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OKLAHOMA CITY -- A child who was born prematurely at Children's Hospital was placed in protective custody this week after the mother refused a potentially life-saving blood transfusion for the infant.
The mother, a Jehovah's Witness, cited her religious beliefs in refusing the blood transfusion for son, who weighed just a pound and a half at birth, Eyewitness News 5's Randy McIlwain reported.
Acting upon a request from the child's doctor, the state stepped in. A judge placed the child in protective custody, clearing the way for the boy to receive whatever medical treatment is necessary to save his life, McIlwain reported.
Allen Poston of Children's Hospital said that a newborn child does not have the ability to make decisions for itself, medically or otherwise.
"It is our responsibility to act in their behalf," he said.
George Johnson of the Department of Human Services said that while in state custody, the child would receive a blood transfusion and other life-saving medical procedures that might be needed.
"Any child that is in state custody receives the best available medical care, no matter what anybody else says or believes," Johnson said.
A spokesman for Children's Hospital said that while the hospital respects religious differences, the hospital has a medical obligation to each patient.
The child's mother could wind up suing the hospital for treating the child, Johnson acknowledged. But he added the responsibility of the state is simple.
"Our reasonability is to preserve, in the best interest of the child, the child's life," Johnson said.
The mother is free to visit the child at any time and faces no criminal charges in the case, McIlwain reported.
The boy will remain in DHS custody while his health remains at a
crisis
level, or until a judge orders differently.
The Watchower Society has ceased disfellowshiping members who receive blood transfusions. This has been widely reported in the U.K. and the story has now been carried on the A.P.
Thursday June 22, 2000 - 12:02 PM ET
NEW YORK (AP) - The Jehovah's Witnesses will continue to reject members who defy the group's prohibition of most blood transfusions, an official of the denomination said.
Spokesman James Pellechia dismissed as misleading news reports that the longstanding policy had been reversed.
The group acknowledges that it has ended its practice of ``disfellowshipping'' - or excommunicating - members who receive blood transfusions. But Pellechia said that a Jehovah's Witness who has a transfusion automatically ``revokes his membership.''
``It has the same effect,'' said Pellechia.
Why the semantic change? Pellechia said the group is simply stating more accurately that a person who rejects its tenets chooses to leave.
But Raymond Franz, a former Jehovah's Witness who once served on the group's Governing Body, believes the Jehovah's Witness leadership hopes that publicly ending the practice of disfellowshipping will lessen negative perceptions of the group in Europe.
Pellechia notes that for two decades some Jehovah's Witnesses have
believed
that the transfusion of fractions derived from major blood components
is
allowable.
The
President of the Constitutional Court of Colombia affirms that denying
a blood transfusion constitutes First Degree Murder -"Religious freedom
is not absolute, there are limitations, a religion that attempts to
claim
the life of a person cannot be legally permitted." Read
highlights of the televised investigative report.We now have a good translation of the comprehensive Colombian
newspaper
article on blood transfusions and disfellowshipping. This
link will take you to the site where the article is hosted by Latin
American AJWRB members. Press the back button to return here when you
are
through.
May 8, 1999 Tulsa World
Dana Sterling
World Religion Writer
INFANT BETTER AFTER SURGERY
But her parents who are Jehovah's Witnesses are disturbed by the blood
transfusion that they say is prohibited by the Scripture.
A baby was improving after surgery Friday, her grandmother said, after Hillcrest Medical Center went to court to get the infant lifesaving blood transfusion. Marcella Buckland, the 13-day old infant's grandmother, said the family of Jehovah's Witnesses is uncomfortable with news media attention. She declined to give any details about baby girl born prematurely April 25. "Just say the bay is doing better now," she said. " I want people to know we do seek medical care. We just don't accept blood. Buckland said the baby had successful surgery Friday, but she declined to say what kind of surgery. Hospital officials said the family had requested that they give out no more information. Court papers indicated that the baby was born roughly in the sixth month of pregnancy. Doctors said she has severe anemia and they requested a transfusion to save her life. A Hillcrest doctor said the baby would die without the blood transfusion and Tulsa District Judge David Winslow ordered it Thursday.
Matthew Suddock, Jehovah Witness, and liaison to the medical community, stressed that church members believe in medical care and do not seek healing through prayer. Church doctrine holds that miraculous healings do not occur in modern times, he said."We do not believe that he(God) lays his hands on us symbolically and heals us. We look to the medical field for that. We believe that getting the best medical care we can is very important," Suddock said.Yet Jehovah's Witnesses also take seriously the command given to Noah in Genesis that people should not eat blood. For believers, Suddock said, that includes taking blood into the body in any form, including transfusions. Suddock said the command was repeated elsewhere in the Bible and still applies today. The church's interpretation also rules out saving one's own blood for later use. Blood that has left the body, must be discarded, he explained. "You can't really skirt God's laws. In those Scriptures,he just excluded Blood from any misuse at all, it is to be poured out on the ground." Suddock said teams of Jehovah's Witnesses all over the world, talk to doctors, nurses and hospital staffs, exploring alternatives to blood transfusions.
Because of their efforts in the United States,court orders such as the one affecting the Buckland family have become rare, he said. He said he had not yet talked to the family but expected to do so in the next few days. Suddock said alternatives to transfusions often exist. He said a team of doctors in Houston has successfully performed open heart surgery on Jehovah's Witnesses without additional blood. He added. "We hold life as sacred, whether it's just conceived, or a preemie or an adult. Suddock said the church has 6 million members worldwide. Based in Brooklyn, NY it was organized in the 19th century, but its members believe that its roots are found in the work of the early followers of Jesus. "Following church doctrine is a matter of conscience," he said. "Each individual--it's incumbent on them to take the information in order to make a decision. We strive to know what the Bible has to say and take it all. We don't exclude part of it"
Dana Sterling can be reached at 918-581-8398
BLOOD OATH DEATH RISK
By CHRIS GRIFFITH - The Sunday Mail - March 7th 1999 - page 3. ( www.news.com.au
)
Jehovah's Witnesses have been asked to sign a document described as a death warrant.
It forbids doctors and hospitals giving the person blood transfusions in an emergency.
The church is taking advantage of a new state law which allows adults to give legally binding directions on their health care in advance of illness, even when the circumstances are life threatening. A newsletter accompanying the forms says: "Brothers living near the Queensland border may also want to take advantage of these provisions since they may at some future time receive medical treatment in a Queensland hospital:"
All 12,000 members of the adult church in Queensland, have been sent a 24 page form with key answers already filled in.
One Jehovah's Witness said signing it was like "signing my death warrant". She said members had been told to return the signed forms to their religious elders or risk "disfellowshiping". However the Jehovah's Witnesses City Overseer for Brisbane, Dale Irwin, denied signing the forms.was compulsory. The church ban on Transfusions was highlighted in December when 18-year-old Tully Ioannides died in the Princess, Alexandra Hospital after refusing 'life-saving treatment. A Queensland Health spokesman said the legal standing of the new health directive was yet to be tested against law it might conflict with, including the Criminal Code.
AMA President David Brand said some doctors could face an ethical
difficulty
witnessing the health directives because they took a Hippocratic oath
to
save lives. Click Here to see the original article.
