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Old fears draining the U.S. blood supply

People who need blood after terrible accidents, C-sections, or as part of their cancer treatment got very, very bad news today.
/ Source: contributor

People who need blood after terrible accidents, surgery or as part of their cancer treatment got bad news followed by more bad news today. 

PolyHeme, a long-awaited artificial blood substitute, turned out to not work any better than saline, according to the results of a controversial test in trauma patients. This means the dream of creating artificial blood that can be used by anyone who needs it regardless of blood type remains just that — a dream.

And despite the pleading of the nation’s leading suppliers of blood, the American Red Cross and America’s Blood Centers, the U.S. Food and Drug Administration announced that it would not lift its 1983 ban prohibiting gay men from donating blood. Actually, forget ‘gay’ men. The ban applies to any man who has ever had sex with another man, even as far back as 1977.

What does this mean to you?  If you are in a car crash, hit by a stray bullet or have a Caesarean section and need a blood transfusion, there may not be blood of your blood type to give you at the hospital. If you are a hemophiliac, have certain genetic diseases or have a child with an immune disease who uses medicines made from blood to survive, you face your doctor telling you there isn’t any medicine available. 

Letting gay men give blood could help bolster the supply.  But, incredibly, despite ongoing shortages of blood that can and do cost lives, and no artificial substitute on the horizon, the FDA is letting prejudice and fear — not science — determine whether gays can give blood.

At one time, long ago, the gay-blood ban may have made sense. But it no longer does.

Testing for HIV and other infectious diseases, as the Red Cross and the America’s Blood Centers experts told the FDA, has improved enormously since 1983. The strict testing of today will screen out their blood if it is infected with HIV.  The only exception is men newly infected within three weeks prior to donating. Admittedly this "window period" during which someone can be infected with HIV and not test positive even with the best of tests is a risk.  But the right response is to exclude anyone who has engaged in any risky sexual or drug behavior for, say, a month prior to donating blood — not those who had sex with a man 30 years ago!

Blood shortages are not going away anytime soon. The members of the Greatest Generation, those now entering their late 70s and 80s, have been this nation’s most reliable blood donors.  They are dying off.  Younger people are not as committed to donating blood.  Yet the demand for blood increases every day.

Americans undergo more bypass operations, organ transplants, C-sections, hip and joint replacements, and other treatments every year.  All require the use of blood. And as more and more people live with immune disorders or diseases that hamper their ability to make blood, the demand for blood also escalates.

We also need blood for other reasons. Sadly, the reality of terrorism and violence at home and abroad has become an all too real part of American life. This means that the chance of not having enough blood on hand in a particular city on any given day where there is a shooting or a bombing or worse is a risk that each one of us faces.

The AIDS epidemic has been with us for 25 years. The policy currently governing blood donation in the United States has remained unchanged for 24 years. Given the need, we should be willing and grateful to accept blood from any healthy American willing to donate.  The FDA just does not get it. Fear and prejudice are terrible reasons to let you or someone you love die.

Arthur Caplan, Ph.D., is director of the Center for Bioethics at the University of Pennsylvania.