Introduction
Blood transfusion refers to transferring blood or blood products of one individual to another to save a life. Blood transfusion is a life-saving procedure after massive loss of blood due to trauma or road accidents, loss of blood during surgery, and in the management of anemia and sickle cell disease. Blood donation refers to the exercise of collecting blood from an individual to use the same blood to save a life during a crisis (transfusion). Ethics are forms of regulations and guidelines that have to be followed to avoid a conflict between science and humanity as regards the use of blood and its products.
Goals
The goals for blood transfusion and donation are to heal and cure hence the blood that is taken from an individual and used on another as a transfusion must be able to offer some beneficial function to the recipient (Macpherson, Domen, & Perlin, 2000). For instance, if an individual is transfused blood but his or her situation worsens then it is presumed that the blood given did not perform the intended function and therefore the goal of healing and curing the patient is not achieved (Macpherson et al., 2000).
Another goal of transfusing blood is to preserve and promote the health of an individual. For example, if a person has been involved in an accident and has lost a lot of blood this person is transfused blood to preserve life since without the blood the individual will die.
Blood transfusion is also undertaken to give palliative care. In such conditions as cancer of the bone marrow, the bone may become unable to produce blood cells in the normal way of hemopoiesis and to argue, the same health practitioners are obliged to give blood to support life (Macpherson et al., 2000). Therefore, the goals that warrant blood transfusion as well as donation are very clear and are intended to promote the health of an individual and support for life (Macpherson et al., 2000).
Ethical principles
The need for the blood donation and transfusion code is ideally to stipulate the ethical principles and rules to governing use as well as distribution of blood. The ethical code affects two areas: the blood centers and the donation – which affects the collection part of the service and the hospitals and the patients that involve the use of the products and blood.
Blood centers and donation
Blood donation should be a voluntary exercise and no individual should be forced to participate, and nobody should be paid for donation. This includes any form of favors and then the donor is supposed to give consent to the blood center to allow it to use the blood and its products. Blood donation is purely voluntary hence, establishing a donation center that would be run as a profit-making venture is very unethical and therefore prohibited.
The donor should be well advised of any potential side effects of the donation exercise before the process starts, e.g. dizziness as well as fatigue. Additionally, anything that might be given to the donor e.g. drinks after the donation exercise to expand the blood volume or drugs to help in increasing hemopoiesis must be internationally acceptable and should not cause any harm to the donor. The medical practitioners in charge of the donation process should ensure that the donor’s health is well handled and protected. Details of a donor and recipient should be held confidential, the donor must not know the person going to receive his/her blood and likewise to the recipient (Macpherson, Domen, & Perlin, 2000). Any other information of the donor must be held confidential and if need be it should be discussed with the donor.
The donor also has to be informed of the risk he might cause to the recipient in case the donor presents infected blood to the recipient and hence he should accept to undergo the exclusion process to eliminate the risk groups narrowing on most unlikely infected blood.
Issues of gender, race, tribe, and religion should not be the driving force in the donation exercise and therefore no individual should be discriminated against in the exercise. Equal treatment needs to be accorded to each donor. A well-trained and registered medical practitioner must conduct the blood donation exercise to ensure the right procedure has been followed, the right quantity of blood has been donated and it will aid in accountability (Elhence, 2010).
This will also ensure the safety of both the donor and the recipient. Blood should not be restricted and therefore any person in need of blood should not be denied a chance since it is public property. Blood wastage, as well as misuse, needs to be avoided, as blood is an integral commodity in health management as it helps in the health improvement of patients.
Hospitals and patients
The patient has to be informed about the transfusion, its importance, and all the risks that might be involved. Therefore, the patient should be given a chance to accept or reject the offer. The patient should not be forced to have a transfusion. In case the patient fails to give consent before the transfusion then it should be done but for the benefit of the patient. Likewise, the donation exercise is done by a registered, trained practitioner transfusion has also to be done by an equally qualified person to ensure the security, and the beneficial effect of the blood is achieved.
Blood transfusion should only be done after a detailed review has been done and it remains the only option for management and no incentive should be given to an individual to procure a transfusion (Elhence, 2010). If possible, the patient should be given only the blood components that he or she requires but in some cases, some centers are not able to process some blood components, and therefore beneficially role has to be weighed versus the risk before a transfusion process (Elhence, 2010).
Areas of weakness
In the area where the patient is asked for consent- sometimes it is not possible, many patients who require blood transfusion are either trauma patients, road traffic accidents and most of these patients are unconscious, when do you get consent? In addition, some religious groups for instance Jehovah’s Witnesses do not allow blood transfusion (Muramato, 2001). Individuals who profess the faith prefer integration of other life-saving methods as well as bloodless operations to restrict transfusions.
According to Muramato (2001), medical practitioners normally integrate such methods as laparoscopy, endoscopy, drug use that either result in stimulation of the production of platelet as well as prohibit loss of blood while undertaking an operation. Since religious predispositions do not warrant blood transfusions, medical practitioners should also integrate volume expanders, reduction of body temperatures, and use of hypothermia while treating a Jehovah witness since it is an inviolable patient’s right to decide on treatment procedure (Muramato, 2001).
In case a doctor gives blood to such individuals/ they might sue you and the code of ethics has no stated clear way of dealing with such circumstances. Additionally, the code has not stipulated justice-seeking mechanisms that a patient can follow if for instance the donor gives false information during the exclusion exercise and the recipient is infected in the process.
Recommendations
The code is adopted by the world health organization and therefore it is a directive by the united nation that all countries should implement the code as far as the blood transfusion process is, it was adopted in the year 2000 and it was again revised in the year 2006. Implementation of the code will reduce exploitation and ensure safety to our blood recipients, donors, and health promotion to all. The code should also include the standard procedures to be performed to establish safe blood for transfusion. In addition, the code should also be amended to allow some for use of blood and blood products for research because from the research one day we will be able to make synthetic blood and also more on the care of blood products should be emphasized in the code so that we should have a gold standard to work from.
References
Elhence, P. (2010). Ethical issues in transfusion medicine. Indian Journal of medical ethics. 3(1), 34- 38.
Macpherson R, Domen, R. & Perlin T. (2000). Ethical issues in transfusion medicine. Bethesda: American Association of Blood Banks Press, 34(9), 123- 34.
Muramato O. (2001). Bioethical aspects of recent changes in the policy of refusal of blood by Jehovah’s witnesses. BMJ; 322: 37-39.