Is it unethical to lie in order to donate blood?

Question

As a gay man in a committed, stable, monogamous, STD-free relationship, I am ineligible to give blood to any major blood bank unless I lie about my sexual conduct. The wording they ask the question in is very concrete, "[The following disqualifies you from donation] Male to male sexual contact, even once, since 1977". According to many sources, the blood is tested for HIV/AIDS after it has left the body and preventing gay men from donating is, ostensibly, to prevent transmission to HIV. They don't ask if I've had any "risky" sexual behavior (straight or gay), or even if I've tested positive for HIV, both of which would be better questions for reducing risk of HIV entering the blood bank, and neither would discriminate against a legal, healthy set of behaviors that I consider part of the core of my sense of being.

I used to give blood regularly because I think it's an easy way to do a lot of good, but since I started having normal, healthy relationships with HIV-negative men my age, I have had to stop completely. I have been tested regularly (every year at the doctor) and have no doubt in my mind that I am HIV-negative. Ultimately, I know it doesn't matter, one pint of blood will not tip the scales in either direction. But on principle, I would like to participate in my work place's blood drive and since I have no particular qualms about lying to a lab tech, can I just gloss over the fact that I and everyone knows to be an antiquated holdover?

Answer 1

There's several strong assumptions going on that might either clarify or change your thought if you bring them directly in.

What I read in what you've got there is this:

Argument 1 - Policy

1. I have sufficient expertise to know the risks involved X.
2. X is not risky
3. X is prohibited by policy
4. Therefore the policy against X is unsound

Argument 2 - Personal Action

1. Policy X is unsound
2. The result of action in violation of X would be beneficial to society on a small scale [it is of relative moral value and positive]
3. Committing action in violation of X would require lying.
4. Truth-telling is of relative moral value.
5. lying is of relative negative moral value. (as contraposition of 4)
6. The value of truth-telling is greater / equal / less than the value of the blood-giving [**still needs to be clarified but I think you are saying less]

It seems like if you have utter confidence in your expertise to comment on this policy, that the only questions remaining are:

(1) Are you correct in asserting your action in contravention of policy X poses no risk? [i.e., is your policy expertise sufficient to contravene existing policy?]

(2) is lying something of relative negative moral value or absolutely wrong?

(3) if it is not absolutely wrong, is its wrongness outweighed by the rightness of blood-giving?

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Analogous Policy Questions

Your answer to question (1) generates a component of moral hazard that compounds the degree to which the lying might be wrong. And it makes you wholly responsible for your choice in a way that people are not when they act in accordance with flawed policies.

To flush that out, if a country sets a speed limit too low and your speeding kills someone, that's different in terms of guilt than if the country has set it too high and you're going a legal speed kills someone. In the latter cases, your driving at that speed is licensed by the government and while you can still be complicit for killing someone, it may be a fault of the policy rather than your judgment (it could still be the fault of your judgment despite the policy). In the former cases, it's all on you. Speeding transfers society's burden of responsibility onto you. You can also consider this with drunk driving.

Similarly, giving blood against the policy transfers responsibility for the consequences onto you. Now, depending on the moral theory you subscribe to, this can refer either to the realized consequences or to the potential consequences from the perspective of sound policy. In other words, on some theories, you are acting deeply immorally if you speed / drive drunk / give blood against policy even if no negative thing actually happens. On other theories, only if something bad happens have you done wrong. This is called moral hazard, and it represents a pretty substantial problem.

After that, it boils down to the lying question and whether that's sufficiently wrong to block other behaviors

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n.b., I'm not competent to speak to this policy's validity. I'm just sketching out where I see philosophical issues that matter to the problem.

Answer 2

I would say that answer is "no" by nearly any moral stance. Indeed, transfusion seems to merge utilitarian, Kantian, and Habbermasian ethics.

Blood transfusion is a form of communication that demands the utmost transparency if it is to be possible and beneficial. Not that that can ever be perfect. If you could communicate directly to the recipient, then they could decide.

But, as in so many cases in the "public representation," a broad statistical filter is necessary. You are well within your rights to contest the wording or to donate at locations with different standards (and I believe there are such clinics). But to simply ignore the standard is to betray those it presumably represents.

Our society is mediated at all levels by "expert representation" that may be frustratingly wrong in specific instances and subject to public challenge. But while the drift towards "self-exception" may be natural, unless it is transparently expressed as dissent, I don't see that it can be moral by either consequentialist or deontic standards.

Answer 3

It depends on your moral theory. (Answer edited following virmaior's comments).

Some consequentalists, such as utilitarians, would probably say that you must donate blood because it maximalizes hapiness (taking for granted that your lie will harm noone in these circumstances, while your blood will produce hapiness). However other consequentialists might take different criteria as desirable consequences.

Some deontologist would say you must not lie. Kant famously argued that you should not even lie to a murderer to protect the life of innocent relatives, but this extreme claim is rarely accepted even by deontologists, so it might depend on which kind of deontologist you are. Some deontologists do not assert that you ought not to lie.

