The ethical complexities of transfusion-free medicine, surgery and research

Ethical issues associated with transfusion-free medicine and surgery have been around since the inception of the concept of this clinical practice. For clinicians, ethical concern and outright moral distress can arise in many situations. While the shared goal between doctor and patient might be transfusion-free clinical practices, the physician is always making mental calculations that attempt to balance the need for tissue oxygenation against the need for human blood transfusion. This chapter discusses various ethics matters, including professionalism in the practice of transfusion-free practice, informed consent, informed refusal, pediatric assent, organ transplantation, and research.