Is This Ethical? – Coerced Blood Donation
An acquaintance is taking some classes right now, and her school has blood drives periodically; in one of her classes, the instructor told them that if everyone donated blood (or at least attempted to), then they would get a day off from class. Personally, I found this appalling, but maybe I’m overreacting. Her fellow students might say, “Shut up! we want a day off from class!” The teacher might say, “Hey, I’m just encouraging my students to do a good deed.” And, hey, the Red Cross offers little gifts all the time to donors, right?
The problem, as I see it, is that normal blood drive incentives are individually based – you give blood, you get the little trinket. Nobody else who gives blood will be denied their “reward” if you don’t also donate. Basing a reward on the actions of others, however, creates peer pressure that is an undue influence on potential donors. The Red Cross itself notes that it “accepts donations only from voluntary blood donors.” Was the choice in this instance truly voluntary?
Aside from which, if some members of her class already knew that they are unable to donate because of one of the restrictions, they would have to choose between two somewhat unsavory options. The first is to go through the screening process (finger stick and questionnaire) anyway, wasting time and potentially going through the process of donating through the “confidential exclusion process” with no benefit to the individual and no ability for the blood to be used.
The second option for a class member who cannot or does not wish to donate would be to refuse to participate from the outset, leaving classmates to speculate on the reason and possibly generating resentment due to the lost free day. A student who refused might also wonder if any consequences would be directly or indirectly administered by the instructor, who offered the reward and is in a position of authority over the students.
Although blood donation isn’t clinical research, I don’t believe this incentive squares with the spirit of the Belmont Report principles of beneficence, or maximizing benefit and minimizing harm, and respect for persons, or treating each individual as an autonomous agent. When research is conducted on humans, informed consent must also be given voluntarily, in “conditions free of coercion and undue influence;” the report explains that “Unjustifiable pressures usually occur when persons in positions of authority or commanding influence — especially where possible sanctions are involved — urge a course of action for a subject.”
In my opinion, this seemingly minor reward created a completely unethical situation. Thoughts?