I'm curious of your opinion - page 6

On another board a group of people are discussing a case. It's about a 25 week premature baby needing a blood transfusion. The family refused the blood transfusion. The court's interceded and... Read More

  1. by   JW-HLC
    Thank you for keeping us on track!

    I think that every good parent does what it thinks is for the very best welfare of its child.
    If a parent does not believe in God they will do whatever is best for the child here and now, probably following all the reasonable medical guidance that they can get and following through on that.

    For a JW parent they will similarly do all they can for their child, including searching for the best medical assistance available. In the end however they have a "spiritual" factor to also consider, the everlasting welfare of both their child and themselves. This is an aspect which others do not have to consider and which they mostly fail to understand. This misunderstanding leads others to wrongly judge that the Witness parents have failed their child.
  2. by   Peeps Mcarthur
    JW,
    Without a lexicon I can't tell if the translation is straying from what I think the Hebrew meaning is. That's as close as your going to get to the original draft unless you go poking around in caves along the Dead Sea. If you bury all your barbecue in dirt, please understand my declining an invitation to picnic.
    {QUOTE}
    'I would still welcome your view on how abortion, and risking miscarriage with a medical procedure stands with someone who so emphatically wants to save a small human life. " {END QUOTE}


    I did'nt say that I emphatticaly want to save a small human life. Even if it was paraphrased in one of those cheesy soap operas. I AM emphatic about the medical outcome of my patient. The mother is my patient in this scenario. I have not agreed to do amniocentises. I have not agreed to abort. So what risk are you talking about.
    Go ahead and serve Red Herring del Dirt Baby if you have to..


    Abortion of a fetus is a medical procedure and as such needs a medical reason. A patients' anxiouseness does not qualify. The fact she doesn't want to get caught porking some strange guy doesn't qualify. The asumption that taking the fetus to term may(I dislike that word) produce an imperfect replicant does not medicaly call for an abortion. So whats your beef?(pun intended).
    As you alluded to, in vivo surgery is also an option(I was going to go there anyway) but that also carries with it great risk.

    Work sucked.
    And I have to go again.
  3. by   JW-HLC
    "abortion of a fetus is a medical procedure and as such needs a medical reason. a patients' anxiouseness does not qualify" - "the asumption that taking the fetus to term may(i dislike that word) produce an imperfect replicant does not medicaly call for an abortion. so whats your beef"

    oh, if only that were true!

    medical abortions are carried out the world over for next to no reason at all. it has become almost an alternative means of "contraception" - "abortion on demand" - 53 million every year; even pop in and have it done over lunchtime and then back to the office!

    {quote...
    british pro-abortion group offers "lunchtime abortions"
    london (cwn) - a british pro-abortion group came under sharp criticism on saturday for its plan to offer abortions for working women during their lunch break.

    marie stopes international said it would begin offering the abortions in major cities next month. "women don't lease their bodies from the state or even from the church. they own them themselves and, if under the 1967 abortion act, they have an unwanted pregnancy ... they have a right to the best service possible," dr tim black, chief executive of the group, told bbc radio. the abortions would only be carried out for pregnancies before the 12th week.

    critics say the procedure, carried out under local anesthetic in three to four minutes, trivializes abortion and offers inadequate support for the women involved. "we are talking now about making abortion available rather like something you buy over the counter and that means people do not have a chance to consider seriously what they are doing," said a spokesman for the catholic bishops' conference. abortions are usually performed under a general anesthetic with follow-up surveillance in hospital... end quote}

    medical abortions are actually encouraged where an amnioscentisis test shows positive for a down's syndrome baby and consent to an abortion is automatic.

    {quote...
    a british government minister has condemned the selective abortion of children with down's syndrome. brian wilson, a new foreign office minister, said that the use of amniocentesis tests which resulted in the elimination of 95 percent of children found to have the condition was "grotesque".

    mr wilson, who has a nine-year-old son with down's syndrome, also condemned the fact that the "assumed social good" of eliminating down's syndrome babies was considered so important that 400 unborn children without down's syndrome died as a result of amniocentesis tests each year in britain in order to identify 100 children with the condition. mr wilson added that the loss of so many down's children to abortion meant that the "few who do make into the world" were not given the care which should be given to them in a civilised society.

    [daily telegraph, 14 april as quoted in news digest for 17 april 2001] ...end quot}

    (my knowledge of these issues i confess stems from the uk and not the usa, but i doubt that the situation is any different there - you will no doubt tell me [with evidence please] if it is not).

    so i guess to sum it up your concern does not necessarily rest with the matter of life - your concern comes for the patient and his/her needs regardless of other factors. you can ignore life if its wrapped up in a patient portfolio, or am i being too simplistic?

