Ethical practices in the area of blood transfusion
Keywords:
Voluntary Blood donor, Donor Confidentiality, Donor Notification, Donor Consent, Consent for transfusion, Patient's right to refusal for transfusion, Rational use of bloodAbstract
National Blood Policy and Drug & Cosmetic Act aims to curb unethical transfusion practices in India. These are related to donors, patients, blood establishments and clinicians. Ethical practices relating to Donors - Blood donation is a gift, so should be based on voluntary, non-remunerated repeat blood-donation. These have low prevalence of transfusion transmissible infections. No one should be forced to donate for family, economic or any other reason. Blood safety depends partly on the information provided by the donor. Unethical practices involve wilfully concealing information about high risk behaviour or medical history. Predonation counselling plays a pivotal role in sensitizing donors for self-deferral. Donor confidentiality, notification and consent are important ethical issues. Donor consent for donation of blood/its components and to the subsequent use of the blood by the blood establishment; regarding acceptance to the risk associated with donation procedure; for testing; for notification about abnormal results and for plasma fractionation for derivation of plasma products & their usage in any hospital is must. Ethical practices related to Patients - Unethical practices relating to patients are more common in our country. Patients do not have access to safe blood, free of charge, or need for replacement or the option of giving informed consent for transfusion after explaining the known risks and benefits of blood transfusion and/or alternative therapies or the right to accept or refuse the transfusion. They should be informed, if harmed and given due compensation. Ethical practices relating to Blood establishments - It is unethical to have a profit motive by the blood establishments. Wastage should be avoided to safeguard the interest of all potential donors &recipients. Ethical practices relating to Clinicians - There are no national guidelines for safe transfusion which leads to unethical/inappropriate transfusions. Rational use of blood helps to cater 4 different patients from single unit of whole blood. This ensures appropriate dosage of the required component and saves from adverse effects of unwanted component transfusion.
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References
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