Donor blood is screened for infectious agents to protect recipients against harmful infections. However, some screening measures may cost more than € 1,000,000  per life year gained.

There may be good reasons for aiming at very high safety levels in blood transfusion, but what costs are justified in times where public health care faces clear limits and basic health services are rationed? This question requires a better understanding of the scope of moral responsibility of blood services regarding precautions and prevention of infection via donated blood. This question is the background for several ethical substudies that aim to clarify and critically review the normative assumptions behind and arguments about current blood screening policies. Through review of arguments and concepts, taking into account the specific features of blood donation practice, this study formulates practical criteria for deciding which tests should be included in blood donor screening.

The PhD study was carried out by Koen Kramer and led by philosopher Marcel Verweij and medical microbiologist Hans Zaaijer; it is fully sponsored by Sanquin. Koen Kramer defended his PhD thesis in January 2018 at the University of Amsterdam.The thesis consists of several published articles:

An inventory of concerns behind blood safety policies in five western countries Published in Transfusion 2015;55(12): 2816-2825. 

Donor blood screening and moral responsibility: How safe should blood be?Published in Journal of Medical Ethics 2018;44(3):187-191.

The precautionary principle and the tolerability of blood transfusion risks Published in American Journal of Bioethics 2017;27(3):32-43

Interpreting and applying the precautionary principle Published in American Journal of Bioethics 2017;27(4):W4-W6

Are there ethical differences between stopping and not starting blood safety measures? Published in Vox Sanguinis 2017;112(5):417-424.