Can lying to the Red Cross be ethical?

Ok, it’s not really the red cross, it’s Canadian Blood Services. I have a friend, let’s just call him D. D is a married bisexual male. He’s been monogomous with his wife for nine years now. Before that he played the field for many years with both genders, usually safely.

Now my huh moment came up when he told me that he donated blood while he was down south last week. “But D,” I asked him, “don’t they exclude gay or bi men?” (Which is another GD or Pit thread of it’s own I’m sure, but let’s try to keep this vaguely on track)

“Well, that’s only if you tell them. I just lie about it. I’ve had blood tests done in the last five years, and I know I’m clean & healthy. And I’m AB-, which is really rare, so it’s my duty to donate,” was his reply. He had no qualms about lying, since in his view, he was saving a life, which has a higher moral duty than telling the truth to a bunch of … well, I’ll just leave out what he called them.

Now, there’s something about his agrument that rubs me the wrong way, but I’ll be damned if I can figure out why. Can anybody here argue this point with him?

In general terms, I think rules should be obeyed. In specific terms, there are definitely times when they should be broken. The “If you’ve ever done anything naughty with another man’s penis you can’t ever give blood” rule is silly. It’s there for a reason, but it’s still silly. The only reason for it is the higher incidence of certain STDs, primarily HIV, among gay men, and if your friend has been monogamous for nine years and has had himself thoroughly tested, I see no harm in his lie.

Our society depends on the integrity of the Canadian Blood Services. D is undermining that integrity.

I actually report that I had a homosexual experience many years ago. Then I claim that I was not the recipient of any body fluids. That results in a consultation with a superior and the acceptance of my blood. Who knows, my blood may be earmarked for special testing, I don’t know, but I don’t believe I have more right than an organization responsible to the public. I’m B- and that’s fairly rare too.

Well, there’s the slippery-slope aspect, for one thing. If D. can decide that the immediate benefit of saving a life with his donated blood outweighs the ethical negatives of deliberately lying to thwart the blood services’ official policy, why shouldn’t a bareback-swinging gay guy make the same argument? “Hey, my rare AB- blood is needed to save lives right now, and that’s more crucial than the risk that I might be transmitting HIV, so I’m ethically justified in lying about my sexual history in order to donate blood.”

Who decides what level of risk is low enough to justify lying to get around the blood services’ explicitly stated policy? If the policy is bad or unwise (and I agree that there’s a case to be made there), I think that a more ethical course is to work to change the policy, not dishonestly circumvent it.

There are also other things that D. could do to address the blood shortage. Does he have any AB- relatives who are straight that he could persuade to donate regularly? Can he volunteer for the blood services or work on a blood donation campaign at his office? He doesn’t have an either-or choice between lying to donate blood on the one hand, and doing nothing whatsoever to help the cause of blood donation on the other.

It’s the very definition of unethical.

Blood services organizations have a very good reaosn to try to minimize the risk of HIV contamination in the blood supply and whether we like it or not, HIV infection amongst gay men is many times higher than the average; male-male sex is still the leading cause of HIV transmission in Canada and the USA. You may disagree with the policy on other grounds, but they are being careful, and who can blame them?

You do not have a right to donate blood. Nobody does. This is not something anyone has an intrinsic right to do. You are not being denied anything you are owed by being told you can’t donate blood. “D” is defrauding a charitable organization, lying, and endangering other people for the sake of his own ego.

Furthermore, he’s a bloody damned fool. AB- is rare, sure… and anyone with AB- blood can receive blood from anyone who’s O negative, A negative, or B negative. It’s O negative that’s really valuable because anyone can receive it. People with FEWER antigens, e.g. type o blood, are the ones with valuable blood. AB- is nearly useless; only another AB type can receive it.

So the nurse sits him down at the interview and asks him explicity “have you read and understood all of these questions? Are your answers all completely truthful?”

Then he lies and doesn’t have a problem with that? I agree with RickJay.

I agree with Mithrander’s friend. Why? Because mostly I think his argument is dead on correct, but also since I don’t think even one person’s desire to circumvent the rules (or a small majority – which I’m sure it would never exceed) would encourage many other people to do the same, leading to that slippery slope assumed. Surely such a rare blood type, coupled with the above scenario (and similar cases), warrants consideration. I understand some indulging unethically and, by extension negligent, I feel those folks would do likewise regardless as who serves as a role model or not.

So sadly, I’d rather face the consequences all the way 'round rather than being letter-of-the-law redeemed.

