scholarly journals Authorization of Involuntary Blood Transfusion for Adult Jehovah's Witness Held Unconstitutional: In re Brooks' Estate

1966 ◽  
Vol 64 (3) ◽  
pp. 554 ◽  
Keyword(s):  
Blood Transfusion ◽  
Jehovah’S Witness ◽  
Jehovah's Witness

scholarly journals Major liver surgery in a Jehovah’s Witness patient: challenges for safe surgery

2019 ◽  
pp. 24-26
Author(s):  
WY Lim ◽  
L Loh ◽  
SR Desai ◽  
SL Tien ◽  
BK Goh ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Patient Autonomy ◽  
Ethical Issues ◽  
Major Surgery ◽  
Blood Products ◽  
Jehovah’S Witness ◽  
Jehovah's Witness ◽  
Safe Surgery ◽  
Patient Consent ◽  
Witness Patient

Jehovah’s Witnesses presenting for major surgery run the risk of major bleeding, which is complicated by the refusal to accept blood transfusion. We present a case of a 63-year-old woman, a Jehovah’s Witness, who was diagnosed with hepatocellular carcinoma and advised for curative laparoscopic liver segmentectomy. Due to the risk of significant intraoperative haemorrhage, her perioperative care was coordinated in a multidisciplinary manner. Informed consent requires the physician to advise on the material risks of undertaking major surgery without blood transfusion and the possible alternatives. Conflicting ethical issues of patient autonomy and beneficence related to refusal of blood products also arise. Perioperative strategies to minimise blood loss, maximise haematopoiesis and tolerance of anaemia to facilitate safe surgery in such patients are also presented. Written patient consent obtained.

scholarly journals Preoperative Hemoglobin Optimization in Jehovah's Witness Cardiovascular Surgery Patients with Anemia and Barriers to Care

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4954-4954
Author(s):  
Patricia Locantore-Ford ◽  
Evani Patel ◽  
Sarah Chen ◽  
Robert C Goodacre ◽  
Brianna Butler ◽  
...  
Keyword(s):  
Health Care ◽  
Cardiac Surgery ◽  
Blood Transfusion ◽  
Care Providers ◽  
Blood Products ◽  
Blood Conservation ◽  
Preoperative Anemia ◽  
Jehovah’S Witness ◽  
Jehovah's Witness ◽  
The Cost

Abstract Cardiac surgery has a risk for extensive blood loss which poses a particular challenge in individuals refusing blood transfusions. Additionally, preoperative anemia with a hemoglobin (Hb) below 13 g/dL in men and 12 g/dL in women is associated with increased short and long-term complications and mortality and increases the need for blood transfusion support. The current guidelines for perioperative anemia management recommend optimizing hemoglobin levels prior to surgery and utilizing blood conservation techniques during the procedure. At present red blood cell (RBC) transfusions during cardiac surgery are usually recommended when Hb levels are below 7-8 g/dL a restrictive transfusion strategy to reduce complications. However, the use of any RBC transfusions is associated with worse outcomes in cardiac surgery compared with those who do not receive transfusions. We have found that JW seek out quality health care and accept the vast majority of medical treatments once they are educated. The Transfusion Free Medicine Coordinator's role in the Anemia Clinic is to endorse clinical strategies for managing hemorrhage and anemia without blood transfusion. They educate and counsel the patients so they can decide as to what blood fractions and cell salvage techniques they will accept. We have found that some Health Care Providers are unaware that ESAs also contain albumin so JW patients may be given this product without that knowledge. The vast majority of patients will accept the use of ESAs but find the cost prohibitive. Jehovah's Witness patients have provided a natural case study for examining how well adjuvant therapies can improve preoperative anemia without transfusions and continue with good outcomes. Hb optimization is achieved through the use of intravenous iron and, if needed, erythropoiesis stimulating agents (ESAs). In Table 1 we highlight our single center data in which all cardiovascular surgeries were performed by a surgeon experienced in blood-conservation strategies. Our thirty-day re-admission rates for all patients was zero percent, compared to state-specific data, which estimates about an 11.7% rate of re-admission. The data illustrate the need to have a target Hb 13 or above to allow for the decline that may occur during the hospital stay. Of note no thromboembolic events have occurred with the use of an ESA in this group. Although ESAs are approved to optimize Hb in orthopedic surgery, they are not covered for cardiac surgery which has presented a significant challenge to patients who can not safely proceed to surgery until a target Hb between 13 to 15 g/dL is achieved. These data highlight the utility and safety associated with the use of ESAs for patients who do not accept blood products at an experienced Center for Transfusion-Free Medicine, such as ours. At this time, since insurance companies do not cover the cost of ESAs for patients needing life-saving cardiovascular operations, cost is a prohibitive barrier for patients. Unfortunately, it is not uncommon for patients to have to borrow money from others or set up payment plans. We hope that analyses like ours will help drive changes in reimbursement policies, particularly for patients who based on religious convictions, cannot receive blood products, and thus for whom pre-operative hemoglobin optimization is of utmost importance. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare. OffLabel Disclosure: Erythropoiesis-stimulating agent (ESA) are indicated for the treatment of anemia due to Chronic Kidney Disease in patients on dialysis and not on dialysis, Zidovudine in patients with HIV-infection, anemia due to myelosuppressive chemotherapy and reduction of allogeneic RBC transfusions in patients undergoing elective, noncardiac, nonvascular surgery

