Wednesday, April 18, 2007
Did Doctors know best?
The Haemophilia scandal is in the news again today (BBC News) . To my mind as a medical student it is crazy that not only would the NHS not start to scan the imported blood / blood products for the blood borne disease (HIV, Hep C, Hep B) once we were able to in the mid-1980's. The 1980's were also a different ethical era, with patients presuming that the "Doctor knew best" and consent was often seen as an add-on, and informed consent was even rarer. Patients in those days seemed to have just accepted that the anything the 'Doctor' did was in their best interests.
The opening of this 'unofficial' inquiry by the Tainted Blood campaign group (website) will hopefully go someway to establishing the reasons why successive governments did not test the imported blood products, or inform patients that they had been infected for, in some quoted cases, 2 years after the event. I accept that these cases may well be the exception not the norm, and are just used because they make a good new story, but one man's case which was featured on BBC Newsnight (link) showed the perils of this policy. Hew as not informed that he had contracted HIV from infected imported blood products until two years after the diagnosis was noted in his medical note. For those two years he had continued to have unprotected sex with his wife, unaware of the risk to her. She contracted HIV from him. Their children, now in their early twenties, are likely to lose both parents earlier than might be normal, due to the actions of the medical profession in the 1970's & 1980's.
Another worrying fact is that the UK government will not allow a full and public inquiry into this problem - why, what have they to hide? Given the numbers who have died, and the fact that the decisions were made over 20 years ago, when a different government was in power, one can only assume that somewhere along the line there are civil servants who are worried about their decisions being exposed in an inquiry. These people are possibly late on on their careers now, near the top of the tree and maybe even running government departments. There is a second governmental consideration, compensation. If the government is found to be a t fault, the calls for compensation by those infected will grow. However, from the governments point of view, the longer you hold out, the cheaper the compensation bill will be, since a death requires less compensation that a blighted life.
The final thing that worries me is the double standards still applying to UK blood products now. Due to concerns about vCJD transmission through donated blood products is a major worry in the UK, ans thus for all UK donations, the white blood cells are removed to reduce the theorectical risk to patients being transfused. However, for plasma products, we do not use plasma from UK blood donations in case it has the prion protein in it, but we instead buy plasma from the USA. The USA still pays for blood donations - thus often those in desperate need of money will give blood to earn some cash; those in need of money are often IV drug users and prisoners; this was the very pool that gave us the tainted Factor VIII way back in the 1970's and 1980's...........and so the cycle starts over again.