~faithfool, not bi but has encountered a penis or two internally… why should heterosexual females be any different after testing or length of time elapsed? Obviously, I’m against those sorts of judgments, that I’m certainly (as well as others) capable of performing/leveling myself.

As RickJay pointed out, though, D.'s AB- blood is the wrong kind of rare. It can only be donated to other AB individuals, who make up only a few percent of the population. And those AB individuals generally can receive blood of other types—they are the “universal recipients” or nearly so, and thus they can use all or most other blood types besides AB.

So why is D. sacrificing his ethics to donate blood that is absolutely useless to most recipients, and not really needed even by the few patients who could receive it?

I personaly think the laws/redcross policy is stupid. I have had sex with men thus I am not elligable to donate. I do think it is unethical to lie to them in order to donate blood.

I still feel, regardless of the specific incident mentioned, that the principle is a good one. As I said, how do they get to discriminate against a certain class (males having sex with the same) versus females copulating with the opposite sex? And what data do we have that say the few who do would encourage others (the less ethical ones) to do likewise? No matter what, in my humble opinion, trying to save another human life under the circumstances describes, that’s all that should count and certainly supercedes the opinion that lying is ultimately (most importanly?) what should be considered of the highest order over the other.

Because of the difference in risk levels. Gay males have a much higher than average incidence of HIV infection; straight females don’t.

Mind you, I agree that it’s a dumb and misguided policy to disqualify donors just for having had any man-to-man sex any time in the past 20 years, irrespective of their current sexual behavior or HIV status. But statistically speaking, it’s fair to say that gay males are a higher-risk group for HIV than straight females.

Like I said, though, anybody could use that argument, even an individual who is genuinely at high risk for HIV. Where do we draw the line? Which people are entitled to say that because they’re trying to save another human life, they’re entitled to deliberately lie about the risks that their actions might involve?

Another thing to bear in mind is that if people start losing faith in the integrity of the blood supply because they think that high-risk individuals lie in order to donate, then they may do things like avoiding operations that they desperately need, due to fear of a contaminated transfusion. So lying in order to donate may not actually end up saving lives in the long run.

Ok, I trust that summation is true. However, I repeat, do you (and others) really assume that the whatever-small-amount who take this step influence others? Or is that just a presumption? I mean, I know that when I’ve donated in the past, the thought of who has and hasn’t played by the rules, has never crossed my mind. Similarly, I’ve never know anyone that it has and therefore I think that should be ultimately taken into consideration.

Again, since I don’t know any better, has this been statistically documented as fact by a reliable source under realistic guidelines (IE: the amount who actually volunteer this information across the board – both heterosexuals and those who identify as either gay and/or bi)?

True, but is there proof that the unethical ones do?

I’d think changing the criteria so as not to discriminate against anyone who didn’t fall within a narrow margin. Say those who’ve been monogamous for seven (isn’t that the earliest cut off for being HIV positive?) years or who’ve never had unprotected sex. Because, no matter what, there’s an element of trust on deciding (by the powers that be) of trust anyone. Where do we draw that line?

I suppose no one is allowed but as I pointed out above, anyone could fall under those auspices anyway. Just sayin’.

Would you lose faith because of someone else’s actions that you don’t even subscribe to anyway? Also, would that effect a life or death choice if you faced it? I understand that there may be some, but if we’re talking about the minority in the first place, wouldn’t the same conjecture apply? Unfortunately, I do agree with your last statement. We all may be in the same position that any reflection holds little merit.

Straight black females have a very high incidence of HIV infection(in some studies higher then gay males) and are statisicaly less likely to know their HIV status. Yet no blanket restrictions prevent them from donating.

Overal I think the surgon general and the red cross should update their policies based on new studies rather then relying on 20 year old data. As that would take time and money they would rather continue bigoted policies then reevaluate them.

You can also look at a more recent decision that prevents gay men from donating to sperm banks even though they can’t show any correlation between gay men donating and recipients of the sperm contracting HIV.

The Red Cross, or Canadian Red Cross, excludes fags for political reasons, not scientific or ethical reasons. People want to know their blood came from straights, not fags. Or blacks. Or jews. Or whatever.

Most of the population is straight, and they like to think their blood is coming from straights.

Only 4% of the population is gay. Depending on how you interpret that, only 2% of the population is gay male. People feel good knowing that 2% of the population has been excluded from their blood supply but they quite happily accept the other 98% of the population’s blood who have been fucking everything in sight and not getting tested for much of anything because they think they’re not at risk because they’re straight.

