A paper and accompanying editorial in this week’s BMJ seem to mark a new low in the erosion of patient safety in favour of political correctness. Since the 2009 BMJ head to head debate on whether the lifetime ban on blood donation for men who have had sex with men (MSM) should be lifted, the pressure on blood services throughout the developed world has increased.
If Grenfell et al’s BMJ paper is the best new evidence for lifting the ban, it is difficult to see what has really changed since 2004 when Jay Brooks argued the case that ‘ the rights of blood recipients should supersede any asserted rights of blood donors’. The conclusion of the latest research among MSM is that since over 10% of them knowingly defy the lifelong ban and feel a one year ban is more acceptable their views should prevail.
The reasons given for defying the existing ban are given as ‘self categorisation as low risk, discounting the sexual experience that barred donation, belief in the infallibility of blood screening, concerns about confidentiality, and misunderstanding or perceived inequity of the rule’ and the sole concern of the authors seems to be to facilitate MSM to be able to donate without having to deceive for such reasons. If such defiance of a lifelong ban is relatively common, it is highly likely that defiance of a twelve month ban will be much more widespread. Accuracy recall of when same-sex intercourse last occurred is likely to be diminished after six months let alone twelve.
The authors’ conclusion that ‘many of the reasons for non-compliance seem amenable to intervention’ defies logic. Intervention to aid compliance among MSM is not what is happening. The rules are being adjusted so non-compliance no longer matters and indeed is certain to be encouraged.
The BMJ is at least to be commended in commissioning the editorial from Brooks as a consistent opponent to the change (though unlike the article, they have not made it available for free to view) and his wryly understated conclusion that ‘The UK will monitor any new cases of HIV in the blood supply attributable to this change and must be ready to quickly revise the deferral’ should be carefully noted and acted upon if the consequences do prove as adverse as Brooks and others foresee they are likely to be.
Those in power who have supported the change should also be held to account for the considerable expense involved in implementing it to no obvious benefit other than not wanting to be seen to offend MSM.