HIV and the Blood Supply: Assessing MANTRA Legislation

Abstract

Despite a dramatic decline in transfusion-associated AIDS, increased safety of the national blood supply, and voluntary efforts to find alternatives to homologous blood sources, Americans remain fearful about the possibility of acquiring AIDS through a blood transfusion. Numerous states have initiated legislative efforts that would require explicit warnings about blood safety and that would direct patients to alternative sources of blood. These proposed laws—known as MANTRA bills, for “mandatory notification of transfusion alternatives”—would require physicians to advise patients of blood transfusion options prior to any surgery. Many would mandate the development of new informed consent documents and involve health departments in the implementation of new regulations regarding transfusions. This article concludes that MANTRA legislation is primarily a symbolic attempt to reassure the public about AIDS. It mandates practices that are being adopted voluntarily; it will not make the blood supply safer; it will increase the cost of health care to individuals and in the aggregate; it may diminish the number of donors to the voluntary blood supply system; and it is likely to intensify public fear about the risk of a blood transfusion.