Transfusion safety with regards to prions: ethical, legal and societal considerations

The purpose of these vignettes is to illustrate that although the dominant ethical, legal and societal position is based on the precautionary principle of deontological non-maleficence, in reality a degree of utilitarian proportionality arises because there is little choice but to balance proposed variant CJD risk management strategies against other ethical imperatives including failure of beneficence, non-maleficence with regard to others, autonomy and justice. There are no easy answers in balancing these issues, but it is important that it is more widely recognised that such moral judgements have to be made and that a wider debate in society occurs over where the balance should lie.