Jehovah's Witness objects to wife's blood transfusion

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Jehovah's Witness objects to wife's blood transfusion

Post by PainRack »

http://www.bbc.co.uk/news/uk-northern-ireland-19974490

A man whose wife urgently needs medical treatment has objected on religious grounds to hospital staff giving her a transfusion of blood products.

The couple are both Jehovah's Witnesses and his 27-year-old wife was admitted to a Dublin hospital on Tuesday after suffering a ruptured ectopic pregnancy.

The man said she had signed a written instruction refusing such a treatment, even if her life was in danger.

However, Dublin's High Court has ruled the transfusion should go ahead.

The Irish state broadcaster, RTE, reported that the hospital sought the court order after a dispute arose between the medical staff and patient's husband over her instructions regarding her treatment.

'Sedated'

The court was told the woman was admitted to hospital had suffered acute abdominal pain and later collapsed, having lost a significant amount of blood.

Eileen Barrington SC, for the hospital, said the woman had told doctors that she was refusing a transfusion of whole blood or red blood cells but would accept platelets or plasma.

Following her initial blood loss, she was treated with her own recycled blood, using a system known as "cell salvage".

The court was told the patient had since been sedated and was unable to express her wishes.

Lawyers for the hospital said she would remain in that state until a certain procedure was carried out to prevent serious infection, but which could involve further bleeding and the need for a transfusion.

The hospital wanted an order permitting it to make the appropriate transfusion for the procedure because, without that option, doctors had said there was a risk of death or serious lifelong disability.

'Core beliefs'

Her emotional husband told the court his wife had signed a document used by Jehovah's Witnesses, known as the Advanced Care Directive, declaring she would never accept platelets or plasma, even if not having the treatment would result in her death.

He said he believed, because his wife was in such terrible pain, it was really hard for her to reason but it was one of their core beliefs not to accept primary blood components of red or white blood cells or plasma and platelets.

However, he said that she would accept "minor fractions" of blood.

The man said he knew his wife of eight years well and she had filled in three Advanced Care Directives over a number of years stating her beliefs, signing the most recent in August 2012.

"At a time when she cannot make up her mind, that is what it [the directive] is there for," he said.

But Ms Barrington said the hospital was contending that the wishes expressed by the woman to doctors on Tuesday evening should supersede the wishes expressed in the directive.

Granting an order allowing the hospital administer non-red blood transfusions, the judge said it seemed to him, from evidence given to the court by doctors, the woman had the capacity the amend the her directive when she told medical staff on Tuesday that she would accept plasma or platelets.
I know, its not news news, but it caught my eye. For the reasonable debators amongst us, could the changing of the wife mind be considered as under duress?


Afterall, such a decision was made when she was in pain.
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Re: Jehovah's Witness objects to wife's blood transfusion

Post by Akhlut »

So, Ireland's medical system is willing to violate religious beliefs to save a woman's life if those beliefs are of a minority religion in Ireland, but they aren't willing to violate their own, Catholic, beliefs to save the life of a woman undergoing serious pregnancy complications by performing an abortion.

That's not hypocritical at all. :v
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Re: Jehovah's Witness objects to wife's blood transfusion

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Errr............ no.


The wife agreed to being tranfused to platelets for a surgical op. She now can't give consent because she's sedated. She needs another op. The husband is refusing to give authorisation to said op because he believes the wife wishes, as expressed by the medical directive is that she would not want platelets.
The hospital is arguing that she has agreed to platelets for another op already, thus, that is her latest decision.
The husband says well, that was made under duress because of her pain.

The judge decides that the woman was mentally competent to have decided to amend her directive and that her verbal consent expressed her explicit wishes......




Lord Squishy on SB sorta cleared this up for me when he explained that the court decision process was to see what the wife wishes were....... although I guess I contributed to the roundabout nature of his answer.

