Deferral Policy Research Articles

The effects and benefits of a latent print AFIS deferral policy

Forensic laboratories in the United States had an estimated backlog of 570,100 requests for all forensic services at the end of 2014. Latent print requests represented approximately 12% of that total backlog [1, NIJ 2019]. With ever-increasing demands and backlogs, a review of laboratory or section practices becomes vital to operations. Work process and business practice changes can increase efficiencies and result in the reduction of casework backlogs and turnaround times. The automated fingerprint identification system (AFIS) deferral policy implemented by the Latent Print Comparative Section (LPCS) of the Phoenix Police Department Laboratory Services Bureau (PPD LSB) was employed to address the latent print backlog. Five years of multiple AFIS request types were analyzed to demonstrate the positive effects and benefits of such policies, including a 26.32% decrease in turnaround time over the data collection and analysis period and a 90.96% reduction in backlogged requests for one year.

Blood, it’s in you to give, just don’t be an African: the Canadian blood system and the African Indefinite Deferral Policy, 1997 to 2018

ABSTRACT The Canadian health care system has been the site of a tense relationship between blood donation policies and African Canadians (read as Blacks). This article explores the basis of that strain, specifically the Canadian blood system’s African Indefinite Deferral Policy and its relative underpinnings to, for example, the Creutzfeldt Jakob Disease Deferral Policy. Drawing from various data sources, the article demonstrates the subtle and diffuse aspects of the deferral policies in terms of the relationship between ethnicity and risk. The analysis provides important insights on the policies, based on the pejorative usage of ethnicity, especially its racial context, and related power dynamics, into understanding the lasting and plagued relationship that Blacks have had with the blood donation regime. Addressing questions around the institutional capacity of Canadian Blood Services and Héma Québec in dealing with minority ethnic groups is essential, particularly if the objective of blood donation policies is to address the health needs of Canada’s increasingly diverse population.

An integrated optimization model for planning supply chains' resilience and business continuity under interrelated disruptions: a case study

PurposeThe adverse interactions between disruptions can increase the supply chain's vulnerability. Accordingly, establishing supply chain resilience to deal with disruptions and employing business continuity planning to preserve risk management achievements is of considerable importance. The aforementioned idea is discussed in this study.Design/methodology/approachThis study proposes a multi-objective optimization model for employing business continuity management and organizational resilience in a supply chain for responding to multiple interrelated disruptions. The improved augmented e-constraint and the scenario-based robust optimization methods are adopted for multi-objective programming and dealing with uncertainty, respectively. A case study of the automotive battery manufacturing industry is also considered to ensure real-world conformity of the model.FindingsThe results indicate that interactions between disruptions remarkably increase the supply chain's vulnerability. Choosing a higher fortification level for the supply chain and foreign suppliers reduces disruption impacts on resources and improves the supply chain's resilience and business continuity. Facilities dispersion, fortification of facilities, lateral transshipment, order deferral policy, dynamic capacity planning and direct transportation of products to markets are the most efficient resilience strategies in the under-study industry.Originality/valueApplying resource allocation planning and portfolio selection to adopt preventive and reactive resilience strategies simultaneously to manage multiple interrelated disruptions in a real-world automotive battery manufacturing industry, maintaining the long-term achievements of supply chain resilience using business continuity management and dynamic capacity planning are the main contributions of the presented paper.

Management of Worker Protection Regarding the Cancellation of the Decision of the Governor of Jakarta in Postponing the Implementation of the Minimum Wage

The purpose of this research is to find out the legal protection for the minimum wage deferral policy. And want to know the cancellation of the decision of the governor of Jakarta on the implementation of the minimum wage. This research method uses normative law. Methods of data collection are observation, interviews with the district court judges and prosecutors involved, documentation studies through existing archives on worker protection laws and official records, and supporting books that focus on labor protection. Decree of the Minister of Manpower and Transmigration No. Kep.231/MEN/2003 concerning Suspension of Implementation of the Minimum Wage. In the Jakarta Administrative Court decision Number 62/G/2021/Ptun.Jkt and Appeal Decision No. 10/B/2014/PT.Tun.Jkt, regarding the setting for the deferral of the minimum wage, needs to be reviewed, also regarding the deadline for the completeness of the files in submitting a deferral of the minimum wage. Agreements between employers and labor unions as a prerequisite for employers to carry out are contrary to law. Unions as legal subjects can sue Ptun. Legal settlement of the cancellation of the suspension of the minimum wage, can provide legal certainty for workers, and cause consequences in the settlement through a process at the Industrial Relations Court. Companies that have been declared void of their decision to suspend wages have not carried out their obligations to pay the minimum wage by the provisions.

