Thanks to recent progress in biotechnology, surrogacy, transplantation of organs and tissues, blood products or stem-cell and gamete banks are now widely used throughout the world. These techniques improve the health and well-being of some human beings using products or functions that come from the body of others. Growth in demand and absence of an appropriate international legal framework have led to the development of a lucrative global trade in which victims are often people living in insecure conditions who have no other ways to survive than to rent or sell part of their body. This growing market, in which parts of the human body are bought and sold with little respect for the human person, displays a kind of dehumanization that looks like a new form of slavery. This book is the result of a collective and multidisciplinary reflection organized by a group of international researchers working in the field of medicine and social sciences. It helps better understand how the emergence of new health industries may contribute to the development of a global medical tourism. It opens new avenues for reflection on technologies that are based on appropriation of parts of the body of others for health purposes, a type of practice that can be metaphorically compared to cannibalism. Are these the fi rst steps towards a proletariat of men- and women-objects considered as a reservoir of products of human origin needed to improve the health or well-being of the better-off? The book raises the issue of the uncontrolled use of medical advances that can sometimes reach the anticipations of dystopian literature and science fiction.

Individuals who donate their blood provide a unique and precious gift in an act of human solidarity. In order to donate blood, prospective donors should be in good health and free from any infections that can be transmitted through transfusion. Most blood donors perceive themselves to be healthy, but some are unsuitable to donate blood due to the potential risk of compromising or worsening their own health or the risk of transmission of infections to patients. Blood transfusion services (BTS) have a duty of care towards blood donors as well as to the recipients of transfusion. This duty of care extends to prospective donors who are deferred from donation--whether on a temporary or permanent basis--as well as those who donate blood and are subsequently found to have unusual or abnormal test results. BTS have a responsibility to confirm test results and provide information, counseling and support to enable these individuals to understand and respond to unexpected information about their health or risk status. Counseling is part of the spectrum of care that a BTS should be able to provide to blood donors--including referral to medical practitioners or specialist clinical services. Pre-donation counseling was recognized as one element of the strategy to reduce and, if possible, prevent the donation of blood by individuals who might be at risk for HIV and other TTI including hepatitis B and C viruses as well as to inform the donor of the donation process and testing of blood for HIV. Post-donation counseling was acknowledged to be a necessary element of donor management as an adjunct to informing donors of unusual or abnormal test results. Blood donor counseling by trained specialist staff is now considered to be a key component of the blood system in most countries with a well-developed blood transfusion service. It may be required at a number of stages in the blood donation process or following blood screening and should be available at any point at which the BTS has an interface with donors. In many countries, however, blood donor counseling is not yet available in a structured way. Blood Donor Counselling: Implementation Guidelines has therefore been developed to provide guidance to blood transfusion services that have not yet established donor counseling programs.

This book explores the sensitive area of medical decision-making in cases where a patient refuses recommended medical treatment for religious or moral reasons. The case in point is the refusal of blood transfusion therapy by Jehovah's Witnesses. The theological and historical basis is examined in depth. The history of blood use in medicine is also analyzed, including the role of bloodletting as the 'queen of remedies' for centuries and eventually the emergence of the reverse practice, blood transfusion. Against this backdrop of theological, historical, and medical information, the study examines the ethical and legal issues raised by the stand of Jehovah's Witnesses. The principle of 'autonomy' and its development into a legal concept, as well as its introduction into medical ethics leading to the development of the doctrine of 'informed consent' into both a legal rule as well as an ethical duty imposed on health care professionals are considered.