a Sanquin Blood Supply Foundation and Wageningen University and Research Center.
b Sanquin Blood Supply Foundation.
Am J Bioeth. 2017 Mar;17(3):32-43. doi: 10.1080/15265161.2016.1276643.
Tolerance for blood transfusion risks is very low, as evidenced by the implementation of expensive blood tests and the rejection of gay men as blood donors. Is this low risk tolerance supported by the precautionary principle, as defenders of such policies claim? We discuss three constraints on applying (any version of) the precautionary principle and show that respecting these implies tolerating certain risks. Consistency means that the precautionary principle cannot prescribe precautions that it must simultaneously forbid taking, considering the harms they might cause. Avoiding counterproductivity requires rejecting precautions that cause more harm than they prevent. Proportionality forbids taking precautions that are more harmful than adequate alternatives. When applying these constraints, we argue, attention should not be restricted to harms that are human caused or that affect human health or the environment. Tolerating transfusion risks can be justified if available precautions have serious side effects, such as high social or economic costs.
对输血风险的容忍度非常低,这一点可以从昂贵的血液检测的实施以及拒绝男同性恋者献血这一事实中得到证明。这种低风险容忍度是否得到了预防原则的支持,就像这些政策的捍卫者所声称的那样?我们讨论了应用(任何版本的)预防原则的三个限制,并表明尊重这些限制意味着容忍某些风险。一致性意味着,预防原则不能规定它必须同时禁止采取的预防措施,因为这些措施可能会造成伤害。避免适得其反意味着拒绝那些造成的危害大于预防效果的预防措施。相称性禁止采取比适当替代措施更具危害性的预防措施。我们认为,在应用这些限制时,不应仅限于人类造成的或影响人类健康或环境的危害。如果可采取的预防措施有严重的副作用,如高昂的社会或经济成本,那么容忍输血风险是可以被证明是合理的。