Answer 3

• we are struggling to meet the current demands and compensating people will increase blood supplies we will have available
• duty to rescue
• life saving necessity-avoid the harm of human suffering
• relatively safe, body replenishes stores

Question 4

what are some risks of blood transfusions?

Answer 4

• wrong blood group
• transfusion transmitted infections (viral, bacterial, parasites)
• acute transfusion reactions
• circulatory overload
• iron overload
• electrolyte abnormalities

Question 5

what is haemovigilance?

Answer 5

a set of surveillance procedures covering the entire blood transfusion chain from the donation and processing of blood to the provision and transfusion, including the follow-up of the patient

Question 6

what needs to be talked about in consent for a blood transfusion?

Answer 6

1) explain why a blood transfusion is indicated
2) what the associated risks are
3) outline if there are alternative options available
4) record the discussion in the patient’s medical records

Question 7

what do you do if a patient refuses blood transfusion?

Answer 7

1) explore reasons for refusal
2) address any concerns
3) explain the health consequences
4) discuss possible alternatives (and the pros and cons)
5) seek advice from your seniors

Question 8

who can consent for a minor?

Answer 8

1) a parent
2) a minor aged 16-18 can consent for themselves
3) a competent minor can consent for themselves
4) the courts (if minor refuses/parents withhold consent)

Question 9

who and what might help in blood transfusion refusal situations?

Answer 9

• elective procedures — planning
• seniors
• contact haematologist
• hospital liaison committee
• hospital legal department
• on call judged — specific issue orders
• medico-legal defence organisation