Copyright 1999 Globe Newspaper Company
The Boston Globe
February 17, 1999, Wednesday ,City Edition
SECTION: METRO/REGION; Pg. B1
LENGTH: 738 words
HEADLINE: Ruling clarifies minors' rights;
Court gives weight to medical wishes
By John Ellement, Globe Staff
Ruling in the case of a 17-year-old Lenox teenager who objected
to a blood transfusion on religious grounds, the state Appeals Court
for the first time yesterday gave minors a voice in deciding whether
they can refuse life-saving medical treatment.
The court said judges must interview the minors and determine
whether they are mature before deciding what is in their "best
interest."
Richard A. Simons, who represents the Lenox teenager, said the
ruling means minors who can convince a judge they are making a
rational, intelligent choice to refuse medical treatment may see their
wishes prevail over the objections of their parents and the state.
"The court is indicating" that judges "may consider the maturity of
the
child to make informed choices," said Simons, a Pittsfield attorney.
"And
when that child expresses their preference and expresses their
religious
conviction, that's what's significant - rather than just saying a minor
has
no say in controlling his or her medical decisions."
At issue in the case were the wishes of Alexis Demos, a 17-year-old
Lenox girl who was seriously injured in a Jan. 26 snowboarding
accident.
As part of the medical treatment at the Berkshire Medical Center for
her
lacerated spleen, doctors said she could possibly need a life-saving
blood transfusion if the spleen started to bleed.
Demos and her parents objected on religious grounds because as
Jehovah's Witnesses they believe a blood transfusion would violate
a biblical prohibition on "eating blood."
The hospital then asked Berkshire Superior Court Judge Judd Carhart
to step in and permit doctors to administer the transfusion if needed,
citing the state's interest in preventing an avoidable death of a
child.
Carhart, after hearing from Simons and the hospital, agreed with the
hospital and ordered the transfusion if needed.
The Demoses appealed, and the court ruled yesterday even though
Demos is no longer in immediate medical danger. The Appeals Court
decided to rule in this case because of the scarcity of appellate cases
in the area of a minors' rights to control medical intervention.
The court said that since a 1991 ruling by the Supreme Judicial
Court,
a competent adult clearly can refuse live-saving treatment. "The law
is
well-settled . . . that a competent adult may refuse medical treatment
even if the treatment is necessary to save her life," Appeals Court
Judge Elizabeth Porada wrote for the court.
The court said it has also been clear since 1991, in a separate SJC
ruling, that judges can order life-saving treatment for minors when
a
parent refuses to give permission. In those situations, judges have
to
weigh what is in the "best interest of the child" along with the
parents'
wishes and the state's obligation to protect its residents.
The court decides what is in the child's best interest based on five
criteria: the minor's wishes, the minor's religious beliefs, the
probability of adverse side effects from treatment, prognosis without
treatment,
and the competency of the minor to make that decision.
But until yesterday's decision, it was unclear whether courts needed
to
hear directly from a "mature minor" about their wishes and also whether
the courts needed to give those ideas weight.
"Although the judge did consider" Demos's "wishes and her religious
convictions in this matter, he made no determination as to her maturity
to make an informed choice," Porada wrote. Carhart "should not have
relied solely on the representations made by her attorney and her
parents, but should have heard her own testimony."
Porada added, "it is appropriate for a judge to consider the
maturity
of
the child to make an informed choice."
The Appeals Court said state law is vague about how to define a
"mature minor" who is legally capable of making important decisions.
"Our laws provide no bright line as to when a minor reaches an age
to make certain decisions in life," Porada wrote in a footnote.
In Massachusetts, for instance 14-year-olds can be sentenced to life
in
prison without parole and 16-year-olds can drop out of school, consent
to have sex, hold a job, and drive. Eighteen-year-olds can marry, vote,
and get an abortion.
Simons said he spoke briefly with Demos yesterday and said she was
delighted by the court's ruling. He said she is recovering, but still
faces
a possibility of needing a transfusion if her progress suddenly slows.
Jehovah's Witness Who Caused Furor by Refusing
Transfusion Dies
By William Branigin
Washington Post Staff Writer
Wednesday, February 3, 1999; Page A05
A Bolivian woman whose illness stirred a controversy over religious objections to blood transfusions died yesterday in a California hospital.
Rosario Villagomez, 51, a former Washington area resident who was a devout member of the Jehovah's Witnesses, died of lung disease more than six weeks after she was stricken with a severe case of gallstones and ensuing complications. Doctors gave the cause of death as "pulmonary fibrosis," said Dana Woods, a spokeswoman for Martin Luther Hospital in Anaheim.
The case divided an immigrant family and became a focal point of a dispute over the Jehovah's Witnesses' doctrine banning consumption of blood. The religious group forbids various types of blood transfusions, including administration of packed red blood cells, plasma and platelets.
Spokesmen for the Brooklyn-based Watchtower Bible and Tract Society, as the group is officially known, denied that Villagomez's religious stand affected her medical treatment. But her cousin, Myriam Collyns, an employee of the International Monetary Fund here, strongly criticized the society over the case, saying doctors told her repeatedly that a blood transfusion could have helped Villagomez recover and that alternatives favored by the Jehovah's Witnesses, while helpful, were insufficient.
Citing "patient confidentiality," Woods said attending doctors would not discuss the case with reporters. On behalf of the hospital, she said only that "we fully complied with the patient's written request that she not receive any blood transfusion or blood derivative products in connection with her care."
After The Washington Post reported on Villagomez's case last month, the Watchtower Society objected to characterizations of the controversy and pointed out that the report mistakenly referred to the Martin Luther King Hospital in Los Angeles.
"The main point is that Mrs. Rosario Villagomez' religious beliefs are irrelevant to her current medical condition," a Watchtower spokesman said in a Jan. 26 letter. It said her illness "resulted from blockage of her bile duct by gallstones and not from her refusal to accept blood" and cited the assessment of a consulting physician, Vinod Malhotra, director of the Bloodless Medicine and Surgery Program at Fountain Valley Regional Hospital and Medical Center.
In a telephone interview a day before she died, the patient's husband, Freddy Villagomez, also a Bolivian immigrant and devout Jehovah's Witness, confirmed that doctors had recommended a blood transfusion when she was admitted in December and said the couple's religious convictions had come into play.
"We decided -- my wife decided -- not to have a blood transfusion in
the first place . . . because of our religious stand," he said.
THE AUSTRALIAN
Another Witness chooses maker over medicine
By ADRIAN McGREGOR
22dec98
AN 18-year-old Jehovah's Witness who declined a blood transfusion has
died in a Brisbane hospital
after a rare rupture of an artery in her leg.
She is the second Jehovah's Witness woman to die after refusing a
blood
transfusion in Princess
Alexandra Hospital in the past fortnight.
The first, a 26-year-old married woman, died in the hospital's renal
unit after suffering a chronic
debilitating kidney disease.
Princess Alexandra doctors said yesterday that if the Brisbane
teenager,
Tully Ioannides, of Bethania,
had agreed to a transfusion, she would be alive today.
Friends said that when told her life was in danger, Ms Ioannides
replied:
"That's all right, there's worse
things than dying."