    "if you bury all your barbecue in dirt, please understand my declining an invitation to picnic."
    you've lost this brit ??????????
  4. by   Peeps Mcarthur
    JW,
    {QUOTE}
    Leviticus 17:13, 14 "Any Israelite or any alien living among you who hunts any animal or bird that may be eaten must drain out the blood and cover it with earth, because the life of every creature is its blood." {END QUOTE}

    Just having a little fun with the paraphrased "cover it with earth" from the scripture you posted. Since you must drain out the blood, you also must cover it with earth(dirt) before it's eaten.
    A barbeque is a sort of picnic with beef cooked on an outdoor grille here in the states.
    After a joke is explained, it's often not very funny.

    Let me state clearly my oppinion(that's not been a problem has it?) about the term "medical need". Medical need refers to the treatment and prevention of disease for the welfare of the patient in the context of our incredibly lengthy thread.
    The only complications these women in your example seem to have are in their psychosocial development. I'm sure there are more abortions done without record than we could find out about to add them to the pile of carnage.
    Unfortunately those same psychosocial midgets are allowed to vote and relatively half of all voters would be women. The people that need votes to keep their jobs(so they can apparently avoid having to work) can't afford to alienate 50% of the voting public so they pass a law that abdicates morality to psychosocial midgets. A cross- sectional demographic that happens to also include pscychosocial midgets that think routine abortion is included in the hippocratic oath agree to perform what they call a medical procedure, and here we are.
    That does not include me.
    You should not perform a procedure without scientific basis for the same reasons you should not exclude one.

    {QUOTE}
    "Oh, if only that were true!"
    {END QUOTE}

    It is true. In practitioners that adhere to science.
    I think we can draw an observation from this example. A social variable that empowers a group within a society that medicine serves to influence medicine itself. That's the point at which it ceases to be treating diseases and becomes a service industry that caters to emotion and belief of patients rather than a healing science.
    Last edit by Peeps Mcarthur on Jan 19, '02
  5. by   JW-HLC
    "A barbeque is a sort of picnic with beef cooked on an outdoor grille here in the states"
    I guess that's what you do when the sun shines - don't get that here!

    "A cross- sectional demographic that happens to also include pscychosocial midgets that think routine abortion is included in the hippocratic oath agree to perform what they call a medical procedure, and here we are.
    That does not include me."

    Then all respect to you (maybe I wouldn't have put it quite the same way, but we have agreement).

    All light-heartedness apart, we may not be so far apart after all - you are maybe a man of principle - so am I. It's just that with you it seems to exclude a "higher authority" when providing medical treatment; with me the "higher authority" is always in the picture. Oh and yes, you probably have a more colourful way of expressing yourself.

    JW's really appreciate every effort of the medical profession and with the advent of Hospital Liaison Committees we are trying to work together for the benefit of a "meeting of minds". We meet with doctors and nurses talking to them about non-blood alternatives and answering their questions.
    Non-witness patients are also benefiting from non-blood surgery, which in truth would never have been at the stage it is today without JW's to "practice on" - ethics would never have allowed doctors to take the risks.
  6. by   Peeps Mcarthur
    JW,
    A slight edit might make it clearer.


    "I think we can draw an observation from this example. A social variable that empowers a group within a society that medicine serves, which influences medicine itself."

    Which influences medicine itself

    You're a social variable trying to influence medicine. If you get your way, you'll have done away with a practitioners critical thinking. It's ethics is driven by unemotional manipulation of raw data to fit into a scientific model. As in the example of the abortions, how you feel about it or what you think is a psychosocial model trying to somehow present itself as a valid string of raw data for an already valid medical one.
    You're (as a collective) indignant that there are few who are as eager as you to incorporate psychosocial influences on critical treatment courses.
    We(as skilled clinicians) are indignant when the above mentioned "influence" effects what we see as our honor. To work and be chosen to preside over the care of our patients.

    Within that honor resides our sense of worth and contribution and once you've stripped that away you have the moral equivalent of an abortion doctor
    It may seem a contradiction to you , but I don't think you understand that you want a caregiver with those same medical ethics that will somehow deploy a course of treatment suitable to you instead of suitable to their training which they have worked so hard to be recognized by.
    If someone would so easily have abdicated those decisions to you. They will have lost their compassion to their patients and become nothing you would want "caring" for you child.

    Although I've enjoyed our exchanges, I wonder if this is the longest thread ever at Allnurses.
    Anyway, no work for me today. All I'm going to do is surf the net and watch football(american football).
  7. by   JW-HLC
    "If you get your way, you'll have done away with a practitioners critical thinking"

    I don't think so, I think practitioners have always been ready to apply themselves to different challenges. The evidence of today is that more and more practitioners the world over are turning to bloodless strategies, not just for JW's but for as many of their patients as they can. The situation with blood is making even those who resist, see the need to dramatically cut their blood use.

