tag:blogger.com,1999:blog-2830084253401570472.post6199333314235005416..comments2024-03-28T09:22:36.967+13:00Comments on Offsetting Behaviour: Transfusions and operating room ethicsEric Cramptonhttp://www.blogger.com/profile/15831696523324469713noreply@blogger.comBlogger23125tag:blogger.com,1999:blog-2830084253401570472.post-75355961253142100012012-05-24T12:55:34.772+12:002012-05-24T12:55:34.772+12:00In mny experience, there is no good time for ethic...In mny experience, there is no good time for ethics debates, because they put collegiality at risk. Most of us are happy to have our ethics handed down from on high, to forestall discussion and collegiality meltdowns. The only exception to what I write here is... the blogosphere!philip meguirenoreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-43366227803737862742010-05-10T21:47:06.524+12:002010-05-10T21:47:06.524+12:00Congrats Eric and family! Six months ago I was in ...Congrats Eric and family! Six months ago I was in a similar situation but all my efforts were focused on stopping myself from fainting - they even had an orderly stand behind me on catching duty.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-7942046358644392722010-05-06T11:49:43.089+12:002010-05-06T11:49:43.089+12:00Best wishes to you all!Best wishes to you all!Shane Pleasancehttps://www.blogger.com/profile/06144367923437327037noreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-9308651542721646872010-05-05T21:29:03.984+12:002010-05-05T21:29:03.984+12:00I wonder if it is because direct donation of blood...I wonder if it is because direct donation of blood to a spouse could be seen as less safe?<br /><br />Typically blood donation has a strong self-deferral culture - don't donate if you meet any of the following criteria for exposure to nasty things. That's backed up by the blood testing performed by the labs, but there maybe some things the labs can't/don't test for and simply try and screen out with the self deferral. I'm guessing that's why your only payment for blood in NZ is a cup of tea and a biscuit - cash probably weakens the self deferral part of the system. <br /><br />With a spouse being the recipient the self deferral mechanism is probably also weakened. Unless you've got that special tickbox that you mentioned earlier for 'take my blood and then bin it cos I've been a bad puppy'<br /><br />And I guess different rules apply with organ donation simply because the supply pool is that much smaller than with blood.Duncannoreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-39468846643910327882010-05-05T20:48:44.130+12:002010-05-05T20:48:44.130+12:00@Duncan: If there were a decent medical reason, I&...@Duncan: If there were a decent medical reason, I'd be happy enough. But the suggestion was that it was ethics that was the binding constraint.<br /><br />@Matt: She did an excellent job of keeping Sue just out of pain's way during surgery, so maybe you're right on the first part. Not sure I get the second: I could buy it if the random donor would risk having status disclosed to spouse, but not where it's folks asking to donate as a special case for their spouse where they wouldn't otherwise be donating. (And before folks ask why I'm not currently donating, I gave about 5-6 pints while an undergrad and have as yet made no withdrawals...)Eric Cramptonhttps://www.blogger.com/profile/15831696523324469713noreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-34947764177817954422010-05-05T19:30:47.597+12:002010-05-05T19:30:47.597+12:00Congrats :)
I am pretty sure that arguing with pe...Congrats :)<br /><br />I am pretty sure that arguing with people is the best way to keep them on their toes - small distractions force people to pay attention rather than rolling through cruise control :P<br /><br />Regarding the ethics I think it could be the medical service following a rule of thumb that protects cheaters in the face of a shortage in the necessary pool of blood - as if everyone was allowed to get tested we would either have a seperating eqm where cheaters get caught, or a pooling eqm where they get caught as well. <br /><br />Not sure this is either socially optimal or even a realistic reason - but that is often the way with arbitrary policies.Matt Nolanhttps://www.blogger.com/profile/05615455113796090765noreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-37134730446212146762010-05-05T19:22:13.801+12:002010-05-05T19:22:13.801+12:00Congratulations to you both. I'm sure Ira will...Congratulations to you both. I'm sure Ira will make an excellent big brother. <br /><br />Regards the ethics, your solution seems nice and elegant - ethics committees obviously need economists on them :). However in relation to spouses and blood donation, I've seem some comment that husbands donating to wives increases risks of complications during future pregnancies. Maybe the anaesthesiologist was just thinking ahead...?Duncannoreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-26588209982258177962010-05-05T14:56:04.760+12:002010-05-05T14:56:04.760+12:00@Roy: You'll note, of course, that my proposed...@Roy: You'll note, of course, that my proposed mechanism deftly avoids all such problems. I'd go further and argue that I ought to be able to explicitly allow Susan access to my details if I wish, regardless of potential implications. But the mechanism is sufficient to get the desired result.Eric Cramptonhttps://www.blogger.com/profile/15831696523324469713noreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-16613647872613845312010-05-05T14:12:57.792+12:002010-05-05T14:12:57.792+12:00Bah. Typo. s/confidentially/confidentiality/Bah. Typo. s/confidentially/confidentiality/Royhttps://www.blogger.com/profile/11225358441598044791noreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-25880015437767974452010-05-05T14:11:36.811+12:002010-05-05T14:11:36.811+12:00It's been a while since I've been involved...It's been a while since I've been involved in medical ethics discussions, but I suspect that there may be a sticking point around the husband explicitly waiving confidentially when the implications of the data being released are not yet clear. Evidence of congenital abnormality? Evidence of STD? Evidence that he's exposed his wife and child to a potentially lethal disease for some time?<br /><br />Like it or not, marrying someone doesn't give you legal access to their data.Royhttps://www.blogger.com/profile/11225358441598044791noreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-5358276675005643482010-05-05T14:05:46.679+12:002010-05-05T14:05:46.679+12:00Congratulations Father Crampton.