Ms Ioannides died on Saturday morning amid emotional scenes, in
which
her family, friends and 20 of
her young Witness congregation played guitars and sang hymns to her
in a bedside vigil.
Her father, Nick Ioannides, also a Witness, said: "It was beautiful,
it was incredible, but it was
heartbreaking. The whole ward stood still, even the staff were choked
up."
But her mother, Ann Ioannides, a non-practising Witness, said: "To a
lot of people, it's not ever going
to make any sense. I had to do what my daughter wanted, but I blame
the hospital. My daughter goes
in with a little problem and it turns out to be a tragedy."
But the hospital's medical superintendent, Michael Cleary, said the case was extraordinarily rare.
He said: "In our quick look around, we have not been able to find a
case where the problem, a
ruptured aneurism in her artery, has occurred in a young person
before."
Ms Ioannides, a coffee shop waitress, was admitted to Logan
Hospital,
in Brisbane's southern
suburbs, at 9.20pm last Wednesday after noticing a swelling in her
calf.
Dr Cleary said Logan staff at first suspected a deep vein
thrombosis,
a clot that could break off, flow
into the lungs and become life-threatening.
After Ms Ioannides was transferred to Princess Alexandra at 8.30pm
on
Thursday, radiologists
identified the real problem as a ruptured aneurism.
But by Friday afternoon, Ms Ioannides's blood volume consisted of
only
one litre of red cells and four of
plasma, as against a normal ratio of three of red cells to two plasma.
"She had lost a huge amount of blood, leaking into her leg tissues
and,
without a transfusion, doctors
were giving a fairly guarded prognosis," Dr Cleary said."
DOCTORS were forced to stand by and watch an ailing woman die in the
Princess Alexandra Hospital last week, because her religion had banned
blood transfusions.
Jehovah's Witness Brisbane Hospital Liaison Committee member Dale
Irwin
said the 26-year-old woman had signed a medical directive alert card
stating she did not wish to receive a blood transfusion or any other
blood
products.
"All baptised Jehovah's Witnesses carry a medical directive/alert
card
which states their express wish not to have blood or blood products
administered and it is signed by them and two witnesses, therefore
making
it a legal document," said Mr Irwin.
Hospital staff refused to comment on the case yesterday, saying the
family
of the dead woman had asked for absolute anonymity. In the Jehovah's
Witness faith, a blood transfusion is the same as eating blood, which
is
forbidden in the book of Genesis in the bible.
Jehovah's Witnesses are also banned from storing their own blood
before
an
operation.
A member of the faith who accepts a blood transfusion for themselves
or
their family will be disfellowshipped by the church, the church's
Internet
page said.
Australian Medical Association Queensland president Dr Dana
Wainwright
said the Brisbane case was a tragedy for the woman's family and for
medical staff treating her.
"It's very difficult to watch somebody die when treatment could have
sustained life," she said.
"We try to save lives as often as we can."
Dr Wainwright said when faced with a patient refusing treatment on
medical
grounds, every effort had to be made to make sure that was the
patient's
current wish.
"We have to respect the patients right to accept or reject
treatments
or
procedures," she said.
"If we don't, it is considered an assault."
Dr Wainwright said non-blood products could maintain a patient's
blood
pressure for a limited time, but there was no non-blood product that
could
be used to replace blood in cases of severe blood loss.
The woman's death in Brisbane came as a Melbourne woman appealed a
court
ruling that overrode her written refusal of a blood transfusion.
The 21-year-old woman began suffering complications after the birth
of her
first child earlier this year.
As she lay unconscious in hospital, her husband obtained a court
order
allowing him to over-rule her wishes.
The woman has now sought leave to take the case to the High Court,
alleging the decision to appoint her husband legal guardian failed
to give
due regard to her right to self-determination and physical integrity.
La Vanguardia - Barcelona Spain
The Spanish spokesman of Jehovah’s Witnesses says that the Bible is clear on the blood issue, and that the decision is personal.
The acceptance of Blood transfusions starts a debate among Jehovah's Witnesses
ISABEL PALACIOS
BARCELONA. – "Abstain from blood", says a bible passage. That translates for Christian Jehovah’s Witnesses to a definite no to blood transfusions. The collective doctrine is in that sense, strict. However, the spokesman of the National Branch in Spain, Aníbal Matos, recognizes "in all countries each brother decides individually; we do not excommunicate for accepting a blood transfusion, we do not impose the faith". (italics ours).
This theme, up to now unknown to public opinion, just came to light in a web page of a group called "The Associated Jehovah's Witnesses for Reform on Blood". "No one knows who they are, and they are creating confusion on this theme" continues Matos. But the truth is that the page has become an open forum of discussion between supporters and opposers of the "non-blood" practice.
The polemic began with the diffusion of the amicable agreement reached within the European Commission of Human Rights, between the Bulgarian Government and the Association of Christian Jehovah’s Witnesses. Both kept a long dispute because of the governments refusal to renew their status as religious association, based on a law of 1994. In the agreement, according to the statement of the Secretary of the European Commission of Human Rights referred to it’s session held on Strasbourg this year, from March 2 to 13, where "the Government agreed to introduce legislation as soon as possible to provide for civilian service for conscientious objectors, as an alternative to military service, and to register the applicant association as a religion."
Jehovah’s Witnesses on their part, agreed to "with regard to its stance on blood transfusions to draft a statement for inclusion in its statute providing that members should have free choice in the matter for themselves and their children, without any control or sanction on the part of the association. (http://194.250.50.201/eng/ E276INFO.148.html).
The agreement and the reactions to it appear in the web page "The Associated Jehovah's Witnesses for Reform on Blood" http://www.geocities.com/ Athens/Delphi/1524. This group is said to be formed by active Jehovah’s Witnesses, that work anonymously precisely because they defend blood transfusions and because society "has threaten to disfellowship those who dare to discuss this issue publicly".
"At this moment - continues the web page - more than five million people are at risk of dying unnecessarily because of a wrong interpretation of what the sanctity of blood means." There are other web sites for ex-witnesses as: http://www.geocities.com/ Athens/Troy/1484 with the intention to provide an electronic mail-list for former members and others persons who are interested in this issue. And the web site of Jehovah's Witnesses, http://www. watchtower.org/languages. "We are preparing a web site because the open debate is unreal", adds Matos.
Jehovah’s Witnesses are around five million worldwide, have more than 85.000 congregations in 230 countries, and operate through 104 branches. They believe that the Bible (in Acts 15: 28,29 as example) teaches that Christians must abstain from blood, and from meat whose blood has not been properly drained.
The prohibition on transfusions extends to red cells, white cells, plasma and platelets. But the donation and use of organ transplants are permitted. According to Matos, there are alternatives to transfusions:
"In Spain, around one hundred hospitals have protocolized the attention for Jehovah’s Witnesses, and in Barcelona there are two centers of bloodless surgery, Delfos Clinic, and Hospital Sagrat Cor".
Stories of the dead ones
The web page of "The Associated Jehovah's Witnesses for Reform on Blood" (ATJPRS), not only brings out the polemic on transfusions. It’s visitors send personal experiences. All tragic, as a result of the "non-blood" policy. At page http://www.geocities.com/ Athens/Delphi/1524/angel.html Jason Patrick is one of them and relates when he picks up the dead daughter of his friends, and includes a note from the "Auckland Times" August 17, 1996 that says: "A YOUNG girl aged 3 tragically died last night in hospital after parents refused to administer a blood transfusion under religious belief."
