If one day your body needs more blood than usual, there can be only two reasons: either you’ve been seriously injured, or… you’re a vampire. Jokes aside, the next time you see a Red Cross blood donation vehicle parked in front of your office, remember this: on the other side of that vehicle are people living through the worst days of their lives—and let’s hope it isn’t their last.
The reason the Red Cross and other blood banks constantly urge people to donate blood is simple: there is always a shortage of blood. At times, this shortage becomes desperate, forcing extremely difficult and ethically complex decisions—both in collecting blood and in distributing it among patients.
To understand just how strange and fragile this system is, we spoke with two blood transfusion specialists—Anne and Dr. Matthew.
5. Giving a patient the wrong blood type can have fatal consequences
Most people know that different blood types exist (A, B, AB, O) and that compatibility between donor and recipient is essential. But very few understand what actually happens when a mistake is made.
Blood types function like an exclusive “members-only club.” For example, if a person has type A blood, their body recognizes type B cells as foreign invaders and immediately attempts to destroy them. As a result, red blood cells break down, releasing toxic hemoglobin, which is extremely dangerous for the kidneys.
“This reaction is immediate and extremely severe,” explains Dr. Matthew.
“The immune system attacks the foreign blood cells, punctures their membranes, and destroys them. The kidneys begin to fail, and then other organ systems collapse like dominos.”
And this is the best-case scenario of a failed blood transfusion.
Moreover, matching blood type alone is not enough. Allergies can also be deadly. In one case, a woman suffered a severe allergic reaction after receiving plasma. It later emerged that the donor had eaten a peanut-containing food before donating blood, triggering anaphylactic shock in the patient.
In addition, there are far more blood types than most people realize. Beyond A, B, O, and AB, there are more than 30 rare blood groups. One of them—the Bombay blood group—is so rare that individuals with this type can receive blood only from donors with the same group. This occurs in roughly one out of every four million people.
4. Absurd restrictions still exist for men who have sex with men
Despite the severe blood shortage, certain donor regulations remain highly controversial. For decades, male donors were asked the following question:
“Have you ever had sexual relations with another man?”
If the answer was “yes,” the donor was automatically disqualified.
Starting in 1977, the FDA completely banned blood donations from men who have sex with men. This decision was largely driven by the AIDS epidemic and the limited testing capabilities of the time. Today, however, HIV testing is extremely accurate, and the risk of HIV transmission through blood transfusion is less than one in two million.
Although the rules were partially relaxed in 2015, strict and often illogical restrictions still remain.
3. Blood donors often lie about their health status
While it is difficult to persuade people to donate blood, some individuals knowingly donate despite being unfit to do so. Why?
“The most common reason is incentives,” says Dr. Matthew.
“Some people know perfectly well that they are carriers of hepatitis B or C, yet they lie to obtain a gift card, donate blood, and never return.”
Others use blood donation as a covert HIV test. This practice is both dangerous and unethical.
2. Hospitals sometimes quite literally ‘bleed’
Despite constant reminders about the importance of blood donation, less than 10 percent of eligible donors donate regularly. In critical situations, this can lead to devastating outcomes.
Dr. Matthew recalls one such moment:
“One night, we had only four units of blood left in the entire system. If a mass casualty incident had occurred, several patients could have died at the same time.”
Furthermore, blood transfusions are not always beneficial. Unnecessary transfusions can lead to high blood pressure, cardiac complications, and even death.
1. Sometimes a hospital may decide to stop giving blood
The most difficult and ethically challenging question is this: who should live?
Dr. Matthew describes one case:
“We had a severely injured child who needed blood continuously for several days. The ethics committee had to consider stopping the child’s blood supply. Eventually, the risk was taken and surgery was performed—the child survived. But not every story ends this way.”
At times, blood supplies are limited, and choices must be made. These decisions may seem cold, but they reflect reality.
Conclusion
Blood is a rare and life-saving resource. It is considered ‘lost’ in only one situation—when it is transfused into a patient who truly needs it.
So donate blood.
You may help save someone’s life—and perhaps the most valuable reward you receive won’t be a free cookie, but the fact that someone gets to keep living.