Perceptions in transfusion medicine: a pilot field study on risk and ethics for blood and blood substitutes

A pilot study was undertaken in the UK in February 2005 to identify the perceptions of risk, effectiveness and ethicality of different hypothetical transfusion options, including blood substitutes derived from different sources, among young adults. Forty-nine men and 92 women completed the questionnaire, aging between 18 and 25 years old (mean +/- standard deviation = 19.7 +/- 1.2 years). Twenty-three percent of respondents had donated blood, an average of 3.1 times. The study assessed the perceptions of donor blood versus 3 different types of potential "artificial blood" [i.e. "chemical" (synthetic), "grown from bacteria" (recombinant hemoglobin), or "based on cow blood" (bovine hemoglobin)] on three dimensions, namely risk, effectiveness, and ethicality, each scored on a 1 (least) to 7 (most) Likert-type scale. Donor blood was rated as significantly (P < 0.05) less risky, more effective and more ethical than any of the blood substitutes. The chemical-based blood substitute was rated second least risky, second most effective and second most ethical followed by bacteria grown substitute. The bovine-based blood substitute was rated as significantly riskier, least effective and least ethical. All the blood products differed significantly for perceived ethicality, with donor blood considered as most ethical and a blood substitute derived from bovine blood as least ethical. Judgments of risk correlated negatively with effectiveness (all transfusion options) and ethicality (all the blood substitutes). Overall, these results indicate that donor blood is currently preferred over blood substitutes in the UK and that judgments of risk about different hypothetical transfusion options are related to perceptions of effectiveness and ethicality.