Willingness and eligibility to donate blood under 12-month and 3-month deferral policies among gay, bisexual, and other men who have sex with men in Ontario, Canada.

In Canada, gay, bisexual and other men who have sex with men (GBMSM) are a population that are willing to donate blood, if eligible, but have a history of ineligibility and deferrals due to concerns that their blood poses an increased risk of HIV entering the blood supply. Our objective was to examine the proportion of GBMSM who are willing and eligible to donate under the 12-month deferral policy (implemented in 2016) and the 3-month deferral policy (implemented in 2019). Data for this study comes from the #iCruise study, a mixed cohort study designed to examine sexual health outreach experiences through online services and mobile apps among GBMSM in Ontario. A total of 910 participants were recruited between July 2017 and January 2018. Eligibility criteria include identify as male (cisgender or transgender); at least 14 years old; having had sex with a man in the previous year or identifying as sexually/romantically attracted to other men or identifying as gay, bisexual, queer or two-spirit; and living or working in Ontario or having visited Ontario four or more times in the past year. Participants completed a baseline and a follow-up questionnaire. A subset of #iCruise participants (n = 447) further completed this questionnaire. Willingness and eligibility to donate blood were assessed under 12-month and 3-month deferral policies. Of the 447 GBMSM surveyed, 309 (69.1%) reported a general interest in donating blood. 109 (24.4%) GBMSM were willing, 75 (16.7%) were eligible, and 24 (5.4%) were both willing and eligible to donate blood under the 12-month deferral policy. Under the 3-month deferral policy, willingness and eligibility to donate blood increased significantly to 42.3% and 29.3%, respectively. The percent of GBMSM who were both willing and eligible to donate blood also increased significantly to 12.3% under the 3-month deferral policy. The increase in willingness to donate blood varied by age, ethnicity, and geographic residence of participants whereas the increase in eligibility to donate blood varied by education level of participants. Under the 3-month deferral policy, GBMSM who were 50 years or older, identified as bisexual or other, had a lower education level, and who were not 'out' to others were more likely to be eligible to donate. GBMSM who reported a general interest in donating blood were more likely to be willing to donate blood under both deferral policies. The most common reason for not being interested in donating blood was the MSM deferral policy itself; many participants interpreted the policy as discriminatory for 'singling out' GBMSM or self-assed themselves as ineligible. Among study participants, both willingness and eligibility to donate blood was significantly higher under the 3-month deferral policy. The results suggest that a time-based reduction to a 3-month deferral policy is impactful but limited. Future research should measure GBMSM's willingness and eligibility under the individual risk-based assessment (to be implemented in 2022).

An individualised approach towards student retention: students at the centre of university deferral and leave-taking policy

An individualised approach towards student retention: students at the centre of university deferral and leave-taking policy

10.33271/ebdut/79.048

Methods. The article uses the following methods and tools of scientific research: generalization, induction and deduction – in order to determine the importance of the use of marketing methods of promotion in the consumer and industrial markets by priority; description and generalization – during the characterization of the architecture of the global brand of lubricants Mobil brand and the description of the logos of the parent brand, master brand, sub-brands and service brand; statistical analysis, index method – during the analysis of the marketing strategic activity of «MasloTrade» LLC in the market of fuels and lubricants of Ukraine, establishing the dynamics of sales volumes of Mobil products by segments of application of lubricants during 2017–2021; method of expert assessments (IFAS analysis) – during the analysis of the internal environment, formulation and assessment of strength and weakness factors; competitive analysis, comparison – during the assessment of the competitive position of lubricants suppliers in the second half of 2021; theory of international marketing, consumer behavior and competition. Results. The importance of the use of marketing methods of promotion in the consumer and industrial markets by priority has been determined. The marketing strategic activity of «MasloTrade» LLC in the market of fuels and lubricants of Ukraine is analyzed. The architecture of the Mobil global brand of lubricants is characterized; the logos of the parent brand, master brand, sub-brands and service brand are described. The prices for fuels and lubricants of different brands in the Ukrainian market in the second half of 2021 were compared, as well as and the properties of lubricant brands. Novelty. Based on the results of the analysis of the internal environment, strength and weakness factors were formulated and evaluated using IFAS-analysis. The competitive position of lubricants suppliers in the second half of 2021 was assessed. Practical value. The analysis allows «MasloTrade» LLC to improve its marketing activities in the international and Ukrainian market of fuels and lubricants, which is manifested in the price, communication components of the Mobil brand promotion, continuation of the debit deferral policy, which helps to support its partners in doing business and promotes its development. Methodological components of the analysis of the internal environment of the company, competitive analysis can be used in the marketing activities of other enterprises.