The girl was Angelique Perrota, she was three
years
and three days old. After that her mother died, and the husband was
declared
in apostasy. Until then, they were Jehovah’s Witnesses. "The web site
is
dedicated to the thousand of innocent victims who have lost their lives
for the doctrine of the Watch Tower Bible & Tract Society" ends the
web. The Watch Tower Society has its offices in Brooklyn (U.S.A.) and
there
is where it’s governing body is gathered.
Jehovah's Witnesses can receive blood?
STOCKHOLM (FLT)
Johanna Kronlid - Copyright: Helsingborgs Dagblad
July 19, 1998
Jehovah's Witnesses ban on receiving blood has been relaxed. In Bulgaria Jehovah's Witnesses have agreed to let their members decide for themselves if they want to accept a blood transfusion.
The Witnesses in Bulgaria were forced to loosen up their stand against transfusions in order to be recognized as a church. The blood ban is a very important factor in the Jehovah's Witnesses teaching. Theologians view the change in the blood stance as revolutionary, but Jehovah's Witnesses in Sweden want to de-emphasize the development.
To receive blood is a question of personal conscience, says Olle
Hjärpe,
information secretary for Jehovah's Witnesses. Previously, members of
Jehovah's
Witnesses were disfellowshipped if they accepted a blood transfusion.
This
is not the case now. We talk with the person and give spiritual
guidance,
but we do not condemn and disfellowship if the person in question
doesn't
openly advocate blood transfusions. Olle Hjärpe can't recollect
any
case where any member has accepted a blood transfusion. The opposite is
usually the case, that the members refuse transfusions. Experts claim
that
Jehovah's Witnesses rarely drastically change views like this. There is
a lot of secrecy inside Jehovah's Witnesses. Earlier, for example, it
was
prohibited to accept vaccines. When this was abolished it wasn't
announced
loud and clear, but rather mentioned in a passing sentence, says Haakan
Arlebrand, Goteborg, who has written a book about Jehovah's Witnesses.
Rud Persson from Ljungbyhed left Jehovah's Witnesses after being
associated
for 30 years . He doesn't trust the information about the Bulgarian
relaxation
from the rules. "If it is correct it is revolutionary. But Jehovah's
Witnesses
are tricky. They can state that this is up to each individual member,
but
later this individual will be shunned anyway, this is bordering on
persecution."
DECISION ABOUT BLOOD TRANSFUSION CAN CAUSE DISSENT AMONG JEHOVAH'S WITNESSES
Copenhagen (TT-RB)
Elfsborgs Läns Allehanda
The ban on accepting others' blood is central in the message from Jehovah's Witnesses. Those who accept transfusion are to be expelled, they said. Until now.
Now, a softening of these iron hard rule threatens to split the organization.
To be accepted as a religious society in Bulgaria, Jehovah's Witnesses have been forced to allow members to decide if they shall accept blood.
The decision is a bomb below the Jehovah's Witnesses if they put the law of the land before the rule against blood transfusions, explains Peter Lodberg, assistant professor in theology with Århus University [Denmark] to Berlingske Tidende [Danishnewspaper].
In Denmark, the Jehovah's Witnesses have worked hard for their right to refuse blood transfusions. It has become a uniting sign of their identity that is now under threat.
The Bulgarian fall has had ripple effects in Denmark, but the
Witness
leaders have until now kept information about what has
happened from the Danish members.
We have chosen to not inform the members, since this case does not
add
anything new, explains the Danish Witnesses'
information secretary Michael Björk.
Björk says that the members who accept blood once are no longer automatically expelled:
On the contrary they need spiritual guidance, says Björk.
Sören Bo Henriksen, leader of the support group for former
Jehovah's
Witnesses, on the other hand hopes this softening for
the Bulgarian witnesses also will spread quickly to Denmark, that angry
members force their leaders to abolish the transfusion
ban. Lodberg also believes that the Bulgarian example will spread to
Denmark.
The latest death in Denmark was a 24 year old woman at the hospital in Hvidovre, when she refused blood when giving birth in October 1996.
However, the prohibition has no doubt been most controversial when
parents
have tried to prevent their underage children from receiving blood
transfusions.
In Sweden, social authorities have intervened to make sure that
children
who need it receive blood.
Rebels fight Jehovah Witnesses' blood ban
By Victoria Combe, Churches Correspondent - London Daily Telegraph
A DISSIDENT group of Jehovah's Witnesses have begun a campaign via the Internet to end the religious organization's opposition to blood transfusions.
The group - the Associated Jehovah's Witnesses for Reform on Blood - claim that the ban on members receiving blood has no Biblical standing and puts lives at risk. A number of Witnesses have chosen to die rather than receive a transfusion.
Last month doctors in Glasgow gave a baby blood to keep her alive although her parents, who were Jehovah's Witnesses, objected. The web site authors have remained anonymous and give an American post office box in Idaho. They claim that some of them are serving Elders and risk excommunication for their views.
Certainly their protests have angered the London headquarters of Jehovah's Witnesses, which is seeking to improve relationships with doctors and offer alternatives to blood transfusions. Jehovah's Witnesses believe that the Bible (in Acts 15: 28-29) teaches that Christians must abstain from eating blood and meat of animals from which blood has not been correctly drained.
The ban on transfusions extends to packed red blood cells, white blood cells, plasma and platelets, but an exception is made for immunoglobulins in certain vaccines. Although giving blood is against the teaching of Jehovah's Witnesses, they do allow organ donations and transplants on the grounds that bone and tissue is not forbidden in the Bible.
The dissident group has challenged the Biblical teaching claiming that a blood transfusion is a "liquid tissue or organ transplant, not a meal".
They state that their purpose is to change the teaching so that individual Witnesses may choose whether to accept blood products or not "without fear of being disfellowshipped or shunned."
Paul Gillies, a Jehovah Witness press officer, said that a member who accepted a blood transfusion would be excommunicated only if they had abandoned the teaching on blood. He said: "Our first response is pastoral. People are often put under pressure in an emergency and we take this into account." He said greater research was being done on limiting blood loss during surgery and on using "volume expanders" such as saline, instead of blood transfusions.
Mr. Gillies was adamant that the teaching was not
about
to change and that anyone who did not accept the Biblical
interpretation
on blood should leave.
The copyline above the article captured the puzzlement: “Faith or love: husband faces hardest choice”. How did two virtues become so mutually exclusive? And yet, what right do we have to comment on their faith anyway? The case stretched our conceptions of autonomy and pluralism. Is it then acceptable for a husband to overrule his wife’s deepest convictions about what she does with her body? The woman had signed an authority refusing a blood transfusion just before she underwent emergency surgery. A statement from a Jehovah's Witness spokesperson described what happened as akin to rape, leaving us in no doubt as to the stigma they attach to the practice.
The Medical Treatment Act considers any treatment without the patient’s consent as “assault”. But no one wants a veneer of autonomy. We don’t want uninformed or unreasoned autonomy. Likewise there are limits to pluralism. Certain religious practices, however sincere, fall outside the law. Female genital mutilation (female circumcision), polygamy, animal sacrifices and, in Victoria at least, Jehovah's Witnesses can no longer forbid their children be given blood transfusions.
