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I am an anesthesiologist and have dealt with a number of JW's in regards to blood transfusions and whats allowed vs. what isn't. First of all, there are two different general reasons for blood transfusion, trauma situations and not. An emergent trauma transfusion is when you get shot/stabbed/car crash etc. and end up in an OR to fix internal bleeding. In this case, you get blood no matter what because its an emergency situation, and hypoxemia secondary to blood loss removes your ability to grant consent. This has been challenged in court, but the end result has been that in emergency situations, giving blood is ok. A lot of JW's accept this and realize its a risk of you know, living. As far as other situations, some JW's are hard core about their beliefs, while some are not. Also, there is a diffference between giving whole blood and blood products. A result of this is that anytime we have a JW, or someone who doesn't want blood products for some reason or another, is that we have a rather large checklist of all the blood products and products derived from human blood. You need to initial each thing that you refuse or accept to receive. Things like packed red blood cells, plasma, cryoprecipitate, clotting factors, albumin, platelets, etc. might be accepted in some cases and not others. What is also interesting is that many JW's do not believe in autodonation. If you are having an elective surgery, most JW's seem to not believe that they can donate their own blood for transfusion in the future. Many however do seem to believe in what is called a cellsaver. Its a machine that is used in the OR, where when blood is suctioned to goes into a machine that filters the red blood cells out and injects them automatically back into the patient with some saline. The idea behind this is that the "circuit" of blood isn't broken, where as in autotransfusion it is. Basically, its a huge headache for doctors because every JW is different. Some are fine with everything but packed RBC's, and some refuse everything all together, but most have various reasons for refusing some and not refusing others. I wish I could find a pattern, but there really isn't. I think it relates to their education level and understanding of what the product is rather than religious conviction, but I could be wrong. Ethically, its not a huge deal when it comes to adults, just a pain in the rear end in terms of paperwork and negotiation. Children however represent a whole other set of problems...
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Mar 20, 2015 13:58
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| # ¿ May 10, 2024 05:29 |
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