The ethics of ordinary and exact justification in blood donation deferral categories for men who have sex with men

Abstract

In 2015, the United States Food and Drug Administration (FDA) changed their indefinite deferral policy towards donors who were men who had sex with men (MSM). I develop an empirical case for the current, revised MSM deferral policy and show that rights-based objections fail. This empirical case, however, misleadingly accounts for an elevated risk for MSM donors because it lumps two distinct kinds of MSM donors into the same category. Building on some recent work that has been published since the revision, I introduce and defend a distinction between MSM donors who have what I call 'exact justification' and those who have what I call 'ordinary justification'. MSM donors with exact justification present no risk with respect to the deferral and should be allowed to donate. I conclude by addressing a practical issue about how primary partner testimony is not enough to create exact justification, but it is enough to sustain it.

Keywords: HIV; MSM; blood donation; deferral category.