A virtue ethicist would tell you to weigh the sort of character that lying develops in you against the sort of character that giving blood under those circumstances develops in you. If you think that lying to donate blood in these circumstances makes you a better person, then you should do it.

Answer 4

From straightforward utility, I would say it is not the best thing one can do to ignore bad policy. The problem is that the bad policy itself creates assumptions in those down the line.

Here is a crazy example: The fact that certain drugs are illegal, allows the superficial assumption for ER attendants that they are or are not germane to various cases. I have been 'dropped' by vengeful hippies (common, oxymoron aside) and had a seizure due to heat stroke while on LSD. (I would not have planned to be stuck out in the sun on anything that affects serotonin directly, had I known it was going to happen.) The staff went very far down a path assuming it was alcohol poisoning, before they actually tested my blood for alcohol. This did me no harm, but could have saved the life of someone with alcohol poisoning rather than heat stroke and a separate reason for unresponsive pupils and delusional interpretations.

The fact that the policy both does not prevent the problem, and that it is in itself a questionable idea, still makes the actions of others more effective. The existence of the policy affects when they stop moving forward, and question themselves. It allows better response to the more general case.

The right thing to do about those kinds of policies is to put pressure on them to be changed, as this allows all the assumptions around them to be addressed as well. I know my own HIV status, but complete revocation of the policy would allow for other people to more readily cause damage, out of carelessness. The strong assumption that one does not need to test blood products very often means that if someone carelessly did give infected blood, more damage would result from the assumptions the policy itself creates, than if everyone were aware of the options.

People in dense enough areas can arrange for blood to be taken from folks without this screening, and sent to places where the HIV rate is already quite high, and where blood is needed anyway, such as central Africa. This is not very efficient, to some degree, it is outright silly, but the quantity of blood collected can be shown to the American Red Cross in attempts to directly affect the policy. Here is an example: http://www.gayblooddrive.com/

Answer 5

I am of the opinion that the policy, as it stands, is correct. The reason is that as worded, it is more "strict/exclusive" than asking if you had "risky" sexual behavior or if you have tested positive for HIV. Since the definition of "risky" is open to interpretation, what one considers NOT risky, may actually be. Also, not testing positive, does NOT mean that you are not currently carrying the HIV virus. By being so strict (not discriminatory), the chance of contaminating the blood banks is as close to zero as possible.
The only exception to the policy would be if a "severe" shortage of blood develops such that some persons would die if they don't get a blood transfusion. In this case, the risk of receiving blood that might be contaminated with HIV, would be acceptable.

Answer 6

Seems that you are weighing your own needs in to prove your moral standing with the needs of the people that the blood bank serve. I will not comment on whether that is selfish or not. The things is though this blood is used on people that are incapacitated and very close to death. They generally do not have the choice to receive this blood is given to them on the cusp of death.

So you it may very easily be prejudice but the better question would be is it unfair prejudice? Something which I would contend it is not. They simply cannot take any chance on this blood harming any person. Especially when the disease that they may contract in such a way leads to such a slow and painful death as what is the case with HIV/AIDS

Answer 7

Let's assume that you donate blood, which will then mixed with blood of other people, and then someone finds out what happened.

Now what should happen and what would happen if everyone involved behaved in a reasonable way is irrelevant, what's relevant is what happens. And what might happen is that someone decides to destroy a whole lot of donated blood because of your action.

That would be a bloody shame, but it would mean that you made a hugely negative contribution.

(If you can 100% guarantee that your lie will not be found out, and if you can 100% guarantee that your blood is no more risky than anyone else's blood, that's a totally different matter).

Answer 8

Interesting question. As usual, we can start developing our answer by examining the underlying premises.

(1) Helping people is morally good; (2) Donating blood helps people

As well as (3) Lying is morally bad

That seems like a good starting point, right? Our question seems to boil down to whether the "Good" of premises 1 & 2 outweighs the "Bad" of premise 3, correct?

Intuitively, a lot of philosophers will default on the fact that the goodness of the former is complicated by more contingency. Just look at it! It relies on TWO premises! The latter must be greater, as it alone is "absolute" in some sense here. That leads to the conclusion that you should NOT give blood. The reasoning is simple: Lying is bad. Period.

Unfortunately, the answer is seldom that simple. Many of the most sophisticated contemporary thinkers, especially when discussing public health, default on strictly utilitarian thought. To these thinkers, whatever is in the greatest interest of the greatest number of people is invariably the morally correct action. One would necessarily have to lie, cheat, steal, or violate the arbitrary (and as you noted, obsolete) laws of an amoral or immoral authority to serve that greater good. Here the answer would be a resounding one in favor of donation.

These are only two of the many arguments regarding the topic however. Many more abound and the ethical dilemmas facing any would-be blood benefactor are innumerable. Good luck.