Doctor Asked For A "Kind" Nurse

911fltrn · Mar 25, 2003

As an 18yr old the patient has the right to make this decision. Its my belief however that if this was a minor the doctor should transfuse the child and involve child health and welfare services.

sjoe · Mar 25, 2003

"What was said about JW was inaccurate."

There are several "branches" of JW (like every other religion in the world), each one thinks it has the "correct" message. What was said about JW IS accurate for some of these branches, inaccurate for others.

BTW, I hadn't noticed that Vegas has later posted that the patient was 18 years old, which removes my argument about parents/minors/children/etc. If this patient had wanted blood products, etc. then specific advance directives would have been in order (ANOTHER reason to complete these directives at the earliest possible age, unless one wishes next-of-kin to make the decisions).

fab writes: "Care of minors presents the greatest concern, often resulting in legal action against parents under child-neglect statutes. But such actions are questioned by many physicians and attorneys familiar with Witness cases, who believe that Witness parents seek good medical care for their children. Not desirous of shirking their parental responsibility or of shifting it to a judge or other third party"

Who cares whether "many" physicians and attorneys...question such actions? Other physicians and attorneys do NOT question such legal actions. It is up to a judge and/or a jury to decide in these cases.

Regardless, the hospital has some serious legal exposure by not contacting the authorities in a timely manner in this case, as do those employees who knew about the situation and did not do so themselves.

Ask Nevada's BON and its attorney general, if you think I am mistaken. (Not about JW, of course, but about legal obligations and remedies.) We don't want Vegas to be posting from inside the slammer in the future.

fab4fan · Mar 25, 2003

There are many alternatives that are acceptable. Procrit and Epogen are among the newer drugs used, very successfully, for that matter. There are other things that can be done, such as hypothermia, hyberbaric O2, and others. I was glad to see someone mention something that should be obvious, but often gets overlooked: microsampling when labs are needed.

As far as a situation in which a minor child would request a transfusion...I honestly don't know. I suppose this would be one of those situations that could lead to a court decision. No one has ever asked me that before, so I don't know, but I will try to find out.

I know that it seems harsh, but bear in mind that this is one aspect of care that is being refused, not all care. Even in a case of massive blood loss d/t trauma, it's the lack of volume that is the initial problem, not blood itself. Medical personnel frequently deal with pts. who have other issues that force them to modify the initial tx. plan, e.g. pre-exisiting conditions, medication allergies, etc.

Parents make very personal decisions for minor children all the time. I think some people (and I'm saying this in general, not people on the BB here specifically) think that parents in this situation have some sort of cool detachment...that is not the case. Witness parents consider children to be a blessing from God, so clearly they would want what is best for the child. But they also have to think about the child's spiritual life as well.

I hope some of this info clarifies things. BTW, the comments about a child being "shunned" and put out by his parents...not true.

Thanks for bearing w/ me on this...got a little hot under the collar last night.:)

fab4fan · Mar 25, 2003

sjoe: There are no "other branches" of JW...any people that have separated and formed variations of the faith are considered apostate.

nursedawn67, LPN · Mar 25, 2003

Originally posted by fab4fan
It was the comments about "why even bother..." etc. (I had someone tell me to "just stay home and bleed to death", so I guess I get a little touchy sometimes).

Anyway, this is the official position, and is in no way meant to prostelytize:

JW position on blood

wow very informative.

whereas I agree that one's religion keeps them from wanting certain medical treatments and that we must respect them, they also have to understand that we are taught to do what we have to save someone. And to see a person dying that we know can be saved by such simple measures blinds us to one's principles.

SharonH, RN · Mar 25, 2003

Originally posted by LasVegasRN

Nothing is going to save this patient except blood products. Period. I still ask what is the point of coming to the hospital, and shouldn't Hospice be offered as an alternative since death has been chosen?

I have taken care of JW's who were near death d/t blood loss. I remember one gentleman who had an H/H of 3/11. He received all medical treatment he could except the blood. My co-workers spoke of his obstinance and how he didn't get it, etc. and he's definitely going to die. He lived. JW's can tell many stories similar to this. They are not refusing all treatment, just the blood. They have not chosen death, just accepted that it would be the consequence of not receiving the transfusion. If they went to hospice, then their loved one would not receive other treatment.

allnurses Guide · Mar 25, 2003

In regards to "shunning" . . . . we have an EMT here who left her JW faith and is shunned by her parents. They do not even acknowledge her or her children. They visit the LTC patients as part of their ministry and walk right past their daughter without acknowledging her. I've never heard of shunning someone for taking blood though.

