1. Ethical Health Care Provision Ethical Issues

2. Ethics in Medicine Ethical Issues = dilemmas involving important moral principles

3. Issue #1: The Blood Supply Blood Products & Their Uses

4. The Blood Supply For most of the 20th century, the Canadian Red Cross (CRC) was the agency responsible for collecting, storing, and distributing blood products Its operations were largely admired until the mid-1980s, when more than 1200 Canadians contracted human immunodeficiency virus (HIV) from blood or blood products supplied by the agency This infection can lead to acquired immune deficiency syndrome (AIDS), which is terminal Some blood recipients were infected with hepatitis C, an infection which, if left untreated, can destroy the liver, causing death

5. Canadian Red Cross Many of the problems related to the simplicity of the CRC’s donor-screening procedures. The CRC had inadvertently allowed people who did not know they were infected to continue as donors, thereby infecting the people who received their blood CRC was a registered charitable organization and was therefore subject to restrictions on the amount it could spend on administrative operations, as opposed to helping the needy. Conducting more comprehensive screenings would have drastically increased the CRC’s administrative costs. In addition, the dangers posed by HIV were not fully understood at this time.

6. Canadian Red Cross What was the solution? The CRC was unwilling to continue in the role of blood provider when it became obvious that greater government oversight was to be implemented. A new agency had to be created to take over the CRC’s role in the Canadian blood supply system. Should it be a private, for-profit agency? Should it be an arm of the federal or provincial governments? Or should it be an independent agency, created by, and responsible to, governments?

7. Canadian Red Cross The prospect of a for-profit company controlling such a vital component of the medical system was not seriously pursued, as it was felt to be contrary to the general principles of the Canadian medical system One has to consider, though, whether it is truly unethical for a private company to profit from providing a vital medical product. Pharmaceutical companies, for example, certainly make a profit this way

8. Canadian Blood Services In the end, a new agency, funded by the federal and provincial governments but independent of them, took over the blood supply functions of the CRC September 1, 1998, Canadian Blood Services assumed control of the CRC’s blood assets, including 17 regional transfusion centres, a national laboratory, and a distribution network. Was an independent but government-funded agency the best ethical choice available for assuring a reliable blood supply? Was it a more ethical solution than the other choices available? Discuss