    "We(as skilled clinicians) are indignant when the above mentioned "influence" effects what we see as our honor. To work and be chosen to preside over the care of our patients.
    Within that honor resides our sense of worth and contribution and once you've stripped that away you have the moral equivalent of an abortion doctor"


    Never would we want you to lose your sense of honour and worth - I would hope that those very senses could be enhanced by not only helping the patient but by considering their spiritual care.

    If you havn't already done so wht not check this link for an extract of what some profesional are saying:-

    Excerpts

    "If someone would so easily have abdicated those decisions to you. They will have lost their compassion to their patients and become nothing you would want "caring" for you child."

    For the reasons already stated I don't see that as being the case, although I understand your thinking. I think if you can work along with the patients wishes (or the patient's parents in the case of a minor child) much good can be accomplished.

    However we except that you too have a conscience and feelings and we do not want to offend them. We understand that we are asking for something "different" from many practitioners, for that reason we encourage practitioners to refer if they cannot work along with us.

    I too have enjoyed the exchange and will understand if you feel "enough is enough". Enjoy your rest time!
  8. by   Peeps Mcarthur
    JW,
    Your link does'nt work on my crappy little computer. Thanks for trying though. I've got Real Player but it won't take the software.

    What I said was that you are asking me to abdicate my authority. You don't REALLY want me to work with you. You want me to work FOR you. That's just a nice way to say "go along with what I want or I will cause trouble".
    That does'nt just happen in pediatrics. It occurs in every department. I've seen patients that mouth it around their endo tubes in the I.C.U.
    If your alternatives are so great they'll be recognized by the regulating authorities and be put in place as theraputic modalities of choice. Why would'nt they. It's expensive to hang blood. There are alot of people behind the scenes from collection, storage, transport, typing, testing, RESEARCH. WHERE ARE THE PROTOCOLS?
    If I relied on scripture I could just "lay on of hands" and my shift would be over. If I relied on "working with" parents their kids would'nt get I.V's or anything else that makes them have pain. There would be very little in the way of medical procedure I imagine.
    Except for the orders you would give.
    There's danger here JW. If you need a court order to get your way then there isn't much science to back you up. Any time a JW wins a court battle a little more power is abdicated to that precedent. We'll have courts and parents making medical decisions that belong to protocol guidelines of clinicians.
    Those court decisions will not be any more based on science than the O.J. simpson trial was on justice.

    Certainly you watchtower folks have a bundle of cash for research that you could use to show the medical community enough data to get the protocols changed so there would be no argument. If there is completed research, why are there no universal protocols? Why all the argument? Certainly the pharmaceutical companies would just LOVE to introduce a substance they can manufacture that would be used universaly as a first choice.

    HEY......There's an idea. Who is it that manufactures the blood being used in transfusions as first choice now?
    Would'nt that be God?
    This is a very interesting quandry.
  9. by   RNKitty
    Okay peeps, I can appreciate some of your points, and I understand where you are coming from. However, you stated:

    Originally posted by Peeps Mcarthur

    We'll have courts and parents making medical decisions that belong to protocol guidelines of clinicians.
    I, as a parent, feel I should be able to make medical decisions for my child. Period.

    Now, the role of doctors and nurses (and here I have an advantage over some parents, admittedly, since I am a nurse and have background in medical terminology) is to TEACH and INFORM the parents of options, risks, and benefits. (The original root word for doctor means teacher, by the way).

    If you go to another culture, where say Eastern philosophy or Ayurvedic medicine is practiced, the clinicians may have a very different recommendation regarding the treatment of the child. Just because Western medical doctors are schooled and trained in one thought doesn't mean that they are always right.

    I appreciate the doctors and nurses who take the time to acknowledge and learn about other treatment options, as well as validate and try to understand the family's values.

    I also appreciate this discussion. You certainly seem caring and passionate about your beliefs and your patients wellfare.
  10. by   JW-HLC
    I am sorry that the link doesn't work for you. If you are able to contact your local Hospital Liaison Committee for Jehovah's Witnesses they will give you the complete 30 minute video free of charge. The content of the video actually answers your question:-
    "If your alternatives are so great they'll be recognized by the regulating authorities and be put in place as theraputic modalities of choice. Why would'nt they. It's expensive to hang blood. There are alot of people behind the scenes from collection, storage, transport, typing, testing, RESEARCH. WHERE ARE THE PROTOCOLS?"

