I’m delighted to announce that Dr. Mike Kesby will give a talk on blood donation this Thursday at the School of Medicine (4pm at seminar room 2 at the medical and biological sciences building). You’re all warmly invited. The abstract is below. It promises to be an excellent seminar!
Unwanted Gifts: Blood, sex, and trust the limits of population based risk management.
Joint authored: Mike Kesby; Matt Sothern
Thursday 14th March at 4pm in Seminar Room 2, Medical & Biological Sciences Building, University of St Andrews
Blood donation is usually framed as an altruistic act. Because blood screening is imperfect Donor Health Check questionnaires (DHC) are used to defer potential donors whose ‘behaviour’ might reasonably suggest they are disproportionately at risk of introducing a Blood Borne Infection (BBI) into the blood supply. DHCs are a form of triage designed to manage (but not eliminate) risk to the blood supply. Taking the UK as a case study, we compare the deferment of two sub-populations with different HIV rates; Men-who-have-Sex-with-Men, (c.5.3%) and black-Africans (c.3.7%) with ‘the-general-(heterosexual)-population’ (c.0.09%) and show that, with respect to STIs, the DHC assesses risk on the basis of broadly defined population-level risk-groups, not in fact donor behaviour. We argue that most DHCs knowingly commit the ecological fallacy – allowing aggregate statistics at the population-risk-group-level to obscure within-group diversity, and inadequately identifying the BBI risk posed by those who fall outside high-risk-groups. Unpacking the category ‘heterosexual’ and attending to the diversity of practices within, would allow for differentiating risk of this supposed ‘low-risk group’ and may also fundamentally change the relative-risk calculated for current ‘high-risk groups’. The link between ontological risk phenomenon (diverse sexual practice) and the epistemological grid currently used to map and manage that risk (homogenized risk-groups) needs examination. We call for more practice-based DHCs that will allow for more accurate assessment of the risks posed by all potential donors.