Blood donation behaviour and attitudes towards the 12-month deferral policy among gay and bisexual men in New Zealand.

Gay and bisexual men (GBM) are deferred from donating blood in many countries. Perceptions by GBM that blood donor deferral policies are unjustifiably discriminatory, especially due to advances in HIV prevention, could contribute to non-compliance and need to be understood. We explore blood donation interest and history among GBM and attitudes towards donor deferral policies for the first time in New Zealand (NZ). Data from a cross-sectional online survey of GBM in NZ were examined. We constructed three groups: (1) never donated blood and not interested; (2) never donated but expressed interest; and (3) previously donated blood. We tested these for association with demographic and behavioural variables, as well as attitudes towards blood donation policy. A total of 607 GBM were eligible for the study, of whom 32.9% reported having donated blood previously, 44.3% had never donated blood but expressed interest and 22.7% expressed no interest in donating. Among previous donors, a third (8.6% of the total sample) reported non-compliance with the deferral policy. Most participants found the 12-month deferral policy to be too strict (81.8%), unfair (75.4%) and homophobic (68.8%). We estimate that, for the first time in NZ, almost 10% of the sample did not report compliance with the 12-month deferral policy for men who have sex with men (MSM). Negative attitudes towards the deferral policy were common and could potentially increase the risk to the blood supply if compliance reduces. Further work is needed to inform a deferral policy that is accepted by GBM while maintaining the safety of NZ's blood supply.

Actions and Attitudes of Men who Have Sex With Men Under Past, Current, and Hypothetical Future Blood Donation Deferral Policies.

Eligibility criteria for blood product donation are important for the safety of the blood supply, though many have called into question criteria that limit donations for men-who-have-sex-with-men (MSM). Recently, in the U.S.A., the Food and Drug Administration (FDA), decreased the 'deferral' period, the period in which one must abstain from sex, for MSM, from twelve months to three. This study examined the proportion of MSM respondents that donated blood under past and current deferral policies, as well as the proportion that would consider donating under hypothetical shorter deferral policies. To achieve this, an electronic survey was disseminated on social media platforms via virtual flier calling for participation from a self-selected convenience sample of the MSM community. Compared to either the 12-month or 3-month deferral policies, intent to donate blood was significantly higher in both alternative two week or no deferral policy scenarios. The majority of respondents who did donate did so without following deferral guidelines under both the 12-month and 3-month policies. There was no significant change in the proportion of those who donated against guidelines between the twelve- and three-month deferrals. While social media is an effective tool for survey work it poses significant risk for selection bias. Further studies with diverse sampling are necessary to better elucidate blood production donation trends within the MSM community.

Factors associated with first-time and repeat blood donation: Adverse reactions and effects on donor behavior.

Blood centers have a dual mission to protect donors and patients; donor safety is paramount to maintaining an adequate blood supply. Elucidating donor factors associated with adverse reactions (AR) is critical to this mission. A retrospective cohort analysis of whole blood donors from 2003 to 2020 was conducted at a single blood center in northern California. Adjusted odds ratios (AORs) with 95% CIs for ARs were estimated via multivariable logistic regression on demographics, donation history, and physical examination data. Where appropriate, Wilcoxon-Rank Sum and chi-squared tests were used to determine significance. First-time blood donors (FTD) exhibited a higher AR rate than repeat donors (4.4% vs. 1.9% p< .0001). When compared with FTDs without AR, FTDs with ARs (FT-AR) were less likely to return (30.0% vs. 47.3%, p< .0001), and, of those who returned, had a higher rate of reaction 20.2% versus 2.8% (p< .001). Factors found to be associated with FT-AR (younger age, increased heart rate, and higher diastolic blood pressure) still correlated positively with AR on return donation, but to a lower degree. FTD who potentially witnessed an AR had a lower return rate (44.6% vs. 47.3%, p= <.001) and donated fewer units (2.38 vs. 3.37, p< .001) when compared to FTD who did not witness an AR. The AR on FTD increases the AR likelihood of return donation. Longitudinal analysis shows that a time-based deferral policy targeted at FT-AR young donors can reduce the number of ARs while not dramatically impacting the blood supply.