    Bloodless alternatives ARE becomming the treatment of choice and the US is leading this. However JW's are not the medical profession - it takes the medical profession to produce papers that can be read by their peers and many professionals are slow to publish. However interesting ones continue to be published (eg recent research shows dangers to critically ill patients given RBC's over 7 days old
    Link

    "You don't REALLY want me to work with you. You want me to work FOR you. That's just a nice way to say "go along with what I want or I will cause trouble".
    No, no, no, - we definitely want to work WITH you, but we want you to work with us as well. We don't abdicate our responsibility for our child when we walk through the hospital doors. What we say is "If you can't work with us say so quickly and let's find someone who can". We believe that it is appropriate to do what RNKitty has just stated re: Risk/Benefit, that means working with the parents not seeing them as a nuisance to the process. That's a bit like the shopworker viewing the customer as being an inconvenience to the running of the business!

    "If I relied on "working with" parents their kids would'nt get I.V's or anything else that makes them have pain. There would be very little in the way of medical procedure I imagine.
    Except for the orders you would give."

    Again, no,no,no - we do not try to take over treatment, why should we most of us ore not medically trained; we just object to blood, virtually everything else is acceptable to us and we actively seek the best treatment we just do our utmost to find alternatives to blood.

    "WHERE ARE THE PROTOCOLS?"
    I can't speak for the US but in Britain many individual hospitals have protocols for treating Jehovah's Witnesses as do the Royal College of Surgeons and the Association of Anaesthetists. The British Society of Haematology is also working on a protocol at this time and one of the HLC's here in Britain spoke to them (at their invitation) at their National Conference in 2001.

    " Any time a JW wins a court battle a little more power is abdicated to that precedent. We'll have courts and parents making medical decisions that belong to protocol guidelines of clinicians."
    If that really did happen, surely it would be a question of recognised authorities seeing "another way", or such a decision would never be made by the courts. We have seen many medical matters decided upon by courts and the medics have had to adjust. Medics are not the only ones gifted with understanding and wisdom, sometimes they are blinkered by their protocols and somone has to stand up and show them that there is another way! Such has been the case throughout history.

    "Certainly you watchtower folks have a bundle of cash for research that you could use to show the medical community enough data to get the protocols changed so there would be no argument"

    If only that were true, even if it were, as a registered charity any funds we have are correctly governed by charity laws - they cannot be used for the medical needs of its members (though as I stated in a previous posting many individual Witnesses privately contribute funds for hospitals, equipment etc). My previous comment still applies - it is medics that must produce papers, no one would listen to what the Watchtower Society said - hence the benefit of the above-mentioned video.

    Interestingly advances are being made with blood substitutes, foremost amongst these is probably a product called "Oxygent" which is currently undergoing satisfactory testing - who knows what the future will hold. One thing is sure, here in the UK the NHS is doing its utmost to reduce the amount of blood used; its NHS Executive Directive "Better Blood Transfusion" directed NHS Trust Hospitals to actively seek alternatives such as cell salvage. In the US? - well just look at how many Bloodless Centres there are. I know these aren't for paediatric cases, but it must say something about the medical view!
  11. by   Peeps Mcarthur
    JW, RN Kitty,
    Since you're both parents that explains alot.
    I'll further(believe it or not) post on this matter tomorrow.
    This is certainly becoming pleasant enough to exchange some ideas.
  12. by   VickyRN
    Freedom of religion is very important, even a sacred right in our society. I do not agree with JW doctrines, but I will defend your right to preach/teach/go door to door and practice your religion. I also believe that parental rights are very important. Only in the most compelling circumstances should the state intervene--matters of life and death involving a minor child. This involves all religious practices, not just JW. For instance, the radical Moslem father who is determined to kill his 16-year old daughter, because he believes she is no longer a virgin and has "shamed" his family. The animist or Moslem family whose cultural/religious ideals include the horrific practice of female circumcision on their 5 year old daughter. The devoutly religious couple who will not allow their teenager with juvenile diabetes to take insulin or see the doctor and she is now in a diabetic coma. The Christian Scientist mother who will not allow her 10-year-old son to receive medical treatment for a broken femur. In many, many cases, the refusal to receive a blood transfusion will result in certain death for a patient. This is a fact. PERIOD. While it is certainly within one's rights as an adult to refuse blood components (as my elderly female patient did and later died as a direct result), in the case of a child, the state must become involved. PERIOD. End of argument.
  13. by   JW-HLC
    It is good to see that you have a willingness to accept the views of other religions and of parents.
    In respect to the issue of specific treatment of a child, there was a time when I would have said exactly the same as you, so I can understand your feelings. Whilst I don't agree with your putting the "circumcision" or "killing for shame" illustrations on the same footing as the JW issue, I can appreciate your views re: the insulin and Christian Scientist cases.

    Just try to remember that JW's actively seek medical attention for themselves and their children, we are not anti-medicine. It is only in the matter of blood where we have a problem and in most cases that can be resolved by using alternative methods. It should be very rare indeed to require a forced transfusion in this day and age.

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