The case in question illustrates the qualifications to respect for autonomy. The Guardianship and Administration Board can at any time override a Power of Attorney “in the best interests” of the patient. Though this is not defined, the Board seems to have favoured the medical interests of the woman over her religious interests—the physical, perhaps, over the spiritual.
In a similar medical case in the United States a number of years ago, John Maurer refused to authorise a blood transfusion when his wife Eleanor started haemorrhaging after their child was delivered. He was asked four times for permission and four times he refused. After Eleanor Maurer bled to death, a shaken Dr Raymond Gagnon commented: “I have never seen anyone die in these circumstances and I hope never to see it again.” Dr Gagnon’s sentiments regardless, this is a regular occurrence (and most often the victims are women and children). Doctors such as J. Lowell Dixon must seek an ethical comfort in such a situation. Dixon finds it in the words of John Stuart Mill from On Liberty which he quotes in an article (which the Jehovah's Witnesses reprint) in the New York State Journal of Medicine:
“No society in which these liberties are not, on the whole, respected is free, whatever may be its form of government . . . Each is the proper guardian of his own health, whether bodily, or mental and spiritual. Mankind are greater gainers by suffering each other to live as seems good to themselves, than by compelling each to live as seems good to the rest.”
Though the Guardianship and Administration Board’s reasons for granting guardianship to the husband is a matter of the strictest confidentiality, the principle of the respect for autonomy which Mill here articulates may have been qualified by a number factors. These must be viewed in the context of the sect’s teaching and practices. For example, are the beliefs genuine? Perhaps the woman being converted six months previously was a factor. A sect member of long standing might have been perceived to have ‘more genuinely’ held these beliefs. Are the beliefs coerced? This might be a value judgment, but in ethics these must be made all the time, and the history of the sect isn’t the rosiest.
A newsgroup of former Jehovah's Witnesses published the case of a Massachusetts’ man who, on his deathbed, accepted a transfusion as the only thing that would keep him alive long enough for his family on the other side of the country to reach his bedside. “The sect’s elders also showed up at his bedside, held a judicial committee meeting right there in the hospital, and disfellowshipped him on his deathbed. The announcement to the congregation included the warning that any who might attend his funeral would face similar judicial action.” Expulsion (or disfellowship) is possible over any transgression of the ‘inspired’ prohibitions contained in their magazines the Watchtower and Awake. Even a casual reading of Jehovah's Witnesses history leaves one thinking Trotsky got off easy. Husbands who wouldn’t ‘repent’ of oral sex in foreplay have been expelled and the wives often counselled to divorce. Participation in birthdays, Mother’s Day, Christmas and Easter are punishable by expulsion. The history of the sect’s teaching against blood transfusions is convoluted and difficult to summarise. But three things are noteworthy. It is based on a reading of the Bible that no other religious movement has ever arrived at; not what one would expect if it were simply a ‘literal’ interpretation. It was in fact first taught 45 years after blood typing made transfusions commonplace. As late as 1940 the then President commented favourably on a surgeon who donated blood to a patient. The organisation has vacillated on many aspects of its prohibition. In the 30's smallpox vaccinations were forbidden, though this was revered in the ’40s. In the early 70's haemophiliacs could receive only one blood fraction though in the late ’70s they were allowed as many as necessary.
Is the patient’s belief informed? The official sect publications are all anonymous and the quotes they use have elicited tirades and lawsuits from scholars who find their writings misquoted, misrepresented and co-opted into the Jehovah's Witnesses ideology. Also, since a Witness can be expelled for reading “apostate” literature (anything opposed to official teaching), it is not that easy to consider the material of, say, the Jehovah's Witnesses Reform Movement (of whom very many are doctors), which seeks to overturn the current prohibitions. We currently are living with the paradox whereby, as we rightly develop a sincere tolerance and respect for minority religious beliefs, we find ourselves feeling guilty for protesting coercive, life-threatening indoctrination. Is this, we wonder, the dominant culture just doing some oppressing of its own?
The notion of pluralism requires we accept the rights of religious groups to maintain their distinctiveness, including the belief that they alone possess the truth. But there must come a time when the fear of degrading or vilifying a group is weighed against that group’s own degrading and endangering the lives of its members. The right to die for ones faith is not questioned. In fact, I deeply respect anyone who will stake their life on the deepest of beliefs. The passionless life is not worth living. But in this situation a noble principle almost became another tragedy.
Daniel Batt is a freelance writer and the Editor of
Zadok
Perspectives, the journal of the Zadok Institute for Christianity and
Society.
daniel_batt@msn.com
February 25, 1998 - Brisbane Australia
"Dad chooses wife's health over religion"
by Carolyn Alexander - Courier Mail, page 2
"A NEW father in Melbourne believes he has given his life to save his wife. Yesterday he chose the life of his wife over his Jehovah's Witness religion ,which forbids blood transfusions. The man's wife gave birth to the couple's first child last Friday, but refused a blood transfusion before lapsing into unconsciousness after losing litres of blood. The 21-year-old woman, who cannot be identified, suffered complications after the birth and continued to bleed until most of her blood was lost.
Soon after the birth, she was transferred from the Mercy Hospital for Woman to the intensive care unit of another hospital. She has not regained consciousness since then. Her distraught husband has been keeping a bedside vigil, but yesterday gave his wife a chance at life by turning his back on his religious beliefs. A relative of the couple who also does not wish to be named , said the father had agonised for days because he feared being ostracised by his church. " He said he wanted to save his wife's life but he lost himself, because he is not going to go to heaven," he said.
Yesterday morning he gained an emergency order allowing doctors to administer a vital blood transfusion. The distressed husband yesterday said the most important thing to him was that his wife recovered . "She is getting better now," he said tearfully. The husband said it was the most difficult decision of his life. The father and his relatives collected his healthy new son from the Mercy Hospital yesterday.
The couple was baptised in the religion last year
and
signed over their medical power of attorney to the local pastor. A
relative
said members of the church had attended the hospital, telling the
father
not to weaken from his original decision not to start legal
proceedings.
"He is scared they might retaliate against him," he said. A spokesman
for
the Jehovah's Witness Church in Melbourne said he was not aware of the
case and was reluctant to comment, but said: "We do not ostracise
anybody."
The spokesman said the edict against blood transfusions was not
something
decided by the Jehovah's Witness religion: "It's in the bible."
COUPLE'S FAITH IN PRAYER AN ISSUE IN DEATH
(Associated Press) Dateline: HOLLIDAYSBURG, Pa.: A couple who believed
that prayer can heal should not be prosecutedin the death of their
teenage
daughter because they did not intend for her to die, their attorney
said
Monday. Lorie and DennisNixon of Altoona went to trial on involuntary
manslaughter
charges in the death of 16-year-old Shannon Nixon last year. Shedied of
a heart attack brought on by untreated diabetes. The couple, who belong
to the Faith Tabernacle Church, also lost ason to illness several years
earlier.
"This case is not about the prosecution of criminals. This case is about the persecution of well-intended, well-meaning parents, "defense attorney Steven Passarello told jurors in Blair County Court. District Atty. William Haberstroh said doctors will testify this week that "there is absolutely no reason why this child should have died."
