"For any shortcomings on the part of the Red Cross, we are deeply sorry"
CMAJ 1997;157:245-6
Re: "The Krever inquiry: time to drop the appeals" (CMAJ 1997;156:1401-2 [full text / résumé])
See response by: J. Hoey
We were surprised to find a review of HIV and the Blood Supply: An Analysis of Crisis Decisionmaking1 published as an editorial, with added statements of Dr. Hoey's views about Canadian events, to which that book makes no reference. Hoey might have taken note of the authors' caution about hindsight: "The risk of hindsight is unfairly finding fault with decisions made by people who had to act long before scientific knowledge became available to dispel their uncertainty."2
The Institute of Medicine (IOM) Committee has been criticized for failing to observe its own caution, and many of its findings have been challenged.3 It has also been suggested that a radical, recent change in public perception of the risks of transfusion has led to severe criticism of actions taken in the 1980s, although "decisions made by the medical and managerial guardians of the blood supply, faced with this new and puzzling epidemic, were not better than those made by other public health officials. But there is no evidence that they were slower, or less considered, than other AIDS related decisions made at that time."4
Such reservations about the IOM report are not noted in Hoey's review; they apply equally to Hoey's critique of Canadian events.
Hoey's further suggestion that the Red Cross and its coappellants give up recourse to the Supreme Court of Canada to define the scope of the Krever inquiry report seems to be a non sequitur. The appeal, which the court has agreed to hear, addresses the rights of the appellants to fair treatment by the inquiry. It also raises legal questions about the powers and conduct of public inquiries in general, which are relevant as well to the recent inquiries into charges against nurse Susan Nelles, into the Ontario government's connections with Patricia Starr and into actions of the Canadian Armed Forces in Somalia. As coappellants, we have no intention of letting these questions go unresolved.
The appeal does not in any way impede Justice Krever from addressing proposals for the future, which we are at least as anxious to see as Hoey is.
Martin Davey, MD
Toronto, Ont.
Roger Perrault, MD
Ottawa, Ont.
Drs. Davey and Perrault are principal Canadian Red Cross Society witnesses before the Krever inquiry. -- Ed.
References
- Leveton MB, Sox HC, Stoto MA, editors. HIV and the blood supply: an analysis of crisis decisionmaking. Washington: National Academy Press; 1995.
- Leveton MB, Sox HC, Stoto MA, editors. HIV and the blood supply: an analysis of crisis decisionmaking. Washington: National Academy Press; 1995:vi.
- Zuck TF, Eyster ME. Blood safety decisions, 1982 to 1986: perceptions and misconceptions. Transfusion 1996;36:928-31.
- Blajchman MA, Klein HG. Looking back in anger: retrospection in the face of a paradigm shift. Transfusion Med Rev 1997;11:1-5.
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