How do I allocate blood products at the end of life? An ethical analysis with suggested guidelines

Lauren B Smith; Laura Cooling; Robertson Davenport

doi:10.1111/j.1537-2995.2012.03658.x

How do I allocate blood products at the end of life? An ethical analysis with suggested guidelines

Transfusion. 2013 Apr;53(4):696-700. doi: 10.1111/j.1537-2995.2012.03658.x. Epub 2012 Apr 23.

Authors

Lauren B Smith¹, Laura Cooling, Robertson Davenport

Affiliation

¹ Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USA. lbsmith@umich.edu

PMID: 22519756
DOI: 10.1111/j.1537-2995.2012.03658.x

Abstract

Blood products are scarce resources requiring prudent and reasoned allocation. The utilization of red blood cells and platelets in terminally ill patients can be complicated and requires guidelines tempered by individualized considerations. Representative cases are discussed in which blood products are requested or utilized by patients at the end of life. Relevant literature is reviewed and ethical issues pertaining to each case are discussed. A practical approach to blood product utilization at the end of life is suggested.

Publication types

Case Reports
Review

MeSH terms

Adult
Blood Component Transfusion / ethics*
Blood Component Transfusion / methods
Child
Colonic Neoplasms / complications
Colonic Neoplasms / secondary
Decision Support Techniques
Female
Gastrointestinal Hemorrhage / etiology
Gastrointestinal Hemorrhage / therapy
Health Care Rationing / ethics*
Health Care Rationing / methods
Humans
Leukemia, Myeloid, Acute / therapy
Medical Futility / ethics
Ovarian Neoplasms / pathology
Palliative Care / ethics*
Palliative Care / methods
Patient Preference
Practice Guidelines as Topic
Terminal Care / ethics*
Terminal Care / methods
Wounds and Injuries / therapy