State law requires parents to protect children who are younger than 18, he said. He pointed out that Shannon had been to adoctor as a requirement for her drivers' license and had seen a dentist. Shannon had complained to her parents for severaldays that she wasn't feeling well, she vomited repeatedly and was constantly thirsty, the parents told police at the time.She asked for a healing ceremony from the church rather than a doctor. She was unconscious for several hours before she died, with a minister and her parents praying over her.
Five years earlier, the couple's 8-year-old son, Clayton, died of an inner-ear infection. That time, they pleaded no contest and were sentenced to probation. They also were ordered to perform community service in a hospital at the request of Haberstroh, who wanted them to see the positive effects of medicine. But no hospital would accept them as volunteers, so they performed their community service elsewhere, he said.
The couple have eight surviving children and Mrs. Nixon, 44, is pregnant again. Haberstroh has said he would not seek morethan a year in prison if they are convicted.
The Nixons are the latest members of the Faith Tabernacle to go up against the state in the treatable deaths of their children.The Nixons are clinging to the belief that prayer rather than medical treatment can heal.
Two other members of the Philadelphia-based sect have been convicted, in 1983 and 1992, of involuntary manslaughter forallowing their [children] to die.
In 1991 in suburban Philadelphia, five more children died during a measles outbreak, and in the 1970s, a Faith Tabernacle couple in suburban Philadelphia lost five children before age 2 to untreated cystic fibrosis.
In church Sunday, pastor Charles Nixon, Dennis Nixon's father, told
the biblical tale of David and Goliath in his sermon as his
daughter-in-law
listened. Mrs. Nixon sat calmly, flanked by female relatives as her
father-in-law
spoke. The biblical David "left the battle in the hands of the Lord, so
he didn't need to worry about winning it," the pastor told the 80
worshipers.
Called "baby killers" by some, the Faith Tabernacle refuses to
elaborate
beyond pamphlets in the church foyer about its beliefs.
Friday November 14, 1997 5:37 PM EST
Blood Supply: How Safe is Safe Enough?
NEW YORK (Reuters) -- The good news is that the blood supply is safer than ever before, with dramatic decreases in the risk of contracting HIV, hepatitis B, or hepatitis C from a blood transfusion in the U.S.
The bad news? Further efforts to increase the safety of blood carries a hefty price tag because millions of units of blood need to be tested to prevent infections in a handful of people, according to a report in the Annals of Internal Medicine. And the efforts needed to reach a "zero risk" blood supply may not only be costly but also have unanticipated side effects that could offset the benefits, according to lead author Dr. James AuBuchon, of the pathology department at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire.
"This success poses new dilemmas, and uncertainty remains about how safe the blood supply in the United States can, or should, be and how much of our limited resources should be spent on making it safer," reported AuBuchon.
In the early 1980s, HIV may have contaminated as many as 1 in 100 blood units, hepatitis C (HCV) was in 1 in 200 units, and hepatitis B (HBV) was in 1 in 2,100 units of blood. Now, HIV contaminates about 1 in 680,000 units, HCV is in 1 in 100,000 units, and HBV contaminates 1 in 63,000 units of blood. The declines are largely due to more strict screening of donors for risky behaviors, as well as testing of the units for signs of the viruses.
Most economists believe such tests are cost effective if the price tag is less than $50,000 per quality-adjusted life-year. The introduction of HIV antibody testing was extremely cost effective, with a price of $3,600 per quality-adjusted life year, according to the report.
"In contrast, many recent and proposed safety initiatives do not measure up when compared with other medical interventions," the authors wrote. HIV antibody testing is very effective, but it can take up to six months for an HIV-infected individual to make antibodies to the virus. If such a person does not admit to risky behavior and gives blood during this window of time, the test will not pick up the virus.
Although a new type of test that detects HIV's p24 antigen can pick up the virus itself, the cost is an estimated $2 million per quality-adjusted life-year saved, the authors noted. The test is projected to prevent eight transfusion-related infections per year in the U.S., a 25% reduction in HIV transfusion transmissions.
However, a far greater threat from blood transfusions, according to the study authors, is that a person might accidentally be given the wrong blood type, a potentially life-threatening mix up that occurs in about 1,000 patients every year.
In ongoing efforts to decrease the cost of health care, "decision makers are faced with critical choices among health care improvement options that pit improved blood safety against other worthwhile effective interventions," the authors concluded.
"Physicians must also widen the horizons of persons who are
concerned
about blood safety to consider all of the health threats faced during
transfusion
-- including, for example, mistransfusion -- so that limited resources
are expended to increase overall safety to the greatest extent
possible."
SOURCE: Annals of Internal Medicine (1997;127:904-909)
New Zealand - August 17, 1996
A young girl aged 3, tragically died last night in hospital after
parents
refused to administer a blood transfusion under religious beliefs.
Angelique
Perrota was travelling North of Auckland with her mother, Simona
Perrota,
when they were hit by a speeding motorist. Paramedics were on the scene
and rushed the young girl to hospital after she was losing blood
quickly.
The parents refused the transfusion under Jehovahs Witness Law where
the
beliefs are strictly for no blood admission of any sort. Doctor Kilby
later
said that `a blood transfusion would of no doubt saved her life' , but
the doctor is well known in Witness circles for his respect of the
no-blood
belief. There are some 11,000 Jehovahs Witness currently in New Zealand
with up to 40 deaths a year contributed to the no-blood belief.
Africa News Service
26-SEP-97
Lusaka (Times of Zambia, September 26, 1997) - A few months ago UTH consultant Professor Chifumbe Chintu stood by helplessly and watched a young woman whose life could have been saved by blood transfusion die because her religious beliefs forbade her from undergoing one.
This was after he had unsuccessfully sent people to look for alternative bloodless remedies to her complication which are acceptable to the woman's Watchtower church. "We stood by and watched her die. It was terrible but because we had no alternatives we just had to watch her die," Prof Chintu said. He said there is nothing as psychologically traumatizing to medical personnel than to stand by and watch patients whose lives they could have saved die because their faith precludes them from taking transfusions.
He added: "To see someone die when you know in your heart that there is something you could do is bad. It is better for someone to become a sinner (by accepting a transfusion) because that person can later repent and be forgiven by God ". Prof Chintu was speaking at a discussion organized by the Medical Journal Club on the safety of blood transfusions and the Jehovah's Witnesses' anti-blood transfusion stance. Mr. Edward Finch of the Jehovah's Witnesses' Hospital Information desk said the church's rejection was derived from religious beliefs and was non-negotiable. He appealed to people to respect that "We expect non-blood medical management. Our study of the Bible has brought us to this conclusion and this is not negotiable. We will go to doctors who respect our beliefs. If they don't they should tell us and we will go to other doctors who will respect our beliefs". Mr. Finch said it was regrettable that a lot of people thought Watchtower church members were a "crazy " lot who preferred to see their children die than allow them to go through a transfusion. This, he said, was far from the truth because if they wished their members death they could not in the first place take them to hospital.
