Lack of Empathy for Women and Other Groups

MarkTwainiac · 2021-01-12T03:21:23+00:00

He said that he “lied about it” when donating blood, because it is a “prejudiced” question anyway. In a follow-up questionnaire, he admitted that he had sex with a man within the past year, so he was prevented from donating blood. He admitted that he did not need the money from blood donations, but he “just wanted to help”. He also expressed concern that some people who want to donate might really need the money for rent, food, etc.

What country is this guy in where people are being paid to donate blood? As I understand it, in most/all of the "developed" world it's taboo or even illegal to pay or expect to be paid for giving blood with the intent that it be transfused/shared with another person.

I thought that only people who donate plasma are paid nowadays, but not people who donate blood.

BTW, I'm probably more familiar with this area than random members of the public. I undergo regular phlebotomy - whole blood letting - a couple of times a year for hereditary hemochromatosis, but also have to have infusions of immunoglobulins taken from plasma at least once a week for inborn immune deficiency.

Re gay men donating blood: everyone who thinks the current precautions are unfair and discriminatory really needs to look into the HIV contamination of the blood supply in countries such as the USA in the 1980s. Lots of people - such as boys and men with hemophilia, women who needed blood transfusions during/after childbirth, young children of both sexes born with certain blood disorders, patients who got transfusions during surgeries, following major car accidents and other traumas - ended up dying of horrible disease long before "their time" because orgs like the Red Cross wouldn't screen male blood donors or the blood they "donated" itself for HIV-AIDS.

In case anyone thinks it's homophobic of me to say this, my views are/were shared by many pioneering gay male AIDS activists like Larry Kramer and others who founded and led organizations such as Gay Men's Health Crisis and ACT UP. Both of which I was involved with in the 1980s and 90s.

MarkTwainiac · 2021-01-12T15:11:36+00:00

You know who is subject to the strictest rules around donating blood? Women.

All around the world, women who've recently given birth are barred from giving blood and in many places breastfeeding women are as well. In the US, the Red Cross won't allow women to donate until six weeks after childbirth, but in many other countries such as Canada, the UK, Italy, the Netherlands women are barred until six months have passed since giving birth. In Australia, the ban is for nine months after childbirth.

WHO recommends women not give blood until at least nine months after giving birth, plus three months since weaning if the woman breastfed. WHO also recommends that women who've terminated or lost a pregnancy not be allowed to give blood until the same length of time that the pregnancy lasted has passed.

Also, traditionally in many places women who'd ever been pregnant and especially women who had a pregnancy that resulted in birth were barred from donating plasma and platelets and whole blood whose plasma or platelets were to be used because in pregnancy some women develop antibodies to Human Leukocyte Antigens (HLA). These antibodies can cause potentially fatal lung damage to patients who receive transfusions of whole blood or infusions of parts of blood (platelets and plasma). (Like all other antibodies, HLA antibodies reside mostly in blood plasma; platelets are the parts of plasma that cause blood to clot.)

https://www.militaryblood.dod.mil/viewcontent.aspx?con_id_pk=2117

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2841001/

https://www.labce.com/spg766771_aabb_recommendations_regarding_plasma_donors_hla_t.aspx

https://www.oneblood.org/media/blog/platelets/can-women-donate-platelets.stml

When testing for HLA antibodies became available in 2016, the U.S. Food and Drug Administration instituted a new requirement that all female platelet and plasma donors must be given an HLA antibody test, and as of October 2016 any woman found to be positive was barred from donating.

More recently, research has been published saying the danger of fatal transfusion-related complications posed by HLA antibodies in the plasma of previously pregnant women is not as great as once feared. What's more, several years of testing women for the HLA antibodies has shown these proteins are not as common in women who've ever been pregnant as previously thought. The likelihood of having the antibodies goes up with each additional pregnancy carried to late term, so the issue is with women who've had multiple pregnancies resulting in either live birth or late miscarriage or stillbirth.

Still, in places like the USA and Australia any woman who tests positive for HLA antibodies is automatically barred from giving platelets or plasma - and women throughout the world still have to answer "invasive" questions about pregnancy history as part of standard blood donor and blood products eligibility screening. But funny thing is, there's been no hue and cry about the supposed unfairness of these rules from women subject to them. Gee, wonder why? /s

https://www.redcrossblood.org/donate-blood/how-to-donate/types-of-blood-donations/platelet-donation.html

https://www.rrvbc.org/wp-content/uploads/2014/10/RRVBC_HLA_TechnicalNotificationSheet_w-Bleeds_PRF.pdf

https://www.oneblood.org/media/blog/platelets/can-women-donate-platelets.stml

https://www.nih.gov/news-events/news-releases/red-blood-cell-donor-pregnancy-history-not-linked-higher-mortality-transfusion-recipients

lefterfield · 2021-01-12T01:54:50+00:00

He admitted that he did not need the money from blood donations, but he “just wanted to help”.