I'm sure y...Congratulations Father Crampton. <br /><br />I'm sure you'll work out a slick design solution to the purported problem--after al,l you'll have to do something while you're lying awake nights listening to baby howls. :-)Peter Cresswellhttps://www.blogger.com/profile/10699845031503699181noreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-9324412267131141852010-05-05T13:29:42.609+12:002010-05-05T13:29:42.609+12:00@Robin: I completely agree with you. On that one,...@Robin: I completely agree with you. On that one, I suppose I can understand doctor-patient confidentiality issues; however, if the husband EXPLICITLY WAIVES confidentiality, and especially if the transfusion request has come from the husband rather than the wife, that does seem more than a bit odd.Eric Cramptonhttps://www.blogger.com/profile/15831696523324469713noreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-21102954932520519602010-05-05T10:09:43.443+12:002010-05-05T10:09:43.443+12:00How did it become unethical to tell a wife that he...How did it become unethical to tell a wife that her husband is cheating on her?!Robin Hansonhttps://www.blogger.com/profile/18396528456436940972noreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-69965347354307942872010-05-05T09:28:02.069+12:002010-05-05T09:28:02.069+12:00Congratulations to you, Susan, Ira, and little Mis...Congratulations to you, Susan, Ira, and little Miss Crampton. It's great to hear that everyone is healthy and that you maintained your usual demeanour in the delivery room.Bernard Darntonnoreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-44551205873547846552010-05-05T09:09:40.700+12:002010-05-05T09:09:40.700+12:00How things have changed. When I was about to have ...How things have changed. When I was about to have a transfusion before our daughter's birth 25 years ago the nurse joked about AIDS. She then reassured me that it would be okay because pregnant women only got blood from female donors.<br /><br />I second Lemmus and the work hasn't finished. A Caesarean is major surgery which requires rest for recovery.<br /><br />Wishing you all joy and wonder.How blessed your wee daughter is to have parents who love each other and her.homepaddockhttps://www.blogger.com/profile/08596903968235369282noreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-26923272578028146422010-05-05T08:16:59.762+12:002010-05-05T08:16:59.762+12:00Congratulations all 4 of you. Glad to hear all is ...Congratulations all 4 of you. Glad to hear all is well, and that small Crampton emerged successfully. Would love to have been a fly on the wall had the ethics discussion continued... Safe to say we're not seeing you tonight then :)Latsnoreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-45586099527934226882010-05-05T07:33:43.848+12:002010-05-05T07:33:43.848+12:00Congrats to you and Sue!
How does Ira feel about...Congrats to you and Sue! <br /><br />How does Ira feel about the new addition to the family?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-21688792014431145212010-05-05T00:46:13.442+12:002010-05-05T00:46:13.442+12:00Congrats - especially to the wife, who was doing a...Congrats - especially to the wife, who was doing all the work while you were chatting up the anaesthesiologist, tsk, tsk. Medical ethics conversation, eh? I'll have to keep that one in mind for the next time I have some explainin' to do.LemmusLemmushttps://www.blogger.com/profile/00917054221547240969noreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-62932507193051273132010-05-05T00:10:52.954+12:002010-05-05T00:10:52.954+12:00Congratulations to you and Sue.
"If we wind ...Congratulations to you and Sue.<br /><br />"If we wind up finding that Sue comes up a bit anemic and tomorrow needs a transfusion, I may jump up and down a bit arguing for my solution through mechanism design."<br /><br />God, you must be a fun guy to have around in a crisis. I'm sure there's a "An ethicist, an economist, and a nuclear physicist walk into a bar" joke to be had here somewhere, but I can't quite find it.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-56910247957894778352010-05-04T23:51:15.268+12:002010-05-04T23:51:15.268+12:00Excellent work. Congrats.
And also: arguing medi...Excellent work. Congrats.<br /><br />And also: arguing medical ethics with the anaesthesiologist during the caesarean section is a splendid idea indeed. There's no such thing as a bad time for an ethics debate.bk drinkwaterhttps://www.blogger.com/profile/16274208803479395825noreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-64515545926270033392010-05-04T23:21:03.351+12:002010-05-04T23:21:03.351+12:00Congratulations!Congratulations!Samuel Konkinhttps://www.blogger.com/profile/00821513835134996401noreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-75008221147431024982010-05-04T23:04:09.297+12:002010-05-04T23:04:09.297+12:00Oh and the link was not necessary - it too easily ...Oh and the link was not necessary - it too easily gives the reference away to non-believers. ;)peteremcchttps://www.blogger.com/profile/02675527971846060507noreply@blogger.comtag:blogger.com,1999:blog-2830084253401570472.post-24291020049113179182010-05-04T23:00:01.135+12:002010-05-04T23:00:01.135+12:00Congratulations!
And bonus points for making a H2...Congratulations!<br /><br />And bonus points for making a H2G2 reference in your baby announcement blog post!peteremcchttps://www.blogger.com/profile/02675527971846060507noreply@blogger.com