Parental Refusals of Blood Transfusions from COVID-19 Vaccinated Donors for Children Needing Cardiac Surgery
Thursday, October 12, 2023
2:30 PM – 3:45 PM ET
Location: Iron (Fourth Floor)
There is a growing trend of individuals refusing blood transfusions from COVID-19 vaccinated donors. The author will discuss three pediatric cases where parents refused blood transfusions from COVID-19 vaccinated donors on behalf of their children in the setting of congenital cardiac surgery. In addition, these families also requested accommodations, including identification of COVID-19 vaccination status of blood donors from standard hospital suppliers, directed donation from a COVID-19 unvaccinated family member, or use of a non-standard blood supplier specifically designed to provide blood products from COVID-19 unvaccinated donors. These cases raised questions about the feasibility, burdens, and ethical considerations of accommodating these requests, and the range of parental discretion in refusing blood products on behalf of a child if their requested alternatives cannot be accommodated. The author will describe the current screening and safety processes for standard blood donation and explore the importance of donor anonymity and challenges presented by directed donation and non-standard blood suppliers. The author will present an ethical framework using the Best Interest Standard, the Zone of Parental Discretion, and the Harm Principle for use when considering situations in which parents withhold consent for blood that cannot be guaranteed to come from a donor who remains unvaccinated against COVID-19. Using these principles, the author will provide the spectrum of clinical scenarios in which parental decision-making authority should be respected or challenged. Finally, the author will provide recommendations to institutional ethics committees for how to approach these requests as they potentially become more commonplace in pediatrics.
Emily Berkman, MD, MA – Pediatric Critical Care, Bioethics and Palliative Care – University of Washington; Jonna Clark, MD, MA – Pediatric Critical Care, Bioethics and Palliative Care – University of Washington; Douglas Diekema, MD, MPH – Bioethics and Palliative Care, Pediatric Emergency Medicine – University of Washington; Nabiha Saifee, MD, PhD – Laboratory Medicine and Pathology – University of Washington; Mithya Lewis-Newby, MD, MPH – Bioethics and Palliative Care, Pediatric Critical Care – University of Washington