scholarly journals Blood transfusion in children: the refusal of Jehovah’s Witness parents’

Open Medicine ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. 101-104 ◽  
Author(s):  
Adelaide Conti ◽  
Emanuele Capasso ◽  
Claudia Casella ◽  
Piergiorgio Fedeli ◽  
Francesco Antonio Salzano ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Health Workers ◽  
Competent Authority ◽  
Legal Framework ◽  
Parental Responsibility ◽  
Best Interest ◽  
Jehovah’S Witness ◽  
Emergency Situations ◽  
Jehovah's Witness ◽  
A Minor

AbstractIn Italy, both parents have parental responsibility; as a general principle they have the power to give or withhold consent to medical procedures on their children, including consent for blood transfusion; however these rights are not absolute and exist only to promote the welfare of children.MethodsThe Authors discuss ethical and legal framework for Jehovah’s Witness parents’ refusal of blood transfusion in Italy. They searched national judgments concerning Jehovah’s Witness parents’ refusal of blood transfusion – and related comments – in national legal databases and national legal journals, and literature on medical literature databases.ResultsIn the case of Jehovah’s Witness parents’ refusal of blood transfusion for their child, Italian Courts adopt measures that prevents the parents from exercise their parental responsibility not in the child’s best interest.DiscussionIn the event that refusal by the parents, outside of emergency situations, exposes the child’s health to serious risk, health workers must proceed by notifying the competent authority, according also to the Italian Code of Medical Ethics.ConclusionWhen the patient is a minor, the child’s best interest always come first.

Causation, Thin Skulls and Equality

1998 ◽  
Vol 11 (1) ◽  
pp. 115-141 ◽  
Author(s):  
Dennis Klimchuk
Keyword(s):  
Blood Transfusion ◽  
Sexual Intercourse ◽  
Criminal Law ◽  
General Question ◽  
Jehovah’S Witness ◽  
Jehovah's Witness

On May 3rd 1974 Mr. Blaue entered Ms Woodhead’s house, demanding that she have sexual intercourse with him. She refused, and he attacked her with a knife and fled. Wounded seriously, she staggered out of her house and collapsed on a neighbour’s lawn. She was taken by ambulance to a hospital, where she learned that she would require surgery. Upon being informed that a blood transfusion would be required, she refused, because permitting the procedure would have been contrary to her beliefs as a Jehovah’s Witness. She was told that if she refused a blood transfusion she would surely die. She said she preferred death to undergoing the procedure, and died early the next day.As well as being an especially tragic case, R. v. Blaue raises several deep and important questions about the doctrine of causation in the criminal law. Did Blaue kill Woodhead? That is, was killing her among the things he did, an action of his rather than an event which followed his action, or an action of Woodhead’s? The general question underlying these more specific ones is: for which of the consequences of his action must a wrongdoer answer?

scholarly journals Jehovah's Witness and consent for blood transfusion in a child: The Indian scenario

2018 ◽  
Vol 12 (1) ◽  
pp. 78
Author(s):  
KG Gopakumar ◽  
T Priyakumari ◽  
Manjusha Nair ◽  
P Kusumakumary
Keyword(s):  
Blood Transfusion ◽  
Jehovah’S Witness ◽  
Jehovah's Witness ◽  
Indian Scenario
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