Blood transfusion and principle of precaution.

Because of the HIV and HCV virus transmission by transfusion during the eig hties, there has been a retrospective reflection about the non-application of the precautionary principle, which has appeared only recently in the med ical world. Since it was difficult to identify the real cause of the above- cited transmission in France, mainly because of the bad selection of blood donors, we feel we are justified in appling this precautionary principle mo re and more, in a monopolistic way, for biological security reasons. As a r esult, the biological research is not limited to looking for a 'degree zero ' risk. Whether it concerns the 'PCR', the research of a new potential viru s, the excessive fear regarding the transfusion of the new ESB agent, the w orry caused by the blood donors who lived in the British Isles, the need fo r security based upon the precautionary principle is increasing endlessly. It is, however, more reasonable to consider that the precautionary principl e should by essence incite a multi-disciplinary reflection involving biolog ical sciences as well as social sciences. The precautionary principle would not make sense if it were not questioned for bad estimations, its harmful influences or its opportunistic use. Transfusion security, which is so impo rtant as a goal and as a principle, cannot appeal to the precautionary prin ciple all the time, since the excessive use of this principle would lead to the paradox of not being able to identify the issues anymore. (C) 2000 Edi tions scientifiques et medicales Elsevier SAS.