I'm curious of your opinion

  1. 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 the courts ordered the hospital to give the baby the blood transfusion.

    What is your feeling? Should the courts/hospital intercede? Or do the parent's have the right to refuse blood in this case?
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  2. 126 Comments

  3. by   babynurselsa
    I guess what makes me more curious is why this has become a national story. I work NICU and this happens every day. I can assure you that there is no way this baby will survive without blood. I have seen the scenario personally where the parents put up a big to do while family or church members are present but when they are alone thank us. I actually had a young set of parents once that put on quite a show when the grandparents were around but as soon as they would leave they would tell us they felt they had to or be ostracised.
    Now there are those that do believe so strongly in their faith that they will resist this treatment based on their own beliefs. I do disagree with that personally for the child.
  4. by   Zee_RN
    Is this a hopeless case? Or is there a chance baby will survive and have a quality of life? I have often seen the elderly or the "hopeless" case in ICU where the family has made pt. DNR and refuses blood. Is this a similar case? Or is it simply on religious grounds?

    Hard to say what I'd agree with. I hate to buck an individual's religious beliefs but I also hate to put the life of a child in danger. A 25-weeker, man, that's tiny.
  5. by   hoolahan
    Regardless of the religion, I say the child deserves a shot, and should get the transfusion. Who knows if this child whould choose that religion when he is older?? Give him a chance to make it to that point!

    If it is a hopeless case, or DNR, then certainly, the child's life should not be unecessarily prolonged which would only add to the suffering of the child and his parents.
  6. by   fergus51
    I don't think it is my place to interfere with someone else's religious beliefs, and until little people can talk, their parents are the ones who decide what's best for them. Personally I would want a baby to have the blood. But a 25 weeker whose parents have religious reasons for refusing treatment? That's a toughie. We let people refuse treatment everyday and I do wonder how this is different.
  7. by   Peeps Mcarthur
    The parents are not my patient.
    Screw what they think.
    The baby is the patient and therefore gets the benefit of whatever treatment is available to me until such time as it is not my patient.
    If God deems it required to intervene I'm sure He'll let me know.

    Quite a bit of procedure is second to a persons beliefs or personal preferrence, but life and death. No way.
  8. by   fiestynurse
    I think it's important to look at the survival rates and outcomes of a 25wk gestation infant.

    - Overall chance of survival = 61% (girls do a little better)
    - 50% chance of being "normal"
    - 100% chance of developing breathing problems and needing
    ventilation
    - 90% chance of developing chronic lung disease
    - 14% probability of significant abnormal brain scans
    - 100% chance of developing jaundice and needing phototx
    - 32% chance of developing a heart condition needing treatment
    - 100% chance of infection
    - Average number of transfusions = 7
    - 100% chance of needing tube feedings
    - 50% chance of developing gut problems needing med/surg tx
    - 10% chance of visual problems
    - High likelihood of IQ <85
    - High likelihood of attention deficit disorder
    - 100% likelihood of being small in growth
    - 50% chance of needing special schooling in the future
    - 80% chance of needing occupational, physical, or speech tx

    I have seen these cases go either way with 25 weekers. It depends on the parents reasons for refusing the treatment and the overall health of the infant. The judge will look at all this when making his/her decision.
    Also, I think we are going to start seeing these cases get more and more National attention. People are seriously starting to question whether we should be spending thousands of healthcare dollars keeping these 23-25 weekers alive, with such poor outcomes. I personally feel it should be each parents PRIVATE decision.
    Last edit by fiestynurse on Dec 31, '01
  9. by   dawngloves
    Most parents that refuse transfusion for religious reasons sometimes don't have a problem with you transfusing after getting a court order. Their baby gets the treatment and they are forgiven by the church because *they* did not say to give it, *you* made that decision and there by relieve them of responsibility.

    I think it's a win-win situation when the courts intercede for that reason.
  10. by   RNKitty
    Fiestynurse: I LOVE READING YOUR POSTS. You remind me of my favorite mentor. It is obvious you think before your speak, and I learn from your posts. They seem to be based on thought and experience and data, rather than just opinion. (Not to insult any other poster, just fawning over fiesty here )
  11. by   SharonH, RN
    I think that people are too quick to dismiss religious convictions of those who they disagree with. If the parents did not want it for their child, they shouldn't give it.
  12. by   sajaha
    This is a tough one. But I would have to go with the decision to intervene on behalf of the child. The child deserves the right to try to survive. We protect children in every other way, why not in this case?

    I do recognize though that the beliefs of the parents would make this a very difficult decision. I would want every other possible thing to be tried before the decision would be made to go against the beliefs of the parents.
  13. by   KRVRN
    Fiestynurse, where are your 25 weeker info stats from? Some of them are quite eye-opening, but some of--as with any statisitics--sound worse than they really are.
  14. by   fiestynurse
    My statistics are from articles by Helen Harrison on prematurity outcome research and the effects of premature birth. She's done tons of good research on this subject. For a 25 weeker these statistics are close to what I have experienced.

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