THE LANCET
POLICY AND PEOPLE
Canadian Red Cross found negligent
T
he Canadian Red Cross Society’s failure to implement aggressive donor-screening in the mid-1980s constituted negligence leading to the death of a Toronto man and the HIV-infection of a 3year-old boy from contaminated blood transfusions, a Canadian court has ruled. In a precedent likely to influence dozens of similar lawsuits now before the courts, Ontario Court General Division Justice Stephen Borins ruled on Oct 8 that the Red Cross acted without the standard of “due care required of it” in safeguarding the blood supply. Borins awarded Can$1 million in compensation to the family of Ronald Osborne, who died in 1993 after being infected with HIV from a 1985 blood infusion received while being treated for Guillain-Barré syndrome. Financial damages for the child, now 16 and still alive, have not been determined. But Borins cleared the Red Cross in the 1993 death of Alma Walker, who had contracted HIV as a 21-year-old mother receiving a “top-up” transfusion following a cesarean section. In her case, there was no evidence that more effective donor screening would have prevented the tragedy, Borins ruled. All three cases hinged on whether the Red Cross moved quickly enough to discourage sexually active homosexual men from donating blood and the impact that such stricter measures would have had on donors. While the American Red Cross had already adopted questionnaires designed to eliminate high-risk donors by asking whether they had AIDS symptoms, the Canadian system, fearful of offending the gay community, was merely asking donors whether they were in “good health”. The Americans “had it right”, Borins ruled. “When something as catastrophic as contaminated blood threatens the lives of recipients, an urgent response is required. The ARC and other blood collection agencies recognized the danger signs, and even though the scientific evidence was not conclusive, they were prepared to act on what I would characterize as a ‘better safe than sorry’ approach.” Wayne Kondro
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Irish drop plan for mandatory abuse reports
T
he Irish government has dropped its plans to introduce mandatory reporting of suspected child abuse by doctors and other professionals. The plans had included a legal onus on doctors, teachers, social workers, and others to report even the slightest suspicion of possible abuse. Instead, the government is proposing to negotiate procedures with the professions as to when they should report suspected child abuse. In the meantime, the current arrangements remain in practice in which the police and social workers must notify each other of suspected child abuse. The Minister of State for Health and Children, Frank Fahey, announced the change on Oct 9 in an answer to a parliamentary question, saying that the focus has changed from one of being narrowly legalistic to one aiming for an improvement in reporting child abuse so that all cases come to the attention of the authorities as quickly as possible. “I am aware of fears that an overlegalistic approach could be counter-
productive and could drive the problem underground so that less abuse would be reported. What I have in mind is the putting in place of agreed protocols on reporting of child abuse by professionals, who of course already have a duty of care to their clients.” There was both unease and concern in the medical community over legal mandatory reporting as there is a Fitness to Practice hearing pending against Moira Woods, the first director of the Sexual Assault Unit of the Rotunda Hospital in Dublin. She faces the hearing after parents in five families claimed they were wrongly accused of child abuse in the late 1980s.Woods denies any misconduct. The Irish Association of Social Workers has welcomed the government’s change of plan because the Association believed a strict legal reporting requirement could encourage over-reporting of vague suspicions. Karen Birchard
Forensic examination allows Guevara’s burial
O
n Oct 17, Che Guevara was given a hero’s burial in Cuba, 30 years after his violent death in Bolivia. It has taken forensic anthropologists 2 years of work to find his body, and it was not until June this year that his body was identified. In l959, when Fidel Castro came to power, Guevara left Cuba to support other revolutionaries in Latin America. In the mid-1960s, he disappeared from public view until October, l967, when a bullet-ridden body resembling him was displayed at the Sr de Malta Hospital in Vallegrande, Bolivia. Within 24 hours the body vanished, and there were no sightings for nearly 3 decades. This situation changed in November, l995, when a retired Bolivian army General, Mario Vargas Salinas, told Jon Lee Anderson, a US journalist, that Guevara had been executed and that his body had been buried in an area adjacent to an old landing strip of the airport at Vallegrande.
In response to these revelations, the President of Bolivia set up a government commission to investigate and to try to recover his remains. The Commission requested help from the Argentine Forensic Anthropology Team (EAAF), which was originally established to locate some of the tens of thousands of people who “disappeared” as a result of the actions of repressive regimes in the region. In spite of this, nothing was found and the EAAF were suspicious that the Bolivian army might be deliberately deceiving them. They therefore extended the search to include the backyard of the hospital where the body was displayed, as well as two adjacent areas which used to be an army camp. In early l997, the EAAF returned to the original airfield site with a Cuban team, and in June a skeleton was found that was eventually positively identified. Peter Kandela
Vol 350 • October 18, 1997