It’s silly. People want to feel good about where their blood comes from. I really don’t think common sense or science has much to do with it.

I want my bottled water to come from Maine, not New York. I want my Pace picante sauce to come from the southwest, not New York City!

Agreed.

AFAICT, yes. For example, here is a table in a Centers for Disease Control report on HIV/AIDS diagnoses in the years 2000–2003. Out of about 126,000 positive diagnoses, 44% were in the transmission category of male/male sex. 34% were in the transmission category of “high-risk heterosexual contact”—i.e., sex where one partner is known to have HIV/AIDS or to have a high risk factor for HIV/AIDS. About 20% were ascribed to intravenous drug use, and other transmission factors accounted for the remaining 2%.

So yes, HIV transmission is much more strongly linked with male/male sex than with heterosexual sex, except where one of the heterosexual partners is in a high-risk group. (And btw, straight women who have high-risk partners are not allowed to donate blood either, any more than gay men are.) If HIV is much more likely to be spread by male/male sex than by heterosexual sex, then it is statistically reasonable to infer that men who have male/male sex are much more likely to have HIV than men or women who have no exposure to male/male sex.

So it does make some statistical sense to exclude men who have sex with men (MSM) from the nation’s blood supply. However, I think it’s dumb to exclude all MSM on the basis of even a single sex act even as far back as 20 years ago. HIV- MSM in long-term monogamous relationships are no more likely to be exposed to HIV than the average person—in fact, they’re less likely—and I see no reason why they shouldn’t be allowed to donate blood.

True, but note that as I said, if they have a high-risk partner then they are also forbidden to donate.

I agree. As I noted, there are more realistic and finer criteria we could use that would include more potential donors without significantly increasing statistical risk levels.

Sorry, but I think this is exaggerated. The Red Cross doesn’t exclude members of other groups like blacks or Jews who, as you point out, are also likely to be victims of social prejudice. Nor does it exclude lesbians, who are just as “non-straight” as gay men are.

Homophobia may well play some role in the decision to bar MSM from blood donation, but I doubt it’s anywhere near as important as the simple fact that MSM statistically just have a much higher-than-average rate of HIV infection.

I wouldn’t be so quick to label him a fool.

Sure, AB whole blood can only be given to another type AB person, but two things have to be considered here:

Doctors (and the hospital blood bank) do not like to give a patient “group compatible” blood if there’s any way to give them group-specific blood. If you take Mr AB and give him some type O blood, because hey, it’s compatible, he’s not going to react to it, but it will make his blood tests wonky for as long as those other cells are in his blood, and that’s a pain in the butt to work with. Trust me. It’s done in emergencies, yes, but the need for blood in true emergency situations is a lot less than the routine need for transfusions to help severe anemia, blood disorders, or after surgery. And in those cases there’s more than enough time to type the patient and give him group-specific blood.

Also, at least here in Canada, blood is rarely transfused as “whole blood”. It’s split into its components: red cells, plasma, and platelets. AB plasma, because it doesn’t have antibodies against the A and B antigens, can be given to anyone. In an emergency, when there’s no time to type the patient and he needs plasma, we thaw out some AB units. O is the universal donor for red cells, but AB is the universal plasma donor.

  • Antigen, MT

It’s not his call to say whether the risks – if any – arising out of his sexual preferences outweigh the advantages – if any – arising from his blood group. He is lying to suppress information so that those who make the decision to accept his blood do so on the basis of wrong information. He is, by deception, forcing his judgment in this matter onto others. He has no right to do this.

The problem is compounded here because of the possibility that his wish to give blood is motivated not only by an altruistic desire to ensure that others have access to his rare blood type, but also by a personal need to affirm for himself the worth, value, validity, safety or whatever of his sexual choices against what he might see – with perhaps some justification – as an irrational attack. But however justified he may be in wishing to affirm his sexual expression against such an attack, he is not entitled to force the costs of that affirmation, however small they may be, on others, by deception, without their knowledge.

This is clearly unethical.

Sorry. That was a bit of hyperbole. It isn’t politically correct to exclude Black or Jew blood and of course they wouldn’t, even though Blacks are getting AIDs more than other ethic groups. Well, in the US. Blacks are a pretty insignificant demographic in Canada.

What’s the statistical data on HIV/AIDS transmission in female to female sex?

It seems to me that blood collection is (or should be) done along the same lines as insurance decisions are made: statistics, actuarial (?).