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UK blood donor ban to be lifted.
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nozzferrahhtoo wrote: »Nor, in fairness, are you. Even remotely. You are making claims about the increase in risks here so by all means take your own advice from the first sentence and provide evidence for these claims.
I made no claims about anything? It’s the Professor acknowledged that there was an increased risk which they quantify as “very, very tiny”, which, as I said in my first post when I cited what they Professor was quoted as saying, doesn’t quantify the risk at all -
"And its been determined both here and in the UK that the risk is in fact a lot smaller than we thought it was. Its not absent, but its very, very tiny."nozzferrahhtoo wrote: »IF no cases of the disease have been detected in 20 years, then what exactly is the risk increase of infection from that particular disease by allowing blood transfusions from that source now? Let us "quantify or give anyone an accurate assessment of the risk involved". Give us the actual numbers here.
We’re asking for the same thing here.nozzferrahhtoo wrote: »Further it would be worth checking how this policy was policed in the first place. Was a background check of donors performed to see if they had ever lived in the UK at all? Or did we just have a check box on the application form and took their word for it? I don't know. But if it was the latter then this MUST be factored into the evaluation of the risk increases because we have to assume some people who lived in the UK and wanted to donate blood.... simply claimed they did not live in the UK and donated that blood. Does anyone know the procedures here?
To be honest I question whether the policy was even a good one in the first place, and whether it actually protected us or anyone from anything at all. 4 cases of infection by transfusion WORLDWIDE were detected and none of them in Ireland. And in fact one of those 4 patients remained entirely a-symptomatic and was fine.
As Prof Stephen Field has said the deferrals were introduced as a precautionary measure at a time when there was great uncertainty about the BSE/vCJD outbreak. In other words it was a knee jerk response that was a well intentioned precaution but we have no idea was it actually warranted, beneficial or useful at all. So we are NOW reversing a policy that likely did nothing much, and you are worried about the attendant risk increases which the people int he know have called "infinitesimal".
I’m not the least bit worried as the decision is of no consequence to me whatsoever, I won’t be receiving a transfusion so why would I be worried? Other people will make that decision for themselves too having carried out their own risk assessment pertaining to their particular circumstances which, as I acknowledged in an earlier post - other people are going to be of a different point of view in their particular circumstances, and I’m fine with that. All the rest of the above are factors which you consider relevant, they’re not necessarily the factors I or indeed the Professor or the people formulating the policies regarding donation and transfusion may or may not consider relevant.
The Professor btw didn’t use the same language as you’re using in their risk assessment, which is why I would like to see the data to quantify in figures what the risk actually is, and not just quantifying it with vague terminology like “infinitesimal” or “very, very tiny” and so on.nozzferrahhtoo wrote: »Worse Prof Field said the blood transfused to the four patients who developed vCJD was not leucodepleted which was a measure introduced by the IBTS in 1999 to reduce the risk of transmitting vCJD by blood transfusion. So allowing blood from a UK source now, if that blood is leucodepleted, has NO increase in risk let alone an infinitesimal one?
That’s not what the Professor says though?nozzferrahhtoo wrote: »All that said, doom-saying and scare mongering the risks is not a useful approach given EVERY medical procedure and EVERY change in medical policy comes with risks. The fantastical comparison between those risks and the policy of a hospital to have a patient sign that they understand the risks for legal reasons, is pretty fatuous. The simple fact is patients after a failed surgery tend to be a lot more litigious against a hospital than a hospital is against it's patients. So there is a damn good reason hospitals do not proceed, even under tiny risk factors, without covering themselves against this where they can.
Why would a hospital be litigious against it’s patients unless it was for non-payment following treatment?
I think you may have missed the point of the comparison of perspectives - the risk assessment a patient will carry out is likely to regard different factors to the risk assessment carried out by a hospital.
The risk I was referring to for the hospital was before a procedure, not after, which is why I acknowledged that it’s not unreasonable for a hospital or the consultant to want to cover their own arses to mitigate against the risk of litigation, any more than it’s unreasonable or irrational that a patient would want to cover their own arse to mitigate against the risks of adverse consequences following from any procedure or treatment. I factored in the risk of exposure to sepsis for example which has a higher prevalence among males than females, neglected to factor in risk of exposure to CPE, because I could only base my assessment of all the potential consequences involved on the data I had available to me at the time.
