Infectious disease marker testing of the autologous blood donor. A case study in clinical ethics.

Abstract

The Food and Drug Administration currently requires written authorization from the patient's physician before autologous units of blood that are positive or reactive for hepatitis B surface antigen or anti-human immunodeficiency virus can be shipped from a site of collection different from the site of transfusion. Additionally, the Blood Products Advisory Committee has recommended the universal testing of all autologous units of blood. The case of an autologous blood donor with positive infectious disease markers is presented. The ethics of infectious disease testing of patients who preoperatively donate their own blood is discussed. Many ethical issues are raised by policies requiring infectious disease testing of the autologous blood donor. Blood banking and transfusion medicine specialists should examine the ethical issues raised by regulatory mandates to perform infectious disease testing of the patient who desires to make a preoperative autologous blood donation. A policy that protects the rights of the patient as well as the rights and concerns of health care professionals should be pursued.