I just wanted to see how much weight the counter-argument of distress would hold in a court of law.... Well, that and explore the positions behind it, sorta challenge some of my own assumptions and positions on this matter.
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Re: Jehovah's Witness objects to wife's blood transfusion

Post by Grumman »

PainRack wrote:I know, its not news news, but it caught my eye. For the reasonable debators amongst us, could the changing of the wife mind be considered as under duress?

Afterall, such a decision was made when she was in pain.
I consider that argument morally abhorrent. It suggests that because the woman was suffering, this inherently invalidates her right to request potentially life-saving treatment to alleviate that suffering. It's like claiming that if you are starving you are no longer able to provide the consent necessary to buy food.
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Re: Jehovah's Witness objects to wife's blood transfusion

Post by Broomstick »

You're allowed to change your mind on advanced directives, but until you do so those directives should be followed. If you're unconscious those directives will be followed, unless there is some record of you changing your mind prior to unconsciousness.

Even so, it sounds like the hospital wants to give her a full transfusion. That's not an option. Her advanced directive is clear, and her verbal consent was restricted to "platelets or plasma", not a full transfusion. Given that she is adult she is allowed to make such decisions, including refusing life-saving medical care.

Seems clear to me that the hospital can give her "platelets or plasma" but not whole blood. Whether her husband objects to the blood components she consented to is irrelevant, as she has stated her wishes already.
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Re: Jehovah's Witness objects to wife's blood transfusion

Post by K. A. Pital »

I would say hospitals should ignore crazy beliefs like this one - they don't cater to the wishes of every madman or obsessively superstitious person now, do they? And this should become the law. Then JWs would leave the nation and come to live in a place more tolerant of dark age madness. Problem solved for the nation, I guess.
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Re: Jehovah's Witness objects to wife's blood transfusion

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Grumman wrote: I consider that argument morally abhorrent. It suggests that because the woman was suffering, this inherently invalidates her right to request potentially life-saving treatment to alleviate that suffering. It's like claiming that if you are starving you are no longer able to provide the consent necessary to buy food.
Its....... a different form of moral outrage you should be looking at.

What was going on was that the woman was supposed to go for an operation to remove the ectopic pregnancy and she gave consent for platelets tranfusion, overwriting her previous written directive. The husband is essentially claiming that the consent was obtained during duress, and that the operation could had been done without the use of blood tranfusions. And it WAS done without blood tranfusions of any kind.
Broomstick wrote:You're allowed to change your mind on advanced directives, but until you do so those directives should be followed. If you're unconscious those directives will be followed, unless there is some record of you changing your mind prior to unconsciousness.

Even so, it sounds like the hospital wants to give her a full transfusion. That's not an option. Her advanced directive is clear, and her verbal consent was restricted to "platelets or plasma", not a full transfusion. Given that she is adult she is allowed to make such decisions, including refusing life-saving medical care.

Seems clear to me that the hospital can give her "platelets or plasma" but not whole blood. Whether her husband objects to the blood components she consented to is irrelevant, as she has stated her wishes already.
It doesn't read like that to me. It sounds like the hospital wants to follow up a tubal surgery with another operation, most probably to staunch any further bleeding and they wish to do it under platelet coverage. They might or might not had desired to infuse blood, but its not in the news article.
Stas Bush wrote:I would say hospitals should ignore crazy beliefs like this one - they don't cater to the wishes of every madman or obsessively superstitious person now, do they? And this should become the law. Then JWs would leave the nation and come to live in a place more tolerant of dark age madness. Problem solved for the nation, I guess.
Yes. Yes they do.

You see, not following some of those wishes constitute assault and battery(for example, the use of restraints to prevent yanking out of IV lines). The law frowns on such cases and given the history of mental asylums, weakening laws that might prevent abuse isn't a wise step IMO.


Ahklut does... bring up an interesting points though.

http://www.independent.ie/health/jehova ... -79512.htm
THE High Court ruled yesterday that doctors in a Dublin maternity hospital can force a seriously-ill Jehovah's Witness to have a blood transfusion despite her refusal on personal and religious grounds. Justice Henry Abbott was told the woman would die unless the procedure was authorised.

