Donating blood is anxiety-producing, redemptive and a great excuse to rationalize eating a bag of cookies.
But is it a human right?
If so, does that right trump maintaining the safest blood supply possible?
These intriguing questions were posed this week by Dr. Elizabeth Perry, associate medical director of Twin Cities-based Memorial Blood Centers. Perry has been following a growing social movement with considerable professional insight.
So it was good to hear Perry agree that it's well past time for the U.S. Food and Drug Administration (FDA) to modify its 30-year ban on blood donations by gay men. And reassuring to hear that this is not an either-or proposition.
End the ban, yes, and do so while maintaining the safest blood supply possible.
"It's an outdated thing," said Perry, who began doing hemophilia care in 1982. "It's been many, many years since we've seen an HIV infection transfused. People do take [donating blood] seriously. They take the donor eligibility questions seriously.
"It's a rule and I understand it," she said of the ban by the FDA, which regulates the country's blood supply. "They want a safe blood supply and we want a safe blood supply. But I think the eligibility guidelines can safely change."
Pretty quickly, actually. After seven years of discussions percolating under the surface, the FDA has moved from unwavering resistance to, in July, a willingness to "consider new approaches to donor screening and testing."
"Things have moved so fast around HIV," said Bill Tiedemann, executive director of Minnesota AIDS Project (MAP). "The FDA looking at this with a serious eye to moving the needle is pretty incredible."
The shift likely is because of multiple outside pressures. The American Medical Association voted in June to oppose the ban. In July, college students in the Twin Cities and across the country organized peaceful protests at blood centers. In August, more than 80 members of Congress called the lifetime ban an outdated measure that perpetuates inaccurate stereotypes about gay men.
Among those lawmakers is Rep. Keith Ellison, D-Minn., a vocal supporter of ending the ban, which he said was "established at a time when there was widespread discrimination against the gay community and we knew little about HIV/AIDS. Despite advances in blood-screening technology, the ban forces blood banks to turn away healthy donors."
In 1983, when the FDA banned gay men from donating blood, AIDS testing was in its infancy. Today, donated blood undergoes nine tests for infectious agents, including HIV, hepatitis B and C, and syphilis, and the window period of detecting the virus has dropped from 56 days to 11 days.
Zach Fincher says the ban is nothing more than discrimination based on sexual orientation, rather than on sexual behavior. Fincher, 24, of Crystal, organized the St. Paul blood drive in July, as part of a National Gay Blood Drive.
The purpose, he said, was to show that there are many healthy gay and bisexual men who want to donate blood and save lives. "There's such a shortage [of blood] out there, and we can't donate."
Fincher added that he had hip surgery in 2011 and 2012, "and got three pints of blood, and I don't care where it came from."
Perry of Memorial Blood Centers supports scientifically based deferral periods for gay and bisexual donors that parallel deferrals used for blood donors who engage in other risk activities. For example, individuals who have had sexual contact with someone with viral hepatitis are deferred from donating for 12 months.
In the United Kingdom, men may donate blood if they haven't had sex with another man in 12 months. In Canada, men can donate blood if they haven't had sex with another man in five years.
Tiedemann of MAP sees this as a good start. "In the world of social justice, one step in the right direction is a good step. It would be nice to lift the entire ban, but it's about the FDA being comfortable with this. This doesn't need to be a fight.
"This needs to be a collaborative opportunity. We want to make sure the blood supply is absolutely perfect."