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How do I allocate blood products at the end of life? An ethical analysis with suggested guidelines


Lauren B. Smith, MD, Department of Pathology, University of Michigan, 1301 Catherine Street, Ann Arbor, MI 48109; e-mail:


Blood products are scarce resources requiring prudent and reasoned allocation. The utilization of red blood cells and platelets in terminally ill patients can be complicated and requires guidelines tempered by individualized considerations. Representative cases are discussed in which blood products are requested or utilized by patients at the end of life. Relevant literature is reviewed and ethical issues pertaining to each case are discussed. A practical approach to blood product utilization at the end of life is suggested.