Blood Transfusions and Medical Ethics

I had a question posed to be that asked if getting a blood transfusion could ever be a mortal sin. 

This falls into the category of Catholic moral ethics that discerns the difference between ordinary means and extraordinary means in terms of medical care. Generally as a Catholic you have the obligation to pursue ordinary means of medical care both for yourself and for others, particularly those you have a specific fiduciary duty to care for, namely children, etc.

 

This is where ethics comes in because with the huge advancements in medical care in the last 50 years, the goal post has shifted in the medical profession as to procedures that are now generally considered ordinary means which at one point would have been in the extraordinary means category. So, there is a lot of grey area within the medical profession and even among Catholic theologians in terms of what is ordinary means and what is extraordinary means.

 

Part of the problem with medical ethics and this topic is that medicinal technology can often move at a more rapid state than moral theologians and ethicists can keep up with. With cutting edge procedures, sometimes it is difficult for Catholic ethicists to keep up with all the new things that push once extraordinary procedures into a more ordinary category. For example, at one point in my lifetime, and I am not an old man, receiving oxygen could have been considered extraordinary means back in the days of ICU oxygen tents that could only be administered in controlled hospital environments. Now, people have home oxygen tanks and tubes a plenty and it's generally no longer considered extraordinary means to have oxygen tanks and what not.

 

Now, having said all that, one general rule of Catholic bioethics is the Church generally in this area of ethics is trying to help believers have as much freedom to act as possible in conformity with the truth and what is morally good. What is morally good in the sense of ordinary means? Generally speaking, basic (i.e. ordinary) care is to preserve the life of the person. This include most forms of comfort care like personal hygiene, medications, food, and water. The classic debate happens over the ethical status of the provision of food and water by artificial means like an IV feeding tube. Generally, feeding tubes are considered ordinary means because letting someone die of dehydration or starvation is really not affirming the basic dignity of the human person and is, frankly, pretty cruel in most cases. There are some exceptions to that in cases of imminent death and all I won't go into, but generally speaking, this holds true in most ethics cases.

 

Now, let's come back to your question of blood transfusions, because it is a good question. Certainly, there are some non-Catholic Christian and non-Christian traditions that hold that blood transfusions violates some moral premises in the Old Testament concerning the prohibition of consuming human blood. Catholic theology has largely rejected that argument, as a blood transfusion is not eating blood as in some sacreligious worship ceremony to a false god nor is it a form of cannibalism nor is it a denial of basic human dignity any more than, say, an organ transplant is a form of cannibalism or pagan worship. (This assumes the organ or blood to be used is acquired by moral and legitimate means and not taken by force, etc.)

 

So, blood taken by legitimate blood donation would meet that category of something that legitimately preserves life. Blood transfusions are a common medical practice and have been since the 1800s. Medical science has identified all the blood types and cross matching protocols for over a century. Protocols for testing and screening blood from viruses like HIV and Hepatitis have been in place for over 40 years. So, medically, the modern procedure is safe and effective.

 

Another operative point in the catechism is (blood generally falls into the category of organ transplant for purposes of this catechism in terms of Catholic medical ethics):

 

CCC 2296: Organ transplants are in conformity with the moral law if the physical and psychological dangers and risks to the donor are proportionate to the good sought for the recipient. Organ donation after death is a noble and meritorious act and is to be encouraged as a expression of generous solidarity. It is not morally acceptable if the donor or his proxy has not given explicit consent. Moreover, it is not morally admissible to bring about the disabling mutilation or death of a human being, even in order to delay the death of other persons.

There may be a few exceptions to this in extreme circumstances. If there were other options or the benefits were doubtful, then, after consultation with your medical team, it could be morally licit to refuse the transfusion. Or, if you had a terminal condition and the only benefit of the transfusion would be to prolong the painful dying process, then you could licitly refuse the transfusion.

Here is a relevant paragraph from the Catechism:

CCC 2278: Discontinuing medical procedures that are burdensome, dangerous, extraordinary, or disproportionate to the expected outcome can be legitimate; it is the refusal of ‘over-zealous’ treatment. Here one does not will to cause death; one’s inability to impede it is merely accepted. The decisions should be made by the patient if he is competent, whose reasonable will and legitimate interests must always be respected” (CCC 2278).

So, unless for those reasons, generally speaking blood transfusions would fall under the category of ordinary means because they meet the standards of preserving the life of the person and is generally a base standard form of medical care in most instances nowadays in Western medicine.

I would just at this point add one theological point to consider in terms of blood donation in general. Aside from the sheer science of medical ethics here, one of the calls in being Christian is to be like Christ. What was one of the things that Christ did? He shed his blood for us. So, a theological argument can be made that donating blood is the giving of life to others. I can think of few things more Christlike than the literal giving of your own blood to help save others. Just a thought (and a shameless plug for blood donation ).