No “fag” blood please, and the organs…well maybe.

Pissed off about the organ donation thing I wrote Health Canada to find out what was going on.  Hell, I have been an organ donor since I would get a driver’s lisence so for them to say I am suddenly ineligible seemed ridiculous.  Here is the response sent to me by Catherine Parker, the manager of the Policy and Promotion Division :

Dear Mr. Hamel

Thank you for your email inquiry regarding the January 7, 2008, CBC news story on organ donation (Sexually active gay men no longer allowed to donate organs). It is in unfortunate that this story was published with so much inaccurate information contained within.

Risks in transplantation are multiple with the primary concern the possible transmission of an infectious disease from the donor to recipient. Calls for Health Canada to enhance federal regulation in transplantation began in the early 1990s. In 1996, Health Canada assembled a group of independent experts in the field of transplantation to develop safety criteria or standards. for transplantation and also entered into a contract with the Canadian Standards Association to have them published.

Following extensive public consultation, these were published by the Canadian Standards Association as national standards in June 2003. Health Canada then proceeded with the drafting of regulations under the Food and Drugs Act, which reference key portions of these standards, thereby making them mandatory. Following extensive consultation, the regulations were published in June, 2007 and came into force on December 7, 2007.

Donor suitability assessment is critical to transplantation safety and is a key part of the regulations. The potential donor’s available medical records must be reviewed for risk factors, clinical evidence, and physical evidence of transmissible disease. A donor medical history interview or questionnaire is administered to the donor’s next of kin. Rigid testing for infectious diseases is also required. Certain medical conditions ( eg. multiple sclerosis, Alzheimer’s, Parkinson’s, Creutzfeldt-Jakob disease, and viral diseases such as mumps, West Nile virus, hepatitis B and C virus and HIV) are considered a contraindication to donation due to possible risks to the recipients. Donors are also assessed for risk factors for certain diseases, notably hepatitis B and C and HIV as in rare cases these diseases may be present but undetectable in the donor via either examination or testing. Donors are considered a potential higher risk for these diseases if they:

are a man who has had sex with another man in the preceding 5 years;
have used injection drugs in the preceding 5 years;
have hemophilia and have received human-derived clotting factor concentrates;
have had sex in exchange for money or drugs in the preceding 5 years;
have had, in the preceding 12 months, sex with any persons described above or with a person known or suspected to have HIV, HBV, or HCV; or have been exposed to HIV-, HBV-, or HCV-infected blood;
are current inmates of correctional systems or have been incarcerated for more than 72 consecutive hours in the preceding 12 months;
have had a tattoo, ear or body piercing using shared instruments in the preceding 12 months;
or have had close contact within the preceding 12 months with another person having clinically active viral hepatitis

These risk factors are based on scientific, epidemiological and statistical evidence generated by the Centers for Disease Control (CDC) and originally published as recommendations in 1994. These CDC recommendations are accepted internationally as risk factors for disease transmission and have been incorporated into regulations in the United States and Europe as well. In Canada the assessment of donors according to these criteria has been in place since the mid 1990’s even in the absence of federal regulations making this mandatory. The CDC recommendations have been reviewed and updated as needed. The risk factors which have been incorporated into the CTO regulations, although based on the CDC recommendations have been reviewed and modified by the Canadian working group of experts to reflect current scientific evidence.

However due to the life saving circumstances which make some transplants urgent and the limited number of donor organs available, it was necessary to establish a mechanism that permits organs not meeting all regulatory requirements to be used in some circumstances. The Exceptional Distribution section of the regulations allows their use, provided the transplant physician, based on clinical judgement, authorizes the distribution and the recipient has given informed consent. Hence organs from donors with these risk factors may still be used under this provision.

