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Blood transfusion in the hemopathies at the end of the lifetime: ethical and organisational aspects Volume 16, issue 3, mai-juin 2010

Authors
Service d'hématologie clinique, Hôpital Saint-Antoine, 184 rue du faubourg Saint-Antoine, 75012 Paris, Centre hospitalier Robert-Boulin, Libourne, Espace Bioéthique Aquitain, Bordeaux, CHU de Tours

Transfusional indications among patients with haematologic malignancies at the end of life are based on alliance of ethical aspects and good practices. Clinical blood transfusion stands at the edges of cure and care. It relies on a right prescription and on consent after proper information. The decisions, whether being a question of prolonging or stopping, will take into account the proportionnality of caring and fall under a participative dynamics. Transfusional practices near death do not differ from those in curative phase concerning safety ; they will be all the better adjusted with clinical need, since a personnalised care project will be fitted with them, and their limits anticipated in terms of cost and efficiency.