Canadian Health Ministry Ban On Organ Donations From MSM
SomeHIV/AIDS advocates in Canadarecently raised concerns about a regulation adopted by Health Canada,the country's health ministry, in December 2007 that bans organ donations frommen who have sex with men, the TorontoStarreports. According to the Star, the ban prohibits organ donationsfrom sexually active MSM, injection drug users and people living with hepatitisto limit the risk of spreading bloodborne infections, including HIV.
Gary Levy, head of the University Health Network -- the country's largest organtransplant program -- said Health Canada'snew regulation formalizes precautions in use across Canada for at least 10 years. Theregulations are based primarily on blood donor criteria that exclude MSM, Levysaid, adding that the restrictions likely go too far in excluding all sexuallyactive MSM. Levy said transplant surgeons will continue to make the finaldecision on which organs are suitable for use. He added that many organs fromknown MSM have been used after physicians determined from retrieval agenciesthat the donor's sexual behavior did not carry a significant HIV risk. Underthe new regulations, physicians will have to sign a form stating theyauthorized the use of an organ that would normally be excluded, the Starreports.
Phillip Berger, head of family and community medicine at St. Michael Hospital in Toronto, said the regulation is fundamentallyflawed because the organ harvesting system depends entirely on the honesty andgoodwill of donors and their families. He added that current screening testscan determine the HIV status of donated organs rapidly and with almost 100%certainty. The only risk would come from donors in the "so-called windowperiod, when they've been recently infected" with HIV, which is an"infinitesimal" worry, Berger said. "To exclude bona fide donorsbecause they've had sex with another man ... would exclude a lot of people whoare no risk at all" for HIV, Berger added (Hall, Toronto Star,1/9).
Stephen Beed, an intensive care specialist and medical adviser to Nova Scotia's organdonation program, said the regulation is extreme. "We need to be carefulthat we don't screen with too broad a brush," Beed said, adding that thescreening system is not perfect and that blood tests can produce falsepositives. According to Beed, the possibility of HIV transmission needs to beweighed against the potential life-saving benefits of organ transplantation.Carole Saindon, spokesperson for Health Canada, said the regulation isbased on risk of HIV transmission and not the lifestyle of MSM. She added thatMSM who have had sex within five years are at a high risk of HIV (Gillis, Halifax Chronicle-Herald, 1/9).
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