A-13888, MAY 3, 1926, 5 COMP. GEN. 888

A-13888: May 3, 1926

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THE PAYMENT OF A FEE OR COMPENSATION THEREFOR TO AN ENLISTED MAN OF THE ARMY WHOSE PAY OR EMOLUMENTS ARE FIXED BY LAW OR REGULATION IS PROHIBITED BY THE PROVISIONS OF SECTION 1765. NOTWITHSTANDING IT MAY HAVE BEEN RENDERED IN AN EMERGENCY. WITH RESPECT TO THIS MATTER YOU SUBMIT THE FOLLOWING EXPLANATION: BLOOD TRANSFUSION IS AN APPROVED MEDICAL PROCEDURE TO SAVE LIFE IN CERTAIN EMERGENCIES. THAT IS TO SAY. IT IS AN ESTABLISHED SCIENTIFIC CONCLUSION THAT HUMAN BLOOD IS OF SEVERAL TYPES. THAT ONE TYPE OF BLOOD CAN NOT BE TRANSFUSED WITHOUT DANGER INTO THE VEINS OF A PATIENT WHOSE BLOOD IS OF ANOTHER TYPE. POSITIVE KNOWLEDGE OF THE TYPE OF THE BLOOD TO BE TRANSFUSED IS NEEDED. SINCE TRANSFUSION IS ESSENTIALLY AN EMERGENCY OPERATION.

A-13888, MAY 3, 1926, 5 COMP. GEN. 888

COMPENSATION, ADDITIONAL - BLOOD TRANSFUSION AS A BLOOD-TRANSFUSION OPERATION INVOLVES ON THE PART OF THE DONOR THE RENDERING OF A SERVICE RATHER THAN THE SALE OF A COMMODITY, THE PAYMENT OF A FEE OR COMPENSATION THEREFOR TO AN ENLISTED MAN OF THE ARMY WHOSE PAY OR EMOLUMENTS ARE FIXED BY LAW OR REGULATION IS PROHIBITED BY THE PROVISIONS OF SECTION 1765, REVISED STATUTES, NOTWITHSTANDING IT MAY HAVE BEEN RENDERED IN AN EMERGENCY.

COMPTROLLER GENERAL MCCARL TO THE SECRETARY OF WAR, MAY 3, 1926:

THERE HAS BEEN RECEIVED YOUR REQUEST OF APRIL 6, 1926, FOR DECISION WHETHER APPROPRIATIONS CARRIED IN THE CURRENT ARMY APPROPRIATION ACT FOR "MEDICAL AND HOSPITAL DEPARTMENT," MAY BE USED TO PAY ENLISTED MEN OF THE ARMY FOR FURNISHING BLOOD FOR TRANSFUSION PURPOSES.

WITH RESPECT TO THIS MATTER YOU SUBMIT THE FOLLOWING EXPLANATION:

BLOOD TRANSFUSION IS AN APPROVED MEDICAL PROCEDURE TO SAVE LIFE IN CERTAIN EMERGENCIES. IT CAN NOT, HOWEVER, BE DONE INDISCRIMINATELY; THAT IS TO SAY, IT IS AN ESTABLISHED SCIENTIFIC CONCLUSION THAT HUMAN BLOOD IS OF SEVERAL TYPES, AND THAT ONE TYPE OF BLOOD CAN NOT BE TRANSFUSED WITHOUT DANGER INTO THE VEINS OF A PATIENT WHOSE BLOOD IS OF ANOTHER TYPE. BEFORE TRANSFUSION CAN SAFELY BE DONE, POSITIVE KNOWLEDGE OF THE TYPE OF THE BLOOD TO BE TRANSFUSED IS NEEDED. SINCE TRANSFUSION IS ESSENTIALLY AN EMERGENCY OPERATION, IT IS EQUALLY NECESSARY TO KNOW BEFOREHAND WHERE SUITABLE TYPES OF BLOOD CAN BE HAD, AND EVERY HOSPITAL APPLYING THIS MEASURE MUST HAVE AVAILABLE A LIST OF PERSONS WILLING TO FURNISH BLOOD (GENERALLY TERMED DONORS) WHOSE BLOOD TYPES ARE KNOWN IN ADVANCE AND WHO CAN BE HAD PROMPTLY ON CALL.

THE ARMY HOSPITALS ARE IN THE SAME SITUATION IN THIS RESPECT AS THE NAVY HOSPITALS, AND PROBABLY IN NO DIFFERENT CASE FROM THE HOSPITALS OPERATED BY THE OTHER GOVERNMENT MEDICAL SERVICES. IN ORDER THAT THE REQUIRED BLOOD TYPES MAY BE READILY AVAILABLE, THE ONLY PRACTICAL PROCEDURE IS TO FIND THEM AMONG THE HOSPITAL PERSONNEL. EVEN THOUGH THE PROPER TYPES COULD BE FOUND AMONG PRIVATE CITIZENS OF THE COMMUNITY OR NEIGHBORHOOD, SUCH PRIVATE CITIZENS WOULD FREQUENTLY NOT BE ACCESSIBLE ON CALL. THE PERSONNEL IMMEDIATELY ATTACHED TO THE HOSPITAL MUST, THEREFORE, IN ACTUAL WORK, BE TURNED TO FOR TESTED DONORS.

THE SITUATION AS THUS PRESENTED IS NOT MATERIALLY DIFFERENT FROM THE MATTER AS PRESENTED BY THE NAVY DEPARTMENT AND WHICH WAS THE SUBJECT OF MY DECISION OF FEBRUARY 24, 1926, 5 COMP. GEN. 658. CAREFUL CONSIDERATION HAS BEEN GIVEN TO THE REPRESENTATIONS AND ARGUMENTS SUBMITTED IN YOUR LETTER, BUT THERE APPEARS NO REASONABLE BASIS FOR CONCLUDING OTHERWISE THAN THAT A PERSON SUBMITTING TO A BLOOD TRANSFUSION OPERATION FOR THE BENEFIT OF A PATIENT RENDERS A PERSONAL SERVICE. THEREFORE, IF SUCH PERSON IS AN ENLISTED MAN, OR HOLDS ANY OTHER POSITION IN THE GOVERNMENT SERVICE, THE SALARY, PAY, OR EMOLUMENTS OF WHICH ARE FIXED BY LAW OR REGULATIONS, THE PAYMENT OF ADDITIONAL COMPENSATION BECAUSE OF THE TRANSFUSION OPERATION IS PROHIBITED BY THE PROVISIONS OF SECTION 1765, REVISED STATUTES. SEE IN THIS CONNECTION 5 COMP. DEC. 916, IN WHICH IT WAS HELD THAT A PRIVATE IN A COMPANY OF VOLUNTEERS WHO HAPPENED TO BE A PHYSICIAN COULD NOT BE PAID FOR PROFESSIONAL SERVICES RENDERED IN AN EMERGENCY TO OFFICERS AND SOLDIERS WHO WERE SICK. SEE ALSO 26 COMP. DEC. 568.

THE QUESTION SUBMITTED IS ANSWERED IN THE NEGATIVE.

IF IT IS CONSIDERED NECESSARY OR DESIRABLE TO PAY ENLISTED MEN, OR OTHER HOSPITAL PERSONNEL, FOR SUBMITTING TO BLOOD-TRANSFUSION OPERATIONS, THE MATTER WOULD APPEAR TO BE PROPER FOR PRESENTATION TO THE CONGRESS WITH A VIEW TO OBTAINING SPECIFIC LEGISLATIVE AUTHORITY THEREFOR.