The consultant nor the medical team nor hospital had any reason to assume one of the potential outcomes of my treatment was that I could possibly bring legal proceedings against them for medical negligence. I certainly hadn’t before, and I was completely aware of the fact that they could offer me no guarantees of any outcomes whatsoever. I couldn’t offer them any either. Among the many differences in our risk assessments is that they have rather anxious beancounters and legal eagles on their payroll
Neither of us were willing to take the other at their word, any more than I would take the Professor involved here at their word without asking them for the data so I could make an assessment for myself. What you refer to as “indulging my paranoia” is simply me carrying out a risk assessment, mitigating against known risks, and acknowledging that there are factors which are unknown.
I don’t expect medical staff or hospitals should be held to a lesser standard of care towards their patients than they expect their patients should have towards them. You do apparently, as is of course your right. I don’t expect we’ll come to a mutually agreeable resolution to that conundrum any time soon, but I’m willing to accept that we don’t share the same perspective.nozzferrahhtoo wrote: »In surgery requiring an anaesthesiologist there are already risk factors. First from the surgery where even the most relatively simply procedure can result in injury or death (I only this month had a co-worker die from an appendix removal) and secondly from the anesthetic which itself can cause injury or death. I am all for you having the right to indulge your paranoia by signing waivers to reject blood transfusion treatment during your procedure.
I’m aware of all that? Perhaps you assumed I wasn’t, and on that basis assumed I was looking for your support in exercising my right? Not necessary, but thank you for your concern.nozzferrahhtoo wrote: »I can not say that it makes sense to me personally though to consent to a string of things, all with attendant risk factors, and go to the effort of rejecting what may have been one of the lowest risk factors on the entire list. But what do I know the minds of some people? There are people with "rapture insurance" to insure themselves against the actions of god during the Rapture..... who probably own houses that are not covered against meteor strikes. People who take taxis and buses all the time are sometimes scared to get on planes despite the risk of injury or death being less.
You’re underselling yourself there really to be fair. I happen to know quite a bit about the minds of people, and I know you do too, because I have seen plenty of evidence that you do. I also understand that rather like the consultant in my case who wasn’t as confident in their abilities as I was, you’re experiencing similar issues due to a lack of confidence in your own abilities. I can also understand why something would be unlikely to make sense to you when you aren’t furnished with adequate data on which you could carry out a reasonable assessment.
That’s why I’m unable to carry out a reasonable assessment as to whether or not this latest decision regarding blood donation is good news, because I simply don’t have the data in order to make that assessment. Other people are of a different opinion and the word of the Professor is good enough for them if they ignore the part where the Professor acknowledges that the risk is not absent. Other people again base their evidence for their opinion on cases that pre-date the ban and were the cause of the ban being implemented in the first place, and because I don’t see their point, I’m at fault? Weird flex, but ok.nozzferrahhtoo wrote: »Our species is not good at measuring relative risks, and acting on them in a coherent way in general. They see one maybe two stories in the news paper though and it sticks with them. A plane crash or some unfortunate who got an infection from a blood transfusion. And their paranoia latches onto that SINGLE case and they think "no way am I ever doing that!".
I’m curious as to what you mean by “relative” in that context? By it’s very nature, the word relative implies that there is an acknowledgement that everyone is going to have different criteria upon which they will base any assessment of risk, or risks involved in anything. It’s the very basis of reason, and so far your reasoning for assessing that “our species” is not good at measuring relative risks, is relative. It appears to be entirely based upon whether or not you would make the same decision as someone else makes in any particular circumstances.
A good example of it is your assessment that my decision regarding my my assessment of the risks to me personally of refusing a blood transfusion. I wouldn’t expect it should make any sense to you, and I’m ok with that. I’m assuming you’re ok with it too given your forthright earlier support for me exercising my rights and your willingness to indulge my paranoia. I may be wrong, we’ll see. I don’t foresee the potential consequences as life threatening at least, so there’s that :pac:nozzferrahhtoo wrote: »What patients should expect is that the medical profession has considered the risks of ANY procedure or policy and weighed those risks up against the potentials to save lives and alleviate suffering. If a policy change means we have the resources to treat and save 10,000 more people for example, but will increase complications from 1 patient in 100,000 to 2 patients in 100,000 then the ethics of that policy change should be evaluated before acceptance or rejection.
