COMMENTARY

The FDA Is Right to Let Gay Men Give Blood, Says Ethicist

Arthur L. Caplan, PhD

Disclosures

February 04, 2016

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I am Art Caplan with the Division of Medical Ethics at New York University Langone Medical Center.

It has been a long time coming, but the US Food and Drug Administration (FDA) has finally overturned a ban that it had in place, saying gay men who have ever had sex since 1976—even once—cannot be blood donors.[1] I have been tracking this issue for a long time. Way back in 2000, I was chair of the Advisory Committee on Blood Safety and Availability, the policy group that basically advises the federal government on issues pertaining to blood donation and blood distribution. At that time, we thought testing was good enough to get rid of the FDA prohibition.

There is a window if somebody gets HIV where they do not have enough virus in their blood for it to be detected. That is probably about 3 months, not a lifetime. So, I thought at the time, we'll get this ban overturned, and it's important to do so.

Why? Because blood donation is dropping. The Greatest Generation—the World War II generation—were the biggest donors. They are just not being replaced.

One thing that doctors need to do is encourage blood donation at church, civic meetings, and out in the community. We are dangerously short many days of the year of just not having enough blood to give to people for surgeries, cancer treatments, and the many things that we use blood for in the healthcare system, so we need a new source of donors.

There are many people in the gay community willing to try to pitch in, and yet they were banned. Well, finally, after arguing and trying to overcome what I think were somewhat homophobic fears about gay people coming into the blood supply that made no scientific sense, in December the FDA overturned the ban. This reversal is sound policy. We need the donors. The testing that we have in place is very, very good.

Some people are still critical, saying, "Well, the FDA still says, 'Be celibate for a year. If you're going to be a donor, you shouldn't have sex with another man for at least a year prior to donating.'" That obviously ignores the reality of safe sex as opposed to risky sex. And you could issue the same warning about heterosexual men who have multiple partners, who visit prostitutes, or who engage in dangerous sexual behavior themselves.

All right, I grant that. Those are problems. However, getting the ban moved is really an important policy shift. It lets the United States join other countries—such as Australia, Canada, France, and almost every other country in the developed world—in saying, "We're going to use this source of blood, because the biggest challenge we face is not who is donating but whether anybody is donating."

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