To ensure safe, sufficient supplies of human blood for European medical practice, national blood establishments reconcile the social image of blood donation with technical risk calculations/deferral policies. The sociotechnical controversy concerning the deferral of “men who have sex with men” (MSM) serves as a pre-eminent case of this challenge. Drawing on the framework of sociotechnical imaginaries, we developed an interpretive case study of negotiation on the deferral of MSM in policy discourse and the public debate between the implementation of the first EU Blood Directive (2003) and the relaxation of lifetime deferral to 12 months in Belgium (2017). We analyzed recurrent arguments made by stakeholders through the High Council for Health policy recommendations, public communications of Red Cross Flanders, and the public debate evidenced in Belgian newspapers. Instances in which MSM deferral is negotiated are part of the co-production of blood- and donor safety. This process allowed to adapt the dominant epidemiological imaginary shaping blood supply risk governance practices in four phases: classic epidemiological imaginary, challenging key elements, contentious debate, and re-adjustment. Deferral became recognized as preclusion from this institutional opportunity to demonstrate high moral virtues. This sociotechnical controversy will likely resurface, as sexually active gay men continue to be deferred.

中文翻译：

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谈判风险组分类和血液安全的共同生产：在比利时推迟男男性行为者作为献血者的公开辩论中动员的社会技术想象的演变

为了确保为欧洲医疗实践提供安全、充足的人体血液供应，国家血液机构将献血的社会形象与技术风险计算/延期政策相协调。关于推迟“男男性行为者”（MSM）的社会技术争议是这一挑战的一个突出案例。借鉴社会技术想象的框架，我们开发了一个解释性案例研究，关于在政策讨论中推迟 MSM 的谈判以及第一个欧盟血液指令（2003 年）的实施与将终生推迟到 12 个月之间的公开辩论。比利时（2017 年）。我们分析了利益相关者通过卫生政策建议高级委员会、佛兰德斯红十字会的公共交流、以及比利时报纸上的公开辩论。协商 MSM 延期的实例是血液和捐献者安全共同生产的一部分。这一过程允许在四个阶段调整主要的流行病学想象，塑造血液供应风险治理实践：经典流行病学想象、具有挑战性的关键要素、有争议的辩论和重新调整。推迟被公认为排除了这种展示高尚道德美德的制度机会。这种社会技术争议可能会重新浮出水面，因为性活跃的男同性恋者继续被推迟。这一过程允许在四个阶段调整主要的流行病学想象，塑造血液供应风险治理实践：经典流行病学想象、具有挑战性的关键要素、有争议的辩论和重新调整。推迟被公认为排除了这种展示高尚道德美德的制度机会。这种社会技术争议可能会重新浮出水面，因为性活跃的男同性恋者继续被推迟。这一过程允许在四个阶段调整主要的流行病学想象，塑造血液供应风险治理实践：经典流行病学想象、具有挑战性的关键要素、有争议的辩论和重新调整。推迟被公认为排除了这种展示高尚道德美德的制度机会。这种社会技术争议可能会重新浮出水面，因为性活跃的男同性恋者继续被推迟。