You appear to be conflating a couple of different perspectives there. Patients can have an input into policy decisions, but they will never be the people with the responsibility to oversee policy decisions. That’s the responsibility of the medical profession and politicians. If reducing the risk of contamination and infection means 10,000 people are inconvenienced in order not to put one persons life at risk, I am of the opinion that is acceptable. The concept isn’t unheard of, rather ten guilty men go free than one innocent man suffer and all that, you’re familiar with Blackstone’s ratio.nozzferrahhtoo wrote: »So by all means lets look at the numbers here. Do you have any? The article states that the policy to date has lost us an estimated 10,000 donors. That is a significant increase in blood sources. So what are the correlative increases in risks EXACTLY here of infection from a disease that has not been detected in anyone in 20 years? Regale us with the figures, because I am with the users who say this is "good news" until the actual figures show me otherwise.
No, I don’t, and it doesn’t appear as though you do either. There is no increase in blood sources, just a figure that 10,000 people are annoyed, arguably because they were perceived to present a risk of contamination. I do understand why they’re annoyed, but allieviating their annoyance should never be a justification for a change in policy regarding their eligibility to donate blood. I have no doubt as I mentioned previously that cost/benefit analyses were done and they had the beancounters working to provide them with figures as to how much would be saved by increasing the potential pool of blood donors vs the potential payout should anyone develop an infection as a direct result of the change in policy, and on that basis I suspect they changed the policy, not simply because of the low risk assessment of contamination and the inconvenience to a relatively small number of ineligible donors expressed as a percentage of all possible donors.nozzferrahhtoo wrote: »Yea but the former tends not to get into newspapers, even if it happens a lot more often. The latter does. And unfortunately the human mind tends to be less impressed by actual statistics of probable outcomes...... than it is by reading a SINGLE case in a news paper and thinking "Oh god I don't want that to happen to me!"
It can be the same with vaccines for example. There are any number of people suffering or dying due to diseases they contract while NOT vaccinated. These do not make interesting stories. ONE single parent convinced their child's autism was caused by a vaccine though? Or ONE single parent who's child actually genuinely did die due to complications of getting the vaccination? Now THATS news.
And people read THAT single news story and decide the best thing for their child is not to be vaccinated at all.
And you can see this in play when the one person complaining about this change in policy is not citing stats, not citing studies, not citing science.... but linking to individual anecdotes (two only, I think so far?) of transfusion gone wrong. Showing absolutely no knowledge or understanding of what the ACTUAL relative risk increase of this change of policy might even be.
Curious as to why you expect anything of me when I haven’t made any claims, but simply refuted the claim made by the OP that this was good news, by simply saying “not necessarily”, and by the Professors own admission the news is to be treated with caution due to the fact that the risk is not absent, but it is apparently “very, very tiny”. If you want stats, studies and science, you’d have every reason to imagine the Professor would quantify their opinion that way, but they didn’t. I’m under no obligation to provide any evidence for someone else’s claims, and to expect that I should is demonstrating an unreasonable double standard on the part of people simply claiming that this is good news without citing any stats, studies, science, etc, etc themselves. Instead, I am being treated to their opinions, and I don’t see why I should be held to a different standard in order to refute their claims, particularly as I have not made any claims one way or the other, but simply suggested it is not necessarily good news, or rather that whether it is good news or not depends entirely upon an individual perspective. I acknowledged that people’s opinions are going to differ, and I’m ok with that.0 -
One eyed Jack wrote: »I made no claims about anything?
Lets not be lying now shall we? Here is your FIRST post on the thread "By permitting more people to donate blood who were previously ineligible, they’ve just increased the risk of contamination in the supply chain for people who are given transfusions.". That was YOUR sentence to which I am referring.
You then followed up with "does not in any way quantify or give anyone an accurate assessment of the risk involved." and I am simply pointing out that when making your posts, you are not doing this either. What's good for the goose and all that.One eyed Jack wrote: »I’m not the least bit worried as the decision is of no consequence to me whatsoever, I won’t be receiving a transfusion so why would I be worried?