THE High Court ruled yesterday that doctors in a Dublin maternity hospital can force a seriously-ill Jehovah's Witness to have a blood transfusion despite her refusal on personal and religious grounds.
it would seem that Dublin is... dysfunctional enough that hey, no abortions overrides no blood tranfusions.
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Re: Jehovah's Witness objects to wife's blood transfusion

Post by Losonti Tokash »

Stas Bush wrote:I would say hospitals should ignore crazy beliefs like this one - they don't cater to the wishes of every madman or obsessively superstitious person now, do they? And this should become the law. Then JWs would leave the nation and come to live in a place more tolerant of dark age madness. Problem solved for the nation, I guess.
Do you believe that a hospital or other care provider should ignore a Do Not Resuscitate order?
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Re: Jehovah's Witness objects to wife's blood transfusion

Post by Stark »

A DNR means care is stopped in certain circumstances, dumb restrictions on 'acceptable' medical procedures mean care must continue until they're dead. I don't doubt that the frustration in these situations is because these people are so stupid they'll refuse things for no reason, but don't actually want to die. Doctors can't just decide 'oh I see' and wheel them into the doom closet to be ignored just because they refuse life-saving treatment; they have to try to save them other ways, and then fail, and then probably get blamed for the inevitable result.
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Re: Jehovah's Witness objects to wife's blood transfusion

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So... if an elderly person is diagnosed with cancer they shouldn't be allowed to refuse aggressive treatment they don't want?

So... if a person is experiencing liver failure and does NOT want a transplant they should be forced to undergo one anyway?

So... if a person is horrifically burned and would rather be made comfortable rather than endure months of hospitalization, amputations, dozens of operations, and years of rehab with a lifetime of disability they should be forced to endure the medical treatment to prolong their life?

One of my regular customers at work recently told me he's had his last birthday - he's been on dialysis for years and has had enough, his body is slowly breaking down, he's outlived his wife and and siblings and half his children, he's out of money, and is entering hospice. Should he be strapped down and forced to endure dialysis for however many more years it can keep him going despite worsening debility and misery?

In most of the Anglosphere (and probably elsewhere) competent adults are allowed to refuse medical treatment and the law insists their wishes be respected.

ETA: Clearly, Ireland is an exception.
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Re: Jehovah's Witness objects to wife's blood transfusion

Post by Stark »

Are you directly comparing refusing high probability of brain damage, years of life-destroying treatment that possibly won't work, or huge ongoing costs to 'jesus will be sad'?
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Re: Jehovah's Witness objects to wife's blood transfusion

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The law as currently written doesn't make the distinction.
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Re: Jehovah's Witness objects to wife's blood transfusion

Post by Stark »

And arguably it shouldn't, but that's the distinction people see; something still reasonably contraversial (people choosing to die rather than suffer) vs something a bit silly (people making treatment more difficult because ... ???).
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Re: Jehovah's Witness objects to wife's blood transfusion

Post by Broomstick »

If a woman was told that continuing a pregnancy had a high rate of causing death or disability to herself should she be forced to have an abortion, or should she be allowed to choose to continue the pregnancy? Why or why not?

Not every reason is going to make sense to everyone else. Respecting the autonomy of competent adults including allowing them to make decisions you don't agree with.
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Re: Jehovah's Witness objects to wife's blood transfusion

Post by PeZook »

I think that Stark is simply describing where widespread frustration with these types of people comes from. Personally I think that humoring these requests is by far the lesser evil and a more ethical choice than letting doctors force patients to undergo treatments they don't want. What we consider silly is a cultural thing anyways, obviously religious orders are gravely important to a lot of people, uh, forgive the pun.