A mixed methods investigation of the relationship between blood donor policy, interest in donation, and willingness to donate among gay, bisexual, and other men who have sex with men in Ontario, Canada

BackgroundAs of 2019, men who have sex with men (MSM) in Canada are ineligible to donate blood if they have had oral or anal sex with another man in the last 3 months. Deferral policies targeting MSM are largely interpreted as unjust by gay, bisexual, and other men who have sex with men (GBMSM) – shaping their desire to donate blood and engage with blood operators. This mixed methods study explores interest in blood donation among GBMSM as well as willingness (and eligibility) to donate under four different deferral policies.MethodsWe surveyed 447 GBMSM who were recruited from the Ontario-wide #iCruise study. Participants were asked whether they were interested in blood donation and if they were willing to donate under each of our four deferral policies. We also completed interviews with 31 of these GBMSM. Participants were asked to describe their feelings about blood donation, their views on our different deferral policies, the impact of a policy change, as well as other means of redress.ResultsMost participants (69%) indicated that they were interested in donating blood. Despite this, an interpretation of the MSM deferral policy as discriminatory was common among all participants. Our mixed methods findings indicate that, among those who were interested in blood donation, the adoption of one of the alternative policies presented in this study (specifically Policy 2 or Policy 3) would significantly increase the number of participants willing to donate and be viewed as “a step in the right direction.” However, many participants who were not interested in blood donation argued that a gender-neutral deferral policy would need to be implemented for them to donate. Participants recommended that blood operators consider efforts to repair relations with GBMSM beyond policy change, including pop-up clinics in predominantly queer areas and diversity sensitivity training for staff.ConclusionWe argue that the most impactful policy shift would be the implementation of an individual risk-based deferral policy that is applied to all donors regardless of sexual orientation or gender identity. However, given MSM’s historical exclusion from blood donations, blood operators should pair this policy shift with community relationship-building efforts.

Blood donor eligibility criteria for medical conditions: A BEST collaborative study.

Donor eligibility questions and criteria for medical conditions vary between blood centres, suggesting that they are based more on local regulations or experience, rather than on published data, which are limited. As the donor population ages, medical conditions become more common. We assessed donor health assessment criteria at blood centre members of the Biomedical Excellence for Safer Transfusion (BEST) Collaborative. Our aim was to compare eligibility criteria and determine their underlying basis. A REDCap survey was sent to blood centre participants, based on medical conditions of greatest interest suggested by the Donor Studies Team of the BEST Collaborative. Participants were asked about current donor health assessment questions, deferral criteria and the basis for their deferral policy (donor risk, recipient risk or both) for 20 medical conditions. Complete responses were received from 26 blood donor centres (24 separate responses) representing a combination of hospital-based centres, large regional centres and community/national blood centres in 14 different countries. Most centres specifically ask about heart and lung conditions, whereas fewer than half inquire about kidney, gastrointestinal or neurological conditions. North American blood centres tended to be less restrictive, while regulatory restrictions are more prevalent in Europe. Most participants felt that the criteria were based on regulatory requirements or experience, rather than on published data. There is considerable variability in criteria by region. Ideally, criteria would be more evidence-based rather than based on regulatory requirements or experience. Deferral criteria must balance donor and recipient safety and maintain an adequate blood supply.

Impact of COVID-19 on blood donor deferral patterns during the COVID-19 pandemic: A retrospective analysis.

Blood donor deferral is an essential tool for blood safety. The ongoing COVID-19 pandemic has adversely affected blood transfusion services all over the world. But its impact on donor deferral rate and the pattern is unclear in light of the new donor deferral policy due to the COVID-19 pandemic. This retrospective study was divided into pre-COVID and COVID (15 March 2019-14 March 2021). All the deferred donors were divided into six different categories: (1) medical causes, (2) surgical causes, (3) drugs and vaccination, (4) risk of transfusion-transmitted diseases, (5) miscellaneous causes and (6) flu-like symptoms. In addition, COVID-related deferrals were also incorporated. All these above categories along with the donor demography were analysed by SPSS software version 25. The donor deferral rate was 17.03% and 12.74% during the pre-COVID and COVID periods, respectively. During the pre-COVID period, Category 3 deferrals and during COVID period, Category 6 deferrals were significantly higher. A reversal in pattern with increased blood pressure (40.2% vs. 24.04%) over-riding low haemoglobin (34.77% vs. 55.5%) was noted in the Category 1 deferral during the COVID period. Category 1 deferral was more in middle-aged adults as compared to young and old adults (p< 0.05). Among middle-aged adults, deferral due to flu-like symptoms was also significantly more during the COVID period (p< 0.05). COVID-19 significantly affected the donor pool and changed the pattern of donor deferral. Understanding donor deferral patterns may help in identifying targeted donor populations and planning donor recruitment strategies in future pandemic crises.

