Medical Freedom as it pertains to Blood Donor/ Recipient
Problem: While autologous and directed donor blood donations have been available and utilized for decades in the healthcare system, it has become increasingly difficult to ensure that a blood recipient’s desire to receive “known donor” status blood is actually achieved. Most frequently, this basic patient right is refused at point of service (e.g.: hospital, clinic) despite the following:
1. A patient’s doctor writes the order for the autologous or directed donor donation.
2. Autologous and directed donor blood is legal, safe, and has a long history of prior use.
3. The 14th Amendment of the Constitution (Section 1) provides protection of a person’s life, liberty, and property without due process of law; nor can it deny any person within its jurisdiction equal protection of the laws.
4. The United States Commission on International Religious Freedom protects a person’s right to freedom of thought, conscience, and religion or belief.
5. The Patient Self-Determination Act of 1990 affirms the common-law right of self determination as guaranteed by the 14th Amendment of the United States Constitution. Under the PSDA, the person receiving care has the right to make choices and decisions about the medical care and the extent of medical care that they would or would not want.
Objective: Legislation To Protect and Preserve the Right to Request and Utilize Autologous or Directed (Designated) Donor Blood, and/or Autotransfusion Technology, Thereby Ensuring a Patient’s Civil Rights, and Religious and Medical Freedom is honored.
● Healthcare professionals, hospitals, clinics, and blood donation centers may not deny, prevent, restrict or make difficult a patient’s right to use autologous and/or directed donor blood when a patient specifically wishes, or a patient’s Medical Power of Attorney requests, or when specifically stated in the patient’s living will.
● Autotransfusion is a procedure available in most hospitals and surgical centers. Special equipment collects and filters blood that is lost during surgery which is then reintroduced back into the body. This is considered to be one of the safest means of replacing lost blood, yet its use is often preempted by donated blood (less safe). Therefore, patients (or their medical power of attorney) should be made aware of this technology and given the opportunity to “opt in” as a first line of defense for surgical blood loss before donated blood is used.
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Resources:
14th Amendment of the Constitution (Section 1): All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the State wherein they reside. No State shall make or enforce any law which shall abridge the privileges or immunities of the citizens of the United States; nor shall any State deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.
United States Commission on International Religious Freedom/ Provisions on Freedom of Thought, Conscience and Religion or Belief: Protects a person’s right to freedom of thought, conscience, and religion/belief.
Everyone has the right to freedom of thought, conscience and religion; this right includes freedom to change his religion or belief and freedom, either alone or in community with others and in public or private, to manifest his religion or belief, in worship, teaching, practice and observance.
No one shall be subject to coercion which would impair his freedom to have or to adopt a religion or belief of his choice.
Freedom to manifest one’s religion or beliefs may be subject only to such limitations as are prescribed by law and are necessary to protect public safety, order, health, or morals or the fundamental rights and freedoms of others.
Religious Adherence in Healthcare is Already in Practice:
● Jehovah’s Witnesses refuse blood transfusions in entirety.
● The Amish do not allow heart transplants and in some orders, heart surgery, because they view the heart as ‘the soul of the body.
● Devout Hindus refuse any drugs, implants, skin grafts or medical dressings that contain pig or cow components.
● Devout Muslims (both Sunni and Shiite) do not approve any drugs, medical dressings or implants that contain porcine (pig) ingredients.
Patient Self-Determination Act (PSDA) passed in 1990: affirms the common-law right of self determination as guaranteed by the 14th Amendment of the United States Constitution.
● The person receiving care has the right to make choices and decisions about the medical care and the extent of medical care that they would or would not want.
What the Red Cross Says about Autologous and Directed (Designated) Donor Blood
● Actively discussed on the Red Cross FAQ site: https://www.redcrossblood.org/donateblood/how-to-donate/types-of-blood-donations/autologous-and-directed-donations.html
● Requires a physician’s order which serves as a prescription for this service
What Texas Based Carter Blood Care Says about Autologous and Directed (Designated) Donor Blood
● Autologous donation is available prior to planned surgery or treatment with the written request of a physician (5-30 days prior to need date).
● Directed donation requires an ordering physician’s signature on the request for Directed Donation, and the patient must provide and approve the names of the directed donors.