This disgusts me. These are not the words of someone who wants to help. This is someone who wants validation for being a good person. People who genuinely wanted to help would put the needs of others above themselves. Recipients of blood donations are vulnerable, in a state of medical fragility - that's why the damn questions are asked. It can't eliminate ALL risks, but as far as whether they're "discriminatory"... honestly, I don't give a shit. I'll leave it to doctors and nurses to decide whose blood they want to stick into another human being who may die without it, and may also die if they get tainted blood. That's not a decision I want on my head, and I don't envy the ones who make it. It's not a fucking right to give your blood to someone else. It's not even a privilege. It's a donation to try and save a life. If your motivation is anything less than that, you are a selfish, disgusting wretch of a human being.

And yeah, I think people right now are terrified of being called racist or phobic, to the extent they'll ignore common sense. The social consequences of honesty on these issues are drastic. For many, they can mean the difference between employment and poverty. Friendship and isolation. If some strangers you'll never meet(probably) have to suffer for it? It's easier to agree.

Edit: My statement above, I don't mean to include people who donate blood out of a desperation for money. I understand that. It's a bad motivation generally, but so long as they're sincere about their health and medical history I don't see a problem with it. What would be better is to not force people into that situation at all, but... much harder problem.

MarkTwainiac · 2021-01-12T16:09:56+00:00

This document from the World Health Organization and the International Red Cross and Red Crescent societies explains why public health experts say it's best for blood donations always to be made voluntarily, without any monetary renumeration - and why these orgs are set on making voluntary-only blood donation the standard in every country on earth.

https://apps.who.int/iris/bitstream/handle/10665/44359/9789241599696_eng.pdf?sequence=1&isAllowed=y&ua=1

The document also identifies the two groups worldwide who are most likely to need blood transfusions - women in/after childbirth and children suffering from diseases like malaria. So it's mainly women and children who bear the brunt when blood is contaminated with diseases like HIV, Hep C and B, and syphilis.

The HIV/AIDS pandemic focused the world’s attention on blood transfusion as a significant route of transmission of HIV/AIDS. It is estimated that blood transfusion accounted for 5-10% of HIV infections in the 1980s and it still contributes to a significant proportion of new infections, particularly in high prevalence countries.

The risk of HIV infection through unsafe blood and blood products is exceptionally high (95–100%) compared to other common routes of HIV exposure: for example, 11–32% for mother-to-child transmission and 0.1%–10% for sexual contact.15 Sub-Saharan Africa has a particularly high level of transfusion-associated HIV compared with other regions due to a higher risk of infected blood being transfused. In some regions of the world, hepatitis B, hepatitis C and other bloodborne infections such as Chagas disease pose an even greater threat to national blood supplies.

In developing countries, pregnant women and children account for a disproportionate number of HIV and hepatitis viral infections through unsafe blood and blood products because they are the main groups of patients requiring transfusion.

Preventing the transmission of infection through unsafe transfusion is one of the core strategies for HIV/AIDS prevention – and is, in fact, the only approach to HIV prevention that is almost 100% effective. In most developed countries, the risk of HIV transmission is [now]very low because of the adoption of an integrated approach based on voluntary blood donation, stringent donor selection procedures, the screening of all donated blood for transfusion-transmissible infections and the use of transfusion only when no suitable alternatives are available.

BTW, donor rules and regs have been set up not just to lower risk of HIV transmission, but to weed out people who might have other blood-borne diseases too. Also, generally barred from donating blood are people with weight below a certain threshold (almost always women), anyone under a certain age, persons with some specific inherited conditions (among them hemochromatosis), and people who previously had certain cancers or medical procedures such as organ transplants. In some places, people are prohibited from donating based on relationship status coz in certain countries and health systems it's seen as inadvisable for family members and friends to donate to patients needing transfusions of blood or blood components. But no one complains about these sorts of rules being unfairly discriminatory.

https://www.redcrossblood.org/donate-blood/how-to-donate/eligibility-requirements/eligibility-criteria-alphabetical.html

https://www.who.int/campaigns/world-blood-donor-day/2018/who-can-give-blood

More on the reasons why blood from unpaid volunteers is considered the safest:

Voluntary blood donors, particularly regular donors, are the first line of defence in preventing the transmission of HIV, hepatitis viruses and other bloodborne infections through the route of transfusion. A number of studies have reported significantly lower prevalence of transfusion transmissible infection markers among voluntary donors compared with other types of donors, with the lowest rates among regular donors.5,16

Voluntary donors are recognized to be the safest donors because they are motivated by altruism and the desire to help others and by a sense of moral duty or social responsibility. They have no reasons to withhold information about their lifestyles or medical conditions that may make them unsuitable to donate blood. They are not placed under any pressure by hospital staff, family members or the community to donate blood and they entrust their blood donations to be used as needed, rather than for specific patients. The only reward they receive is personal satisfaction, self-esteem and pride.