Queried on which part of the Bible speaks against blood transfusions for believers, Mr. Finch pointed to Acts 15 verse 29 which reads : "Abstain from things offered to idols, from blood, from things strangled and from sexual immorality. If you keep yourselves from these things you will do well. Farewell." Arising from that verse, the church has come up with special forms which its members who are admitted to hospital sign to affirm their refusal of blood transfusions.
The form reads in part: "My refusal of blood or blood components is absolute and not to be overridden in ANY circumstances by a purported consent of a relative or other person or body. Such refusal remains in force even though I may be unconscious and/or affected by medication, stroke or other conditions rendering me incapable of expressing my wishes and consent to treatment options and the doctor treating me considers that such refusal may be life threatening" But one doctor disagreed with the church's stand on transfusions saying there was nowhere in the scriptures where God or Jesus spoke against blood transfusions.
She interpreted abstaining from blood as stated in Acts 15 verse 29 to have meant that people should have nothing to do with anyone who had killed (spilled) blood. She claimed that a doctor or nurse who saved a patient through a blood transfusion was better than a Christian who stood aside and watched a patient die because of religious beliefs only to utter 'may your soul rest in peace' afterwards.
Dr Peter Mwaba accused the church of indirectly of contributing to the high death rate of its Third World members who have no access to alternative remedies to a transfusion as compared to the Western flock who these are readily available. He added that by virtue of being poor, Watchtower members in Africa cannot even afford the alternative remedies, thus making them more susceptible to death than Jehovah's Witnesses in the West. Mr. Finch: "Everyone in Zambia is disadvantaged when it comes to medical care. There are not enough drugs in our shops. So it is not true to say it is only Watchtower members disadvantaged because of expensive alternative s". Dr Mwaba: "The rich Jehovah's Witnesses should donate alternative medicines to fellow members in Africa".
Mr. Finch said it was erroneous to assume that every member of the church in the West was rich because some of them were poor. He conceded however that something could be arranged for Watchtower church members and proposed discussions between medical practitioners, the church and authorities at the Ministry of Health. He argued however that the members of his church being taxpayers had the right to receive alternative remedies to blood transfusions and dismissed the notion that blood was cheaper that other alternatives, citing the expensive tests used to determine the purity of the blood. Dr Edward Mwinda,director of the Zambia National Blood Transfusion Service (ZNBTS) told the gathering that transfusions were not entirely safe as they could lead to infectious diseases HIV, Hepatitis, Malaria and other infections. He said a negative aspect of each transfusion was that they suppressed the immune systems of the body.
Another factor that could lead to complications was when someone is given blood that is not compatible to his blood group. But to ensure that only safe blood is stored there was a deliberate policy to target groups that are less vulnerable to infectious diseases for donations. Emphasis had also been placed on accurate laboratory testing of all blood samples. The national policy also required collected blood to undergo certain compatibility tests. But to minimize the risks of patients receiving contaminated blood from donors it is possible for patients to prepare themselves for the "rainy day" by donating their own blood for future use in what is called 'autologous' transfusions.
A donor's blood would be safely stored in the hospital until the
time
when they needed it. Another form of 'autologous' transfusion involves
collection of blood being lost from a patient and channeling it back
into
the blood stream. While doctors admit that blood transfusions can lead
to infections, they are also unanimous that loss of blood, if not
quickly
corrected, can lead to death within a few hours. Dr Soka Nyirenda
explained
that when there was massive loss of blood the little that remains in
the
body is diverted to vital organs like the brain, heart and liver. There
is however a danger that unless the blood that is
diverted from the other less vital parts of the body is quickly
replenished,
body tissues in those parts will die. While blood transfusions may not
be entirely safe the question that should be answered by those
unwilling
to accept them is whether refuse to accept transfusions and risk
immediate
death or undergo and hope to live for many more years. These are
individual
choices that doctors are sworn to respect.
By Martin Wamunyima
Copyright 1997 Times of Zambia. Distributed via Africa News Online.
Evangelical couple sentenced in daughter's death
June 10, 1997 Web posted at: 10:16 p.m. EDT (0216 GMT)
HOLLIDAYSBURG, Pennsylvania (AP) -- A couple convicted of involuntary manslaughter for relying on prayer instead of medicine to treat their daughter's diabetes were sentenced Tuesday to at least 2 1/2 years in prison.
Dennis and Lorie Nixon got a year more than prosecutors had requested. Their daughter Shannon, 16, was the second of their 10 children to die under such circumstances.
Shannon died of treatable complications from diabetes a year ago after Dennis Nixon's father, pastor of the Faith Tabernacle Congregation in Altoona, Pennsylvania, prayed over the girl and anointed her with oil.
The Nixons were put on probation after pleading no contest in 1991 in the death of their 8-year-old son from an ear infection. Lorie Nixon is expecting a baby in July.
Copyright 1997 The Associated Press. All rights reserved. This
material
may not be published, broadcast, rewritten, or redistributed.
Giving blood may offer some protection against heart attacks reports a study in this week's BMJ.
Researchers looked at 2682 middle aged men in eastern Finland to see if there was any association between blood donation and risk of heart attack.
"The blood donors' risk of acute myocardial infarction was 86% less than that of the non-donors" say the authors.
The mechanism through which donating blood reduces the risk of heart attacks could be the depletion of body iron stores, say the researchers. It has been suggested that mild iron deficiency reduces the risk of heart disease. However, the study points out that "blood donors seem to be generally more health conscious and more healthy than those who do not donate blood" and this may have affected the results. The link between giving blood and lowered risk for heart attack was, however, still significant even after the main coronary risk factors had been taken into account.
Contact: Professor Jukka T Salonen Finland
Tel: 00 358 17162 910 Fax: 00 358 17162 936 e-mail:
salonen@reivi.uku.fi
Court dismisses blood transfusion suit http://www.japantimes.co.jp/
The Tokyo District Court dismissed on Mar. 12 a suit filed by a Jehovah's Witness demanding that the government and six doctors compensate her for administering a blood transfusion without her approval.
Presiding Judge Takashi Oshima rejected the claim by the 68-year-old woman from Chiba Prefecture, saying the doctors' decision to give her the blood transfusion without her consent was not illegal. The plaintiff, whose name is being withheld, was seeking 12 million yen in damages from the government and six doctors at Tokyo University's Institute of Medical Science.
The woman, who has been a Jehovah's Witness since 1963, had a liver tumor removed at the hospital in September 1992 after the doctors guaranteed she would not need a transfusion during the surgery, according to the lawsuit. Before her operation, the plaintiff had written and signed a document detailing her desire to not receive a transfusion for religious reasons. The document also absolved the doctors of any blame in case her condition worsened as a result of her refusal to accept blood during surgery. The doctors accepted the document and agreed not to give her a blood transfusion under any circumstances, the plaintiff maintained.
In his ruling, Oshima said the "special contract" exchanged between
the doctors and the patient was "invalid." Making such a special
contract
"goes against medicine's first goal, which is to treat and save the
life
of the patient, against the noble value of human life, and against the
doctor's obligation to save the life of the patient in the best
possible
way," Oshima said.
Baby May Die from Refusing Blood
By Michael E. Young / The Dallas Morning News, 12/06/96
Valerie Marie Hernandez was born with a broken heart.
The dilemma lies in how to fix it.
