Blood for Sale

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The New York Blood Center is predicting a real crisis as this summer winds down. They, and other blood centers around the country, are warning that they will run dangerously low as Labor Day approaches. Cancer patients may have to delay life-saving procedures until the blood supply is replenished. But accidents cannot be delayed, and patients will still rely on the gift of life. So you'd think the Food and Drug Administration and blood centers would be promoting policies to make it easier for blood centers to collect blood from life-saving donors.

Instead, in what can only be described as a reckless commitment to the precautionary principle, regulations in the name of absolute safety are actually making it more difficult for blood centers to meet the demand.

The FDA's policy to "defer" donations from men who have had sex with other men at any time since 1977 has been controversial for years. Because blood tests prior to transfusion are highly accurate, but not 100% foolproof, the policy has merits. But gay men are forbidden from donating even if they can provide current proof that they are not HIV positive.

FDA's explanation, that the "policy reduces the likelihood that a person would unknowingly donate blood during the 'window period' of infection," doesn't hold up to scrutiny. After all, the rate of infections that fall within the window are very low, and do not meet the "high risk" category that the FDA uses to justify the overall policy. Further eroding the credibility of the policy is the FDA's own position that heterosexual women "with multiple partners [are] allowed to donate blood despite increased risk for transmitting HIV and hepatitis." The infection rates of gay men who have recently tested negative are likely lower.

Even those people about whom there are no health concerns face regulatory constraints, though. The FDA and blood centers tightly regulate how centers can show their appreciation for blood donations. At the New York Blood Center, incentives or gifts to donors may not cumulatively exceed $25.00 in value. I learned this the hard way when trying to give away gym coupons to create some buzz around a blood drive that I'm helping to organize.

What is the rationale? Would people who would otherwise not be eligible to donate blood lie about their eligibility only for the incentive? No, since incentives are given to all presenting donors, even those who are deferred. So lying won't do any good. So the only thing this policy does is make it harder to attract life-saving donations.

Either the dire warnings about blood shortages are just hype or these policies (of deferring certain donors who have evidence that they are not HIV positive, and forbidding incentive exceeding $25 in value) give too much weight to one sort of risk, while failing to acknowledge what blood centers say is the very real risk of not having enough blood come Labor Day.