Aussienurse2 · Mar 25, 2003

I have had several JW clients in the past and have always felt that advocating for them was a privilage, just as I would expect a nuse to advocate for me in particular beliefs that I have. I want to donate my organs, my family are very much against this, I would expect any one of you to facilitate MY wishes. Clients have the right to their faith, if this involves death then so be it. I cannot change their faith to suit my own, only offer kindnes, freedom from pain and a hand to hold.

We always want to save everyone but if through saving them we condem them to a life that they felt was not worth living have we really saved them at all?

ella1 · Mar 25, 2003

Fab4fan, am very impressed with the way you have responded to the queries. As someone who was raised as a Jehovah's Witness - although no longer an active member - I find it amazing that people love to hone in on the old "they wont take blood" issue! Other religions believe in female genital mutilation for goodness sake but that isnt brought up every time that particular religion is mentioned!

I didnt realise that a blood transfusion was the only medical treatment that was available in a hospital, because it sounds like from previous postings that if you wont have one there is no point in even coming into hospital! I am not speaking as a Jehovah's Witness as I am not an active member - but I am speaking as someone who has a pretty good understanding of their beliefs and who knows that they love their children just as much as every good parent does. They feel they are following what the Bible says and are making the right decision.

ShandyLynnRN, BSN, RN · Mar 25, 2003

Originally posted by Aussienurse2
We always want to save everyone but if through saving them we condem them to a life that they felt was not worth living have we really saved them at all?

That is a very good point. I totally agree with that in the cases of adult patients. And since the patient is 18, I suppose he can make his own decisions. However, I cannot force my religious beliefs on anyone, even my own child. How many "preachers kids" have we known that have rebelled because their parents' faith was "forced" onto them. That is why I think those decisions need to be made based on what the child wants AND needs.

I understand that JW believers, believe whole-heartedly that their children would be "lost" if they chose to receive blood or blood products. I can't imagine having to make that decision.

CHICKTOEAGLE · Mar 25, 2003

This is obviously an emotional topic for a lot of us. I appreciate fab four's very specific and clearly intelligent responces and explanations. We must try to respect religious beliefs of all faiths. My maternal Granny converted to J. W. from Catholism and so did many of her children.Therefore I was exposed to a varied amount of her belief system ,and loved her dearly.At one point ,before her death, she required renal or. All the siblings were fighting amoungst themselves.My sweet Granny went through the procedure w/ amazing courage and lived another 10+ yrs. just a personal story.............CHICK:kiss

emily_mom · Mar 25, 2003

Originally posted by cna on her way
I have to say that I don't understand this either. I could not stand by and watch my child die when there was something that I could have done about it. If a child is under the age of 18 and you bring them to a hospital for treatment, then we should be allowed to do just that. Just as a christian can believe "spare the rod, spoil the child" would it not be child abuse to hit a child with a rod? Children are not our property and we should not be able to decide if they live or die. This is just my opinion and I am not trying to put down anyones faith. I just don't see how allowing a minor child to die if blood would've saved their life can be justified.

stevielynn Hey Fab 4 - misconceptions run amok . . . I see what you mean. " spare the rod and spoil the child" by cna
I've always heard that was comparing raising our children to sheparding sheep . . . . the shepard guides the sheep with the rod. They don't hit them with the rod.

Christian parents are often confused about the issue of corporal punishment, believing that they must spank their child in order to be godly parents. They take literally the phrase, "Spare the rod and spoil the child." Some religious teachers reinforce this notion by quoting scriptures out of context. Among the verses they cite: "Folly is bound up in the heart of a child, but the rod of discipline will drive it far from him" (Proverbs 22:15); "He who spares the rod, hates his son, but he who loves him is careful to discipline him" (Proverbs 13:24); and "Do not withhold discipline from a child; punish him with the rod, and save his soul from death" (Proverbs 29:15).

At first reading, these passages might seem to support spanking. But this is not the only way to interpret them. The term rod is used throughout the Bible in connection with the shepherd's staff: "Your rod and your staff, they comfort me" (Psalms 23:4). The shepherd's staff is, in fact, used to guide wandering sheep along the right path, not to hit sheep who stray. So a compassionate reader could interpret the Bible as saying that parents must lead and guide their children but not harm them. This teaching is developed beautifully in the book A Shepherd Looks at Psalm 23, by Philip Keller.

Finally, note that references to the "rod" are found primarily in the Old Testament. In the New Testament, Christ preaches compassion, love, and understanding, as does Paul. We would hope that all parents, hearing teachers warn about sparing the rod will remember Paul's words in 1 Corinthians: "Shall I come to you with a rod, or in love and the spirit of gentleness?" - William Sears

You are totally right, StevieLynn! Many of the Mennonites in our area believe in this, but they don't beat their children either. You can make anything sound like God's word when taken out of context. Thanks for bringing this up. :kiss