In a well-organized blood donor programme, voluntary donors, in particular regular donors, are well-informed about donor selection criteria and are more likely to self-defer if they are no longer eligible to donate, thus reducing the need for temporary or permanent deferrals. This also leads to less wastage of donated blood, with all its associated costs, because fewer blood units test positive for infection and need to be discarded.

Family/replacement donors are usually not informed about conditions that may make them unsuitable to donate blood. Even if there is a donor selection process to assess their eligibility to donate, they may be unaware of the significance of some of the questions in the donor interview. In their eagerness to donate blood to save the life of a loved one or their fear of distressing or displeasing their family, replacement donors may conceal information about their health status or lifestyle behaviour. This poses an increased risk of the transmission of infection, often resulting in a higher volume of donated blood that has to be destroyed because of evidence of infectious disease markers.

Paid donors often lead lifestyles that expose them to the risk of HIV and other infections that could be transmitted through their blood. The highest prevalence of transfusion-transmissible infections is generally found among paid or commercial donors.People who accept payment for their blood are primarily motivated by the prospect of monetary gain rather than a desire to help save lives. The need to protect their income from blood “donation” compromises issues of honesty in the donor interview and they are highly unlikely to reveal reasons why they may be unsuitable to donate blood. Further, they are often undernourished and in poor health and may give blood more frequently than is recommended, resulting in harmful effects on their own health.

Meeting the nation’s need for safe blood and blood products through the donation of human blood should be based on ethical principles including respect for the individual and his or her worth, the protection of the individual’s rights and wellbeing, the avoidance of exploitation and the Hippocratic principle of “primum non nocere” – first do no harm.

Paid donors are vulnerable to exploitation and commercialization of the human body as they usually come from the poorer sectors of society and become paid blood donors due to economic difficulties. Any form of exploitation of blood donors, including payment for blood,coercion and the collection of blood from institutionalized or marginalized communities such as prisoners diminishes the true value of blood donation. A blood donation is a “gift of life” that cannot be valued in monetary terms. The commercialization of blood donation is in breach of the fundamental principle of altruism which voluntary blood donation enshrines.

In systems based on family/replacement donation, the onus of providing blood is placed on the patient’s family and friends rather than on the health system. Patients and their families are placed under considerable pressure to find blood donors at a time when they are already stressed because of the patient’s illness. Relatives who are unwilling or ineligible to donate blood and who cannot find other suitable replacement donors may resort to paying others to donate, even if this practice is forbidden by the country’s legislation. The problem is particularly acute when patients require regular transfusion for conditions such as thalassemia and blood is required every month or even more frequently. Patients are also disadvantaged if they have been referred from distant health facilities and have not been accompanied by relatives or friends.

MarkTwainiac · 2021-01-12T15:53:59+00:00

To reiterate what I said in my initial post about this, in the US and most of the wealthier countries of the world, people are not paid for giving whole blood (or AFAIK for giving platelets either) - it's only customary to get paid for giving plasma. The process of giving blood and plasma are different, as are the rules and regulations governing them. If blood is taken from donors who are paid for it, the rule of the US FDA is that it has to be labelled accordingly - and hospitals and other ethical and reputable medical facilities won't use any blood that's been bought.

But when these rules were originally put in place, they didn't cover blood plasma - nor did anyone anticipate that one day devising and selling commercial products from plasma would be a big industry.

Good article explaining the difference between donating blood and selling plasma in the US: https://www.statnews.com/2016/01/22/paid-plasma-not-blood/

In the US, the standards for plasma donors are different (usually lower) than for whole blood and platelet donors coz plasma donations in the US are generally performed by commercial blood products companies, and coz plasma is broken down into various components used for specific medical purposes. These are marketed and sold as individual products. In the process, plasma products are subject to extensive and thorough cleansing processes that are very effective, but which whole blood couldn't withstand coz the red cells are too fragile.

Plasma donation — in which blood is drawn, plasma separated out, and then blood cells and other components put back into you — is often compensated. The FDA doesn’t require paid plasma donations to be labeled. The reason is that plasma collected this way never goes straight into another person. It’s broken into many different protein products that will become pharmaceuticals. Along the way, these components are processed to remove or kill any virus stowaways. “The risk of infection is inherently much lower,” said Dr. Christopher Stowell, who recently chaired the FDA’s Blood Products Advisory Committee. Whole red blood cells are too fragile to undergo the same kind of processing as plasma.

And there’s some evidence that paying for plasma does, indeed, lead more people to conceal their disease status or risk behaviors. For instance, the Government Accountability Office looked at California’s blood versus plasma supply back in the 1990s and found that the plasma had much higher rates of HIV. There are reports of desperate donors lying about illnesses to donate for cash.

Rationalmind · 2021-01-12T07:09:05+00:00

California politics are a problem. The politicians in your state are obsessed with superficial details like skin color or “gender expression.” California politicians are too corrupt and need to be prevented from their DC takeover.

GenderCritical

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