Looming Blood Shortage Raises Ethical Questions about Allocation
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While much attention is currently focused on how hospitals will allocate ventilators when the expected surge of COVID-19 cases outstrips supply, Jeffrey Kahn, Andreas C. Dracopoulos director of the Berman Institute, highlighted another looming medical issue caused by the outbreak – a severe disruption in the nation’s blood supply.
In a March 27 New York Daily News commentary, Kahn wrote that the American Red Cross and other suppliers of blood should be prepared for an ongoing 25% cut to their regular supply.
Kahn highlights a number of factors that “make blood and its allocation somewhat different than the allocation of ICU beds or ventilators:”
- The perishability of blood and reliance on volunteer donors to meet needs;
- Disruption to the “usual ability to move blood to where it’s most needed … since supplies are suppressed nationwide;”
- The variability of patient needs in amount of blood required for treatment.
“Utilitarian logic is clear that we should save as many as possible, and the numbers overwhelmingly favor saying no to the cases requiring massive transfusion,” writes Kahn.
“If only ethics were so simple. We need to think about who is most likely to be affected by refusing or reducing the numbers in Mass Transfusion Protocol cases, where the critical supply threshold should be for invoking restrictions, how that supply might look tomorrow as compared to today, who should decide about whether to say yes or no to high volume cases, and whether and under what conditions it is acceptable to start on a massive transfusion case but stop when a certain limit of units is reached.”
However, as Kahn points out, unlike many other situations arising from COVID-19, in this instance “there is something many of us can do that is as easy as it is precious: Give blood! This is up to each one of us as individuals. The step you take today can prevent medical professionals from making terribly wrenching choices tomorrow.”