However, idiots who blame doctors for failing to save a person who willingly decides to make treatment vastly more difficult can, frankly, fuck off.
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Re: Jehovah's Witness objects to wife's blood transfusion

Post by Stark »

Totally; heaps of the coverage of this sort of thing (and its been going on for aaaaages) has a disapproving tone, like 'those doctors should have just FIXED IT RIGHT UP instead of making us feel faintly embarrassed that people are allowed to make ODD DECISIONS'. Remember all the topical episodes of TV medical dramas where the lesson of the day was 'gosh, those crazy folk'?
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Re: Jehovah's Witness objects to wife's blood transfusion

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@Broomy
Are you refering to UK or US laws?
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Re: Jehovah's Witness objects to wife's blood transfusion

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Mostly US as, of course, I am not nearly as familiar with UK laws.
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Re: Jehovah's Witness objects to wife's blood transfusion

Post by Crazedwraith »

Spoonist wrote:@Broomy
Are you refering to UK or US laws?
You realise neither UK nor US law applies in this case? Since the story is from the Republic Of Ireland.
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Re: Jehovah's Witness objects to wife's blood transfusion

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Crazedwraith wrote:
Spoonist wrote:@Broomy
Are you refering to UK or US laws?
You realise neither UK nor US law applies in this case? Since the story is from the Republic Of Ireland.
My mistake, I scrolled to the top and the link said ...uk-northern-ireland-19974490 thought hmm wasn't it Ireland (since the abortion thingie) then thought hmmph maybe not.
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Re: Jehovah's Witness objects to wife's blood transfusion

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Very confusing, there being two Irelands like that.
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Re: Jehovah's Witness objects to wife's blood transfusion

Post by Cykeisme »

I find all these religious objections to emergency medical procedures very silly.

Saving a life (or level of functioning of limbs, organs, etc) needs to be acted upon in a time-critical manner during the emergency itself, and fixing that shit is a hell of a lot harder than breaking it.

Thus, logically, medical treatment (particularly emergency medicine) should always be administered; the recipient has the option of later reversing the effects of treatment through much easier procedures, sometimes with little to no medical knowledge required.
For example, in the event of an unwanted life-saving blood transfusion, they can always terminate their own lives afterward. In the case of, say, a saved limb, they can always have it amputated afterward.
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Re: Jehovah's Witness objects to wife's blood transfusion

Post by PeZook »

Yeah, I'm sure a person who refuses a blood transfusion because they believe God will get angry with them for accepting it is gonna accept your reasoning that suicide will fix it.

It won't, because they believe they are going to Hell if they kill themselves!

Some people believe silly stuff and make life-altering decisions based on it. We can accept their wishes as adults, or basically let doctors assault them. As others pointed out, where do you pass the line? Are you going to send cops to people who decide to stop dialysis and bring the patient to the hospital in handcuffs?

It doesn't even make any damn sense from a purely cold monetary perspective: you're going to spend resources saving a patient who doesn't want to be saved, just so that he's released home and then hangs himself?
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Re: Jehovah's Witness objects to wife's blood transfusion

Post by Jub »

Here's a hypothetical.

What if a doctor gave her blood and neither her nor her husband knew about it? Now suppose that she makes a full recovery because the doctors were able to work under proper conditions and nobody is the wiser. Is this a bad thing? How about, if in spite of their extra efforts the worst happens; does that change anything?
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Re: Jehovah's Witness objects to wife's blood transfusion

Post by PeZook »

Yes it does make a damn difference, because it violates explicit wishes of the patient. It's an issue of medical ethics: how would you like it if people slipped medicine into your food without your knowledge?

Every person has a basic right to make decisions about his or her own health care - and yes, that includes silly decisions for stupid reasons. Violating that right is unethical, for much the same reasons as forcing people to do what you want in other areas of life where the public good is not threatened. Are you going to bribe the pizza delivery man so that he does not deliver pizza to your overweight neighbor? Break into people's homes and spray antiseptics on their toilets? Install spy cameras to make sure they are taking their medicine? Carefully wash their sex toys?

If the above suggestions make you feel uncomfortable, then you know why slipping medicine into a patient against their express wishes is considered unethical.
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