مقايسه عواقب حقوقي، اجتماعي و اقتصادي ناشي از بيماري هاي منتقل شونده از راه خون در ايران و جهان

Legal, social, and economic consequences of transfusion-transmitted infections in Iran and in the world

Background and Objectives Reports concerning serious illnesses caused by transfusion transmitted infections (TTI) in 1980s have caused numerous legal, social and economic consequences both for the patients and the societies. As a result, several lawsuits against authorities in the government and industry have been filled by the patients or advocacy groups. In Iran in 1990s such lawsuit was started against authorities of national blood transfusion organization. In this paper, comparative consequences of theses lawsuits have been evaluated. Materials and Methods Main databases such as Pubmed and ISI Web of Science have been searched for any such reports in both developing and developed countries in the past three decades. Results Although prevalence of TTI (e.g. AIDS and hepatitis C) in Iranian patients was substantially lower compared to the data reported in developed countries, compensation paid to the patients, as percent of GDP per capita, was significantly higher. Similar discrepancy was also observed in extension of the compensation and verdicts against national authorities that was much severer. Iran was the only country which had to provide in addition to substantial compensation free comprehensive treatment for the patients in extra to the existing national insurance system. As a result of such lawsuits, Iran has closed its only national plasma fractionation plant and after that it had to rely only on imported plasma products to meet the patientsʹ need. Conclusions Comparison of consequences of TTI in Iran with those of developed countries indicates a clear imbalance between the event and its consequences. This obviously has caused a clear unfair shift of the countryʹs health system privileges toward TTI contracted patients. On the other hand this unfair verdict against national authorities has ignored concepts of failure and fault in medical interventions.