Proposal to require medical officials to honor requests for direct blood donations rejected

DES MOINES — A proposal to require hospitals and blood banks to comply with all patients’ requests for blood donations from a specific donor was squashed Tuesday by Republican state lawmakers in the Iowa House.

The bill would have required hospitals and blood banks to honor any blood transfusion patient’s request for a blood donation from a known donor, like a family member, unless there was an imminent risk to the patient’s life.

Medical organizations and blood banks were uniformly opposed to the proposal, saying it would endanger patients’ health and create logistical problems for blood banks.

The legislative proposal recently passed the Iowa Senate, with only Republican support.

But after hearing from representatives of blood banks, hospitals, and individual health care experts during a legislative hearing Tuesday at the Iowa Capitol, Iowa Rep. Steven Bradley, a Republican from Cascade and the leader of the three-member legislative panel considering the bill, announced he does not support it and that it will not advance in the House, effectively killing it for the 2024 legislative session.

Bradley noted in addition to the testimony he heard during Tuesday’s hearing, he also heard from two more experts: his two nephews who are physicians.

“When I showed them this bill, they said we don’t need this bill,” Bradley said.

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The bill had been proposed by Sen. Jeff Edler, a Republican from State Center, who said it was proposed after guidance issued by the federal Food and Drug Administration related to direct blood donations. Edler characterized his proposal as a simple way to honor Iowans’ individual health care choices.

In October 2023, the FDA issued a warning against websites that offer the delivery of blood from individuals who had not been vaccinated for COVID-19, and said that seeking direct blood donations based on the donor’s specific characteristics, like vaccination status, sexual orientation, gender or religion, lacks scientific support.

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“I will say there are plenty of evidence-based reasons for why we don’t do routine direct donations,” said Rep. Austin Baeth, a Democrat from Des Moines who was on the legislative panel and is a physician. “And then there’s also just logistical reasons … to be able to manage all of a sudden a ground swell of people who want to have their blood now banked, the capacity to be able to store that, and then knowing that the shelf life of a unit of red blood cells is maximum 42 days.”

Tuesday’s legislative hearing drew medical officials from both ends of the career spectrum to testify in opposition: Samuel Choice, a fourth-year medical student at the University of Iowa, and Bob Shreck, a hematologist with 40 years of experience as a physician and former director of a blood center.

Choice said the proposal would have required physicians to violate their code of ethics, which calls for them to do no harm, because direct blood donations carry a higher risk of transmitting infectious diseases, according to the FDA.

“I appreciate that you are thinking about the autonomy of patients and the rights that they have, but I don’t think this bill is actually doing right by them. You’re asking doctors to be impelled by the government to give care that they know is demonstrably worse,” Choice said during the public testimony period of the hearing. “It’s as if you were going in for a surgery and your patient said, ‘I really don’t want you to wash your hands before you do this surgery.’ …

“Why should a physician, who knows that that’s worse for you, be impelled by the government to do something that would be worse for their patient and cause them severe harm?”

Other groups that testified against the proposal Tuesday included the American Red Cross, Iowa Medical Society, LifeServe Blood Center in Des Moines, and ImpactLife blood banks, which has two locations in Cedar Rapids and one in Iowa City.

Bradley, Baeth and Rep. Tom Moore, a Republican from Griswold, all declined to advanced the bill, Senate File 2369, essentially disqualifying it from further consideration this session.

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