I don't know why they don't just exclude everybody who's ever had sex at all…oh, wait – that'd probably mean no donors whatsoever!
This clearly doesn't stem from a scientific standpoint. If they claim to be worried about disease, then this implies they don't bother actually testing the blood they do get and just rely on peoples' word. Presumably if you look like a nice person, you must have clean blood.
I applaud the NBS for being so open about their decision, whether we agree with it or not. They have access to the facts, we do not. The only person I knew who died of HIV / AIDS was gay, one out of about the 5-10 homosexual people I know. I know that a sample of one in ten is hardly statistically relevant, however the NBS have a much larger database.
I don't think they are being homophobic. They assess the risks across all sections of society and select the lowest risk options that will yeald the blood supply that they need. That is sensible given the limited resources they have. It is all about risk management*.
As an aside they don't want mine or your mum's blood either for different reasons.
(*) The same applies in the car insurance industry. Cars of a certain type are automatically barred from drivers under a certain age (usually 25) because statistics say that young people are more likely to have accidents in fast cars. There is no assessment of the individual drivers concerned.
Does the NBS actually need more donors? If not, then its all moot anyway. I'm assuming ‘more blood is a good thing' anyway …
It looks to me like the NBS have been backed into a PR corner by militants kicking up a fuss, and are shoring up a socially unpalatable stance (to some) with questionable science. They're not going to ‘spin' their way out of this, I suspect. The trouble for them is that said militants have won change elsewhere on the basis of scientific evidence, so this rather looks as though they have their fingers in their ears and are hoping it all goes away.
The present approach excludes perfectly healthy donors, while including a vast number of unhealthy donors. Diseases of all kinds exist across the whole population, and yet this blood is potentially accepted into the system. If the concern is indeed around disease, they should be screening for it. That is the only reliable way to manage the risk, and if they aren't already screening each and every donation for disease then they are playing Russian roulette with patient health.
The only logical reason I can think of for excluding donors from even entering the system is to save time (and cost) at the point of collection. It seems sensible that the base criteria should be that donors are disease free. If the donor's opinion about the state of their own health based on exposure to risk factors (needles, unprotected sex, whatever) is good enough to self-screen for this purpose (as it apparently has always been), then that applies equally to the whole population. To do otherwise implies that gay men have poor judgement when compared to their heterosexual counterparts (and it is this part I personally find insulting). Safe sex is safe sex, whoever's putting whatever wherever. And since even a healthy test result from last week isn't cast-iron guarantee of health at the time of donation, all samples will still need screening, wherever they come from.
The way the insurance industry carries on is hardly an example of common sense: their motivation is purely financial. That lot would have us all live in bubble wrap just so they don't have to pay out. Statistics only describe a limited portion of the reality we live in, but the accountants keep hoping the rest of us don't notice that.
I don't think the position of the NBS owes much to logic and science, but (I suspect) stems from the traditional presence of religion within the caring professions, and the psychological significance of having the blood of in your system. Whatever the motivation, I think the NBS are on a losing wicket with this one: other blood services have changed (or been made to change) their position, since it has been scientifically proven to the satisfaction of courts of law (if you count Australia) that there is insignificant additional risk involved in accepting gay blood over straight.
Having said that, I'm very keen that PC pressure groups don't automatically win victories in these situations, so I would welcome this whole issue being taken through our own courts.
No probs with me for blogging !
All blood is screened before use but they pool most of the donations & then test samples from that pool (for cost & logistics reasons – some of the tests take some days to give a result). If any test on any pool is positive for undesirable contaminants of whatever type they have to ditch the whole pool. For some very rare blood types individual donations are tested. All tests done are chosen on a statistically based risk assessment.
I have to say that i wasn't too chuffed having 3 pints of American blood back in 1999 given that they pay donors there so you are more likely to get people lying about their state of health & i did have a pyrogenic response to it (slightly high temperature). But until about 3 years ago I was still allowed to donate blood myself BECAUSE it was non-European blood with allegedly lower risk of CJD (human “mad cow” disease). Incidentally I once saw some statistics saying that the risk of catching CJD was less than that of being electrocuted by an alarm clock even taking into account non-mains operated and clockwork ones …
“Lies, damned lies & statistics” (quote of unknown origin dating from at least 1795) but we couldn't operate today without using them!
OK by me.
To add to this, P*** – I think you answered your own question….
|| The only logical reason I can think of for excluding donors from even entering the system is to save time (and cost) at the point of collection.
I think this is what is happening. No national organisation is going to be ‘phobic about any section of society because it is at best morally wrong and at worst illegal. To quote a training mantra – Good; Fast; Cheap – pick two. They have fast and cheap at the expense of ‘good'. As a ‘universal blood' person I can live with them saying I can't give blood, but if I had a blood group that was rare then I would, and I would expect the NBS to, question the rules. After all, I may need mine back again sometime.
I agree that there should be some sort of review, however it needs to go hand in hand with a public education programme. Contrary to some beliefs homosexuality is not a blood desease or something that you can catch or be cured from (why would you want to?). Equally not many homosexuals are ‘camp' or ‘wear sensible shoes' (of those I know). There is a media stereotype that needs to be addressed, then maybe the NBS will be shamed into reviewing their policies.
Their risk assessment should not ignore the most significant diseases, since these are not exclusive to gay men and may be present in any given sample (/pool of samples). If their tests are not rigorous enough to screen for these, then this issue is far more worrying to me.
If their tests are sufficiently comprehensive, then self-screening based on an individuals own risk-assessment is at best a saving in cost/time and at worst means the service misses out on some healthy blood. It is not definitive, but could significantly reduce the proportion of unhealthy donations.
Self screening does not require a faculty of judgement that is the exclusive preserve of the heterosexual portion of society.
Simply put, it looks like the NBS doesn't trust gays, but they do trust everyone else to make that judgement. Personally, I don't: in my view their tests should eliminate the need for trust in their donors in the first place, with self-screening purely as a ‘nice to have' to ease the burden as much as possible.
While on the subject of pooled donations and testing, why is it that all people who contribute to a pool that fails tests aren't advised to seek medical tests? They may be now, but last time I asked this there appeared to be no feedback to the donors concerned.