An Urgent Call For Donations
By Arthur Caplan, Ph.D.

Dr. Caplan is the chair of the Health and Human Services Advisory Committee on Blood Safety and Availability and is the director of the Center for Bioethics at the University of Pennsylvania. This column was originally posted on the Microsoft NBC web site in late July.

Every summer, especially around the Fourth of July and Labor Day, blood collection centers all around the nation begin to warn that they are facing a shortage of blood donors. The same thing happens at Christmas and other major holidays. The warnings about shortages are so familiar that they have lost their urgency. But the talk of shortages is not something any American should ignore.

RECENTLY, the Department of Health and Human Services, Advisory Committee on Blood Safety and Availability, which I chair, held a hearing in Washington on the blood supply. We were shocked to learn that not only do Americans face spot shortages in blood when regular volunteers are on vacation or on holiday trips but the shortage is growing worse.

The number of people who donate blood has fallen steadily for the past five years; at the same time that the demand for blood has grown annually. If these trends continue, in a year or two there will be not only spot shortages in blood but year-round, chronic shortages.

The health-care system cannot function without whole blood. Blood is to heath-care what oil is to transportation. When there is not enough of it the whole system grinds to a halt. Without an adequate supply of blood, surgeons cannot perform transplants and joint replacements, birth moms are at high risk if they need a Caesarean section, and those getting many forms of cancer treatment or treatment for severe injuries risk death.

Why is the shortage of blood growing worse? No one seems sure but a number of factors seem to be involved:

• Americans do not understand how vital blood is to their health.
• Younger Americans are not as strongly motivated to donate as their parents and grandparents, some of whom got in the habit of donating during wars.
• Some Americans are worried that they might contract a disease by donating blood; a fear that is simply unfounded.
• Some donors are turned off by the screening questions that are asked to ensure a safe supply of whole blood.
• A few donors find it more attractive to sell their blood at plasma centers rather than donating whole blood for free.
• Some of the steps taken to ensure a safe blood supply have resulted in some people being excluded as potential donors who might be perfectly well-suited to the task.
• And there seems to be a societal decline in the sense of community that is essential to motivate people to do the right thing and help their neighbor by donating.

We need to act now to avoid a crisis in the supply of blood. We need to push groups like America's Blood Centers and the Red Cross to seek ways to encourage more donors. The Federal government needs to ensure that blood donors are properly recognized and that the donation process is as hassle-free as possible. We need to make sure that in the pursuit of safety we do not wind up adopting policies that put us all at risk by making it too hard to collect an adequate supply of whole blood. And we need to push research harder to find blood substitutes and adjuncts to help increase the supply.

Most of us presume that if we need blood it will be there for us. That presumption may soon not be true. But we can act now to make sure that the gap between supply and demand is closed so that no one dies for want of blood.