A 30-year-old Jehovah’s Witness presents for
emergency surgery. Which of the following
options is likely to be LEAST ACCEPTABLE to this patient during
the perioperative
period?
a) Transfusion of pre-operatively donated autologous blood
b) Transfusion of human albumin solution
c) Epidural blood patch
d) Intraoperative cell salvage
e) Cardiac bypass
Answer: a
Explanation
An adult patient with capacity is entitled to refuse to consent to
medical treatment for
good reason, bad reason or no reason at all, and no opinion should
be attributed to a
patient simply because they are a member of a religious group.
Patients are entitled to
change their minds at any time and the only thing that matters is
what treatment the
patient wishes to have at the time when the decision has to be
taken. Due to an
interpretation of several biblical texts the established Jehovah’s Witnesses’ view is
that an individual’s life is represented by their blood and that the prohibition of
blood transfusion is a deeply held core value and a sign of
respect for the sanctity of
life. As a result of this a number of treatments are either
regarded as unacceptable or a
matter for personal belief. The former group includes transfusion
of whole blood,
packed red cells, white cells, plasma, platelets and preoperative
autologous blood
collection and storage for later reinfusion (also known as
pre-deposit). The latter group
includes blood salvage (intra- and postoperative, e.g.
intraoperative cell salvage or
blood collected in drains), haemodilution, haemodialysis, and
cardiac bypass, blood
‘fractions’ of
plasma or cellular components (e.g. albumin, immunoglobulins, clotting
factors), transplantation, including solid organ, bone, tissue,
etc, and epidural blood
patch. Jehovah’s Witnesses often have advanced directives detailing their specific
beliefs and requests and these should be identified wherever possible.
Reference
Management of Anaesthesia for Jehovah’s Witnesses, 2nd edn. Association of Anaesthetists
of Great Britain and Ireland, 2005. Online at
www.aagbi.org/publications/guidelines.
htm (Accessed 30 November 2009)
Transfusion confusion.
ReplyDeleteJehovah's Witnesses doctrine allows a liver transplant but not the blood that is in it.
Jehovahs Witnesses DO take blood products now in 2012.
They take all fractions of blood.This includes hemoglobin, albumin, clotting factors, cryosupernatant and cryo-poor too, and many, many, others.
If one adds up all the blood fractions the JWs takes, it equals a whole unit of blood. Any, many of these fractions are made from thousands upon thousands of units of donated blood.
Jehovah's Witnesses now accept every fraction of blood except the membrane of the red blood cell. JWs now accept blood transfusions.
The fact that the JW blood issue is so unclear is downright dangerous in the emergency room.
More than 50,000 Jehovah's Witnesses dead from Watchtowers deadly arbitrary blood ban,some estimates run as high as 100,000 dead
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Danny Haszard ajwrb(dot)org
JW blood reform site