In recent years, pediatric cardiologists have become increasingly adept at correcting Valerie's condition, called hypoplastic left heart syndrome.
But Valerie's case is compounded by a dispute over her treatment: Her parents, both Jehovah's Witnesses, say their religious beliefs won't permit another person's blood into their week-old daughter's body.
Her doctors at Children's Medical Center say they can't perform the necessary surgery without blood transfusions.
"There are only three options in this case," said Brian Alford, a hospital spokesman. "The first is to do nothing; the second is to operate on the heart; and the third is to perform a heart transplant. Two of the three require blood in the procedure."
Without surgery, Valerie will die in a matter of weeks, doctors say. The left half of her heart didn't develop properly, which means that she has just one functioning pump, or ventricle. Healthy hearts have two.
Doctors are using medicine to help Valerie's blood circulate adequately, but that's strictly a short-term measure.
Officials at Children's can't discuss the specifics of Valerie's case because of privacy laws, but Dr. Charles Fraser Jr., head of congenital heart surgery at Texas Children's Hospital in Houston, said babies born with Valerie's condition usually require surgery within a month of birth.
Valerie's parents, Diego and Tanya Hernandez of Irving, said they want their daughter to have the operation she needs. "We want someone to operate, and the doctors say they will, but only with blood transfusions," Mr. Hernandez said.
As Jehovah's Witnesses, allowing someone else's blood to be pumped into their little girl is unthinkable.
"That goes right back to the Bible," explained Robert Johnson, a spokesman for the Jehovah's Witnesses in New York. "That's something we won't give in on."
In Genesis, the first book of the Bible, God forbids Noah and his followers from eating meat "that has its lifeblood still in it." In Leviticus, God says, "You must not eat the blood of any creature, because the life of every creature is its blood."
In the New Testament, in the book of Acts, Jesus' apostles write to the Gentiles: "You are to abstain from food sacrificed to idols, from blood, from the meat of strangled animals . . . ."
And so Jehovah's Witnesses have.
"For centuries, the issue was blood in food," Mr. Johnson said. "But during World War II, transfusions became somewhat common on the battlefields and then in the hospitals, and it was at that point that Jehovah's Witnesses took a stand against them."
For five decades, that opposition hasn't wavered.
Instead of using someone else's blood, Jehovah's Witnesses ask doctors to use "volume expanders," such as a saline solution, to keep veins and arteries from collapsing. They encourage the use of medicines that stimulate production of red blood cells. They tout machines that clean, circulate and recycle the patient's own blood.
And usually, Mr. Johnson said, they find doctors who will take those extra steps.
"We realize our position poses a challenge for a surgeon that he doesn't have from the rest of his patients. And there are some doctors who don't want to be bothered, and we understand that," he said. "The doctor can make his decision, and we've made ours."
Dr. Fraser has operated successfully on the children of Jehovah's Witnesses without using blood transfusions, including heart transplant surgery on a child weighing 18 pounds.
But that's much larger than Valerie Marie Hernandez.
She weighs only about 6 pounds, Dr. Fraser said, far too small for surgery without additional blood.
"To my way of thinking, with a child of 2.5 kilograms, this is an easy decision," he said.
The great problem is that a child of Valerie's size has only a bit more than a cup of blood, about 250 milliliters, in her whole body.
"To do this surgery, we need to connect the child to a heart-lung bypass machine, because we have to have some way of supporting circulation," Dr. Fraser said.
But that's a pump like any other, and it must be primed with at least 700 milliliters of liquid to make it work. If doctors used anything but blood, Valerie's red blood count would fall from 40 percent to 10 percent or so, low enough to cause significant damage to her brain, kidney and other organs.
"That's the least amount [of blood] we could possibly use, and that assumes we can do surgery with no additional blood loss," Dr. Fraser said. "And that's impossible."
Valerie's parents said they hope that somewhere there's a heart-lung machine sized for infants. Or that there's a surgeon who is willing to attempt the surgery without using additional blood.
"I know they've used [nonblood] products with larger babies," Mr.Hernandez said. "They say it's impossible with a baby this size, but nothing's impossible. There's always a first time. Maybe they can try this, and if it works, imagine how many children can be saved."
Dr. Fraser said he understands the family's concerns. Surgeons use as little additional blood as possible in any surgery. "That's what we'd want for ourselves and for our own children," he said.
But in heart surgery, some blood loss is inevitable. And a child this small doesn't have any to spare.
"In my opinion, and in the opinion of almost every pediatric cardiac surgeon in the country, this operation really can't be done without transfusions," Dr. Fraser said.
Ultimately, both sides said, this case could end up before a judge.
If Valerie's condition deteriorates beyond a certain critical point, her surgeon at Children's could petition the court to give temporary custody of Valerie to Child Protective Services. That was the process used in the case of Rachel Stout, the Fort Worth girl whose parents refused to allow surgery to remove a diseased colon.
If custody were granted in Valerie's case, the CPS then could allow the operation and the transfusions doctors say they need.
Dr. Fraser said no surgeon would allow a child to die for want of a blood transfusion.
But for the Hernandez family, this is much more than a legal issue.
"Even in ancient times, blood has been sacred. It's the life-giver,"
Mr. Hernandez said. "We all have our own blood, and that's what we want
for our girl." ”
http://www.dallasnews.com/metro-dfw/dfw35.htm
(link to current news from Dallas Morning News, not this text)
Judge Orders Blood Transfusion
96-11-22 - The Associated Press ROANOKE, Va. (AP) -- A Jehovah's
Witness
has received a life-saving blood transfusion even though she told
doctors
it was against her religious beliefs. Carilion Roanoke Community
Hospital
intended to honor Doris McDaniel's request. But a judge on Wednesday
sided
with family members who claimed the 72-year-old woman changed her mind
as she lay dying in her hospital bed. ``A hospital is supposed to save
lives, not take lives,'' said Richard McDaniel, her husband of 53
years.
``If they let her die without the blood transfusion, it's legal
murder.''
McDaniel received the transfusion Wednesday night and her condition was
improving Thursday, according to a family lawyer. Many Jehovah's
Witnesses
refuse blood transfusions based on the Bible, which states people
should
abstain from blood. Leviticus 17:10 reads: ``Whatsoever man ... eats
any
manner of blood, I will cut him off from among his people.'' Despite
the
dangers, Doris McDaniel wanted to stick to her beliefs. ``We had argued
about that quite a bit,'' her husband said. ``She's kind of
hardheaded.''
When she fell ill after surgery, her husband said she nodded ``yes''
when
he asked if she would accept a transfusion. The hospital refused to go
along. At a subsequent hearing, the church claimed Mrs. McDaniel could
not make an informed decision because she was sedated, unable to speak
and on a ventilator. ``A patient's wishes have to be respected, even if
the patient has become incapacitated after expressing those wishes,''
hospital
lawyer Elizabeth Schell said during the hearing. But the judge gave
more
credence to the family. ``Family members are experts in family
matters,''
Roanoke Circuit Judge Robert Doherty said. ``Certainly the doctors
could
have no more expertise about this woman's feelings than someone who has
lived with her for 50 years.'' The cDaniels' granddaughter said not all
family members support the move. ``To me, if she's going to die soon,
at
least let her go with some dignity,'' Cathy McDaniel said.
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