Contextualizing the Patient Blood Management (PBM) Program Through the Lens of Bioethical Principles

In an increasingly specialized medical landscape, Patient Blood Management (PBM) has emerged as a multidisciplinary and ethically grounded approach to optimize patient care, reducing the risks associated with transfusions-particularly their inflammatory and immunosuppressive effects-and improving clinical outcomes. This review examines the relationship between PBM and the core principles of bioethics-autonomy, beneficence, non-maleficence, and justice-while highlighting its role in promoting patient safety, reducing healthcare costs, and ensuring equitable access to healthcare services. PBM provides a structured model based on preoperative anemia management, intraoperative blood conservation, and postoperative physiological optimization, with the potential to reduce transfusion rates by more than 60% and mitigate adverse outcomes, including infections, cardiovascular events, renal dysfunction, and mortality. Despite consistent evidence supporting its benefits, widespread implementation faces barriers, including significant gaps in medical education regarding blood transfusions and PBM, as well as its therapeutic alternatives. Ethical challenges related to PBM adoption involve informed consent, interprofessional conflicts, communication failures, and cultural diversity in care decisions. Furthermore, emerging technologies such as artificial intelligence introduce new ethical considerations related to autonomy, privacy, and equity. This review highlights PBM as an essential strategy to improve clinical outcomes and promote ethical, patient-centered care, particularly in resource-limited settings, in line with global health policies that call for its urgent implementation.