The socialization of tax deferral and MSME resilience strategies during the COVID-19 pandemic

Several support programs have been issued by the Indonesian government to tackle the COVID-19 effects. These efforts were also geared towards overcoming the current economic problems, while sustaining public purchasing power. A typical instance includes the MSMEs tax deferral policy. Therefore, the purpose of this study is to provide a detailed information on the MSMEs tax deferral initiative by the Indonesian government during the COVID-19 pandemic. This activity was conducted online using Zoom, with the attendance of numerous business owners in Karawang regency. The form of these tax incentives encompassed income tax (PPh) Article 21 (DTP), final income tax, final PPh in certain labor-intensive sectors, exemption of income tax Article 22 on Import, reduction of income tax Article 25 installments and preliminary return of VAT (value-added tax). Based on this research, the public were well-informed on the MSMEs tax deferral provision, and were therefore encouraged to explore the inherent opportunities.

Inside debt and shadow banking

This study examines the effect of inside debt arising from CEO compensation deferral policies on shadow banking. We construct a parsimonious model that shows that increased bank inside debt leads to increased shadow banking. Using a CEO compensation deferral policy imposed on the Chinese banking industry in 2010, we empirically test our theoretical prediction on the effect of inside debt on shadow banking proxied by non-principal-guaranteed wealth management products. We find that banks that adopt the CEO compensation deferral policy exhibit higher levels of shadow banking than their counterparts and that this result is not contingent on bank size or the extent of government control. Moreover, the effect of inside debt on shadow banking is stronger in banks with higher loan-to-deposit and non-performing-loan ratios and in banks with CEO turnover, suggesting that the compensation deferral policy induces CEOs, especially newly appointed CEOs, to do more shadow banking to circumvent regulations regarding the balance-sheet risk and to boost performance.

Science in action? A critical view of UK blood donation deferral policy and men who have sex with men.

The rules that govern blood donation vary globally. Some potential blood donors are ineligible for immediate blood donation, and as such are deferred until such time that they become eligible. This practice, the blood donation deferral period, is intended to reduce the risk of blood-borne infections being transfused into a blood product-recipient. As blood screening technologies improve, the risk of an infected blood product remaining undetected decreases-and so too have the deferral periods for certain donors. Much has been made of the importance of an evidence-based, scientific approach to protecting blood product-recipients. However, these deferrals are controversial. What exactly determines the blood donation deferral period? This article argues that blood donation deferral periods are not merely the result of enacting empirical data. Instead, the deferral periods represent a negotiation between scientific evidence, experts, politically expedient narratives, institutionalised risk aversion, as well as more mundane concerns such as operational feasibility. As a case study, I examine how the UK Advisory Committee on the Safety of Blood, Tissues and Organs changed the 12-month deferral period for blood donation from men who have sex with men to a 3-month deferral period.

HIV, HCV, and HBV incidence and residual risk in US blood donors before and after implementation of the 12-month deferral policy for men who have sex with men.

In December 2015, the men who have sex with men (MSM) deferral was reduced to 12 months in the United States. We compared human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV) incidence and residual risk before and after this policy change using data from >50% of the US blood supply. Three estimation intervals from the Transfusion-Transmissible Infections Monitoring System were compared: 15-months pre- and two consecutive, nonoverlapping 15-month post-MSM deferral implementation. Repeat, first-time, and weighted all-donor incidences were estimated. Residual risk was calculated for all incidence estimates using the incidence/window-period method. HIV repeat donor incidence was 1.57 per 100 000 person-years (phtpy) in the second 15-month post change and not significantly different from pre-MSM incidence of 2.19 phtpy. Similar values were seen for HCV (1.49 phtpy vs 1.46 phtpy) and HBV (1.14 phtpy vs 0.97 phtpy). In some cases, higher estimated incidence, but without significant change from pre-MSM to the second post change period occurred for males and first-time donors (eg, first-time donors, second post change period: 6.12 phtpy HIV, 6.41 phtpy HCV and 5.34 phtpy HBV). Estimated per donation residual risk was 1:1.6 million for HIV, 1:2.0 million for HCV and 1:1.0 million for HBV based on weighted incidence for all donors. Repeat, first-time, and overall donor incidence did not vary significantly comparing pre-MSM to either of the post-MSM estimation intervals. Residual risk estimates vary by study, but all yield residual risks in the United States of ≤1 per million, and thus far have not shown increasing risk with the 12-month MSM policy change.