On January 7, 2007, the CBC aired a piece on its evening news which erroneously stated that these Health Canada regulations ban homosexual males from being organ donors. In fact all Canadians, including gay men are eligible to be organ donors. There is nothing in these regulations preventing donations from gay men. The regulations state that all donors must be assessed for risk factors that could indicate a higher possibility of infectious disease transmission, even if the possibility of such is low. One of these risk factors pertains to a man who has had sex with another man within the past 5 years. If a donor has this risk  factor, the organs can still be donated and used but the recipient must be informed of the risk factor and give their consent first. This is not a new requirement. This has been standard transplantation practice in Canada for over a decade. There have also been suggestions that these regulations have been developed “in secret” by Health Canada. Nothing could be further from thetruth. The regulations were developed with the transplant community to bring ongoing best practices into regulation.  Extensive consultation on these regulations took place over an eleven year period prior to their finalization.

I am providing you with two links. The first is to the Cells, Tissues and Organs section of the Health Canada website which provides additional information on this project and its development. The second is to a recent news release by the Trillium Gift of Life Network.

http://www.hc-sc.gc.ca/dhp-mps/brgtherap/reg-init/cell/index_e.html
http://www.giftoflife.on.ca/page.cfm?id=F97F1751-94B5-4373-94B0-7AA953B2B704

This presents a few issues,  first of all in organ donation time is of the essence, so do they really have time to locate my family and find out if I am gay or not? (Probably they could just tell from my stunning fashion sense).  And if someone can refuse my organs because I am gay, can they refuse someone else’s if they come from someone black? (also a high-risk group but the prejudice is pretty apparent)  Does that push that patient to the bottom of the list?  Do they ask the next eligible patient if they want my organs?  What other information is passed along to the potential recipient?

I think it is also interesting that one of the determinants is “have been incarcerated for more than 72 consecutive hours in the preceding 12 months.”   Probably because if you have been incarcerated for more than 72 conecutive hours you get moved from the usual holding cell/drunk tank to the general inmate population. If that isn’t a statement about the prevalence of inmate rape I don’t know what is.

I’ve decided that I will do a little more research, especially since the blood donation discrimination had been going on for years.

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5 Comments

  1. Discrimination definitely sounds wrong, but have you ever thought: why do insurance company refuse drivers with records of reckless driving? It’s all based on statistics. Currently, and statistically, gay men in modern societies do in fact have a higher percentage of HIV infections.

    Health Canada is trying to minimize receiving tainted blood (based on statistic reports), minimize the chance of getting sued by tainted bloor receivers, and try to save as many people as possible “logically”.

    Time will change, and hopefully gay men will no longer be the group that has a higher population of HIV infected people.

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  2. admin

    Oh Absolutely!

    I got a copy of the Advance Data from the National Center for Health statistics (US) and there are some crazy statistics.

    Gay men account for almost half of all the new HIV cases and yet are such a small segment of the population. I came across another article claiming if you are a gay male practicing anal sex your increased likelyhood of HIV goes up 8000 times! I find that a bit hard to swallow but there is definitely an increased chance.

    However I think the problem is they are equating something you do with something you are.

    If 50% of the reckless drivers are Chinese, should we ban all Chinese from driving?

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  3. “If 50% of the reckless drivers are Chinese, should we ban all Chinese from driving?”

    Depends on the severity.

    If 50% of bull dogs have super high tendency to bite the heads off of young kids in a park, as a city legislator, would you consider banning such dogs?

    Now consider this:

    If 50% of the blood donated by gay men are HIV positive that would kill the blood receiver, as a health organization, would you consider rejecting donation from gay men?

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  4. admin

    Yes and no.

    If 50% of blood donated by gay men was infected then you would be justified in such precautions. However, the stats are that 50% of the new HIV cases are gay men.

    This is only because it is really easy to get HIV from anal sex, and perhaps gay men’s propensity for multiple partners. Nothing really to do with being gay. By that I mean if you were a straight woman who enjoyed a lot of anal sex with different men, then you would probably have the same risk. It is the behavior that is determining the risk. But they don’t ask if you enjoy anal sex. They specifically ask if you have sex with men.

    But to use your bull dog analogy, let’s say there are 5000 bull dogs in Canada. If 50% of attacks by dogs were by bull dogs, and there were 4 dog attacks this year, and 50% were by bulldogs then there are only 2 attacks. But If 50% of bull dogs attacked, and there were 5000 bull dogs, then we are looking at 2500 attacks by bull dogs. Quite a different number.

    The funny thing about statistics is that by changing one little thing you get a very different result.

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