I think you know damn well what I meant by that sentence. Again I am referring to YOUR claim about the increases in risks. Nothing to do with your personal worry of your own personal safety.One eyed Jack wrote: »The Professor btw didn’t use the same language as you’re using in their risk assessment
Why would he when talking to the media and, hence, that common lay person to medical science like yourself? He is not likely to talk the same talk in a scientific context as he would talk in a media context. I know I wouldn't. And for good reason.
However which language specifically am I using that you feel he didn't because much of my post was DIRECT quotes from him from a few sources, not just the RTE link that started the thread.
To be honest I think the risk is non-existent and he is just using words like "infinitesimal" to cover himself from talking in absolutes. Which is a good science way to talk. But when there has only been 4 cases of infection WORLDWIDE ever from transfusion, none of them in Ireland, and there has not been a detected case of the disease here or in the UK for nearly 2 decades..... I think it really is just a linguistic pedantry difference between talking in absolutes and not. The risk from my knowledge so far, is zero.One eyed Jack wrote: »Why would a hospital be litigious against it’s patients
WHOOOSH over your head. It would not, that was my entire point of why the comparison you are making in your "perspectives" analogy is a ridiculous one.One eyed Jack wrote: »I don’t expect medical staff or hospitals should be held to a lesser standard of care towards their patients than they expect their patients should have towards them. You do apparently, as is of course your right.
Not what I said at all, so I thank you to keep your words and opinions out of my mouth.One eyed Jack wrote: »I’m aware of all that? Perhaps you assumed I wasn’t
Not at all, quite the opposite in fact as I went on to discuss how I find it ridiculous that any patient who is aware of the risks attended on every step of the entire procedure, would be concerned about a single one near the bottom of the list. But as I said some people read a single news story about someone who was harmed or injured and the human mind latches on to that.One eyed Jack wrote: »I’m curious as to what you mean by “relative” in that context?
As above I am talking about ALL the risks in a procedure. The risks of waking up damaged from an anesthetic, if you wake up at all for example. Or the risks of the procedure itself. Or the risks of infection. And so on and so on. Relative to these risks the risk of a complication related to a blood transfusion is what? It seems to be a negligent risk at best these days.One eyed Jack wrote: »If reducing the risk of contamination and infection means 10,000 people are inconvenienced in order not to put one persons life at risk, I am of the opinion that is acceptable.
Then I can do nothing but be deeply gladdened that you are not on any committee or board that influences medical ethics. Further I think you willfully misrepresent the situation, and my post, by talking about the 10000 people who "are inconvenienced" as neither have anything to do with that. My post was damn clear in fact that I said nothing about people who "are inconvenienced" and I said everything about the fact this is an increase in available blood resources.
I could not care less if people who want to give blood are inconvenienced and personally aggrieved because some policy stops them from donating. I do however care that blood donations are a limited resource and increases in it are good news. And if we increase the supply by 10% and this comes with a miniscule risk of, for example, 1 person in 100,000 or less.... then that is an ethical choice I am glad they made, and you did not.
If we/they thought like you I am not even sure what medical science would get done. Take vacinnes for example. We do those because they save lives. Just like we do blood transfusions because it saves lives. BOTH policies come with risks however. Small ones, very small. But the fact is for all the lives we save with vacinnes for example, vacinnes DO occasional harm.... sometimes permanently..... sometimes even kill...... isolated individuals. Blood Transfusions will too. The ethical concern is always to weigh up the quantity of that potential harm..... against the multitude of benefits. If we were operating on a "Do not put even 1 person at risk" policy we would get nowhere at all.One eyed Jack wrote: »No, I don’t, and it doesn’t appear as though you do either.
Except, you know, all the ones I mentioned in this post and the last. While not complete, I have cited a hell of a lot more figures here than your vague hand waving and scare mongering has achieved.One eyed Jack wrote: »There is no increase in blood sources
How do you know this given the policy has only JUST been changed FFS? Crystal ball again? From one of the articles that came out today "The Irish Blood Transfusion Service estimates that 9,000 donors were lost when the ban was put in place. It hopes that by lifting the ban, the blood supply from donors could increase by up to 10%."One eyed Jack wrote: »I do understand why they’re annoyed, but allieviating their annoyance should never be a justification for a change in policy regarding their eligibility to donate blood.
Great! Then by all means take that up with someone who A) Cared and
Espoused that argument. Since I fall under neither category I suspect you are just playing the old game of post filler here. 0 -
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