Blood donation by men who have sex with men: using evidence to change policy.

In 2011 in the United Kingdom (UK), excluding Northern Ireland, the deferral of men who have sex with men (MSM) changed from lifetime to 12months. We describe MSM who donated before and after this to inform further policy reviews. Characteristics and sexual behaviours of donors identifying as male from routine surveillance are described. Rates of infections are compared pre- and post-implementation of a 12-month deferral. Donors are compared with screen negative male donors responding to a large-scale survey during 2013/2014. Comparing the five years pre- and post-change, the rate of confirmed positives for markers of HBV, HCV, HIV and syphilis decreased by 6·9% from 14·1 to 13·1/100000 donations. The rate of recent infections was unchanged (1·72/100000). Of 22776 survey responses identifying as male, MSM disclosed sex between men over 12months ago giving 99·35% compliance among male donors. Two-thirds of the 72 non-compliant MSM reported one to two partners and one-third had no new partners within 12months. The most commonly reported reason for non-compliance from MSM both positive and negative for infection was 'not important to declare' (37·2% and 40·7%). Test seeking was rare (9·3% and 2·1%). Compliance with the 12-month MSM deferral policy was very high. The very low rates of infections post-change demonstrated the effectiveness of the policy. These data were an important part of the 2017 review of all sexual behaviour deferrals.

Is the Blood Donation Deferral Policy a Reflection of Anti-LGBTQ Institutional Bias? Community Perceptions Amid the COVID-19 Pandemic

As part of its responsibilities to protect the safety of the American public, the United States Food and Drug Administration (FDA) regulates activities associated with blood donation. One FDA policy concerns the deferral period of blood donation by men who have sex with men (MSM), and their sexual partners. The policy risks reinforcing stigma against people in the lesbian, gay, bisexual, transgender, queer/questioning (LGBTQ) community. The 2019 novel coronavirus pandemic created an urgent need for blood products; hence, the FDA shortened the deferral period for MSM and their sexual partners. Yet, the public’s support of the deferral policy remained unclear. U.S. community adults (N = 829, Mage = 46.83, 50.3% women, 9.5% lesbian, gay, bisexual (LGB) individuals) rated their approval of the FDA’s deferral policy and attitudes toward blood donations from people across various sexual orientations and gender identities. Approximately 78% of participants reported positive attitudes toward receiving blood from heterosexual donors, whereas 54% reported positive attitudes toward receiving blood from LGBTQ donors. Participants were inclined to believe that the 2020 policy revision was motivated by an increased demand for blood donations amid the coronavirus pandemic rather than an intent to reduce discrimination. Relative to LGB participants, heterosexual participants were less willing to receive blood from LGBTQ donors, more likely to endorse the FDA’s deferral policy, and less likely to consider this policy to be discriminatory. Grounded in a minority stress framework, understanding public opinion can contextualize the possible negative impact on LGBTQ health and inform future FDA policies.

And If It Takes Lying: The Ethics of Blood Donor Non-Compliance.

Sometimes, people who are otherwise eligible to donate blood are unduly deferred from donating. "Unduly" indicates a gap where a deferral policy misstates what exposes potential donors to risk and so defers more donors than is justified. A number of bioethicists and public health officials have criticized specific deferral policies in order to reformulate or eliminate them. Policy change is undoubtedly the right goal because the policy is what prevents otherwise eligible donors from donating needed blood. But this policy-level focus passes over a largely undiscussed question: if policy change takes time and there is a need for blood now, then what should unduly deferred donors do in the meanwhile? Blood banks and federal agencies recommend that deferred donors donate their time or money until they become eligible, but blood is a non-fungible good: donated cash or volunteered time cannot replace a transfusion. Further, this request ignores the fact that otherwise eligible donors could safely donate their blood in addition to their time and money. If a donor justifiably believes that her blood does not pose a risk to a recipient, but knows that honestly answering a donor questionnaire would unduly defer her, then is she morally justified in lying on the questionnaires in order to donate blood?