Baby's best interest will be focus of court in case of parents refusing vaccinated donor blood - ethical theorist

The parents refusing to allow vaccinated blood to be used during their baby's heart surgery want to use blood from a donor of their choice but a transfusion medicine specialist says this isn't as safe as blood that had been tested and screened.

The baby's parents have refused to let medical professionals use vaccinated blood in the procedure to treat their child's severe heart disease.

Te Whatu Ora has made an application under the Care of Children Act asking that the baby be placed under the guardianship of the court before appointing the doctors as agents of the court for medical care, and the parents agents of the court for all other care.

Haematologist and transfusion medicine specialist Dr Jim Faed told Morning Report if the parents continued to refuse volunteer donation, directed donation may be considered but it wasn't as safe.

"It's usual practice, and it's safest, if volunteer donated blood is provided for all transfusion needs."

There were a few instances of parents asking if they, or others, could provide the blood in a direct transfusion, he said.

"That can be done, it's not encouraged because it may not be as safe as the more highly selected donors who are used particularly for transfusion of very young babies."

Screening goes a long way to filtering out risk, he said.

"But with donor screening and testing, transfusion in New Zealand is incredibly safe."

There wasn't research showing risk of vaccinated blood Faed said, and he didn't expect there to be any risks.

"The vaccine would have been cleared, it's biological material, it'll be broken down, it doesn't last very well. What it does is it conditions the immune system to make antibodies and to have cell mediated defence," he said.

"It's not just blood that might be needed in a cardiac surgery procedure, it might be plasma in the period after the surgery when bleeding is being stopped, it might be platelets."

Lawyer acting for the family, Sue Grey, told Morning Report the parents want what's best for their baby.

The baby was born with a congenital heart defect and has already had one operation, Grey said.

The parents had found their own blood donors they want used, she said.

"The question is whether this is an appropriate case for direct donor blood."

The Blood Service said it did not keep blood for vaccinated and unvaccinated donors separate and there was no risk from the Covid-19 vaccine.

The reason the couple were in court was to create a public discussion about Covid-19 vaccinations, she said.

When the court looks at cases like this, they focus specifically on the child's best interests, University of Auckland ethical theorist specialising in healthcare ethics Dr Monique Jonas told First Up.

The court would look at what was good for the child's health but also their emotional and developmental interests as well as their relationship interests, she said.

Jonas hadn't seen a case like this in New Zealand courts related to Covid-19.

"But there is precedent around refusal of blood transfusions for children and that really comes from refusal for religious grounds.

"I'm expecting that the courts will see this case in the context of those precedent cases."

If the surgery needed to be done urgently before the court hearing, Jonas said she expected clinicians would do what they regarded in the best interests of the child.