Jehovah Witness and Blood Transfusion

Nurses General Nursing

Published

I have a family member who is a Jehovah witness, and she has a daughter and sister who still practice under this religion, she herself has not been practicing as a JW for a very long time in that she has not attended any meeting ect....

She has taken very ill, and her spouse has okd for her to have a blood transfusion, her daughter was going to come up to the hospital to see her, but I am afraid after this news she may not. I asked her nurse that we she was ready to give the transfusion, could she lock off the room to give the patient some privacy while she was having this procedure and she stated she was not able to, she stated, that she understood the pt, was a JW but that since they had the approval of her spouse to perform the blood transfusion, she would not be able to do this she asked that we contacted the daughter and speak with her about this.

My question is this and why.

Is this a liability for the hospital treating her?

If so how much of a liability is it?

I ask this question because the hospital seems to be rushing the family member on her way, and whenever you mention anything about the approval of the blood transfusion, all the staff become extermely nervous this includes the doctor. The family is so divided in this and we almost lost her the other day, now this I am afraid it may create a bigger argument then they already have. The daughter has now begun to avoid seeing her and I cant understand why?

What happens in a case like this, should the hospital be giving the blood transfusion? and if so is it impossible for them to provide some privacy during the transfusion?

Be_Moore

264 Posts

Specializes in Pulmonary, MICU.

If the spouse (next of kin) gave permission and the patient was unable to consent, then there is no legal problem. The problem is more moral/ethical in nature, and the reasoning for the rushing is that many times you want to transfuse before the problem becomes too big to solve..and/or maybe the patient would have poorer outcomes without a transfusion. So it was likely in her best interest to transfuse, but also in the best interest of the hospital to be quick about it just to avoid drama.

If the spouse (next of kin) gave permission and the patient was unable to consent, then there is no legal problem. The problem is more moral/ethical in nature, and the reasoning for the rushing is that many times you want to transfuse before the problem becomes too big to solve..and/or maybe the patient would have poorer outcomes without a transfusion. So it was likely in her best interest to transfuse, but also in the best interest of the hospital to be quick about it just to avoid drama.

I guess I can understand that, but my heart really go out to this pt, Could they have locked down her room or direct any vistors to the nursing station before entering the room for privacy?

I really hate to see her looking for a daughter that is not there or feeling bad for a choice that her very own spouse made for her in a life and death situation?

June59

25 Posts

Specializes in Med/surg.

This is a sad case, as I wonder what the patient would want & she obviously cannot speak for herself. I am curious if she had a living will & if within it she stated she would want a blood transfusion. As for locking her room, that would be inappropriate. If she needed emergency assistance, it would impede the providers access to her. Probably the better solution would be to have a no visitors/no info status during her hospitalization. However, her daughter may be offended & blame the husband.

Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

Spouse first, children next.

EVEN if spouse is 2nd husband and NOT father of said kids--always legal spouse first.

crawlyberry

89 Posts

Hi...Still a new nurse under a year. Finally experience my 1st patient who refused to have a blood transufion even though her H/H came back with panic levels. Because of her refusal, the doctors are basically treating her with iron and oxygen. I did give one dose of Procrit 10,000 units sq. The family has threatened to call the head of the hospital, etc. because they feel that the docotors aren't doing enough. The hematologist is the one that ordered the iron and oxygen, and stated it would be a long process before her H/H would come up. What more can be done? Thanks...everyday is a learning experience.

June59

25 Posts

Specializes in Med/surg.

Yes, I agree, just sad that there is or may be dispute among the family members. A living will with specifics may save a lot of heartache.

June59

25 Posts

Specializes in Med/surg.

Crawlberry, I am curious, did your patient state why she did not want the transfusion?

dtchavey

34 Posts

Specializes in Oncology, and Gerentology.

and this is why we discuss things very thoroughly with our POA.

Specializes in Peds Hem, Onc, Med/Surg.

As a Witness I have to say the daughter might have or not a problem. you won't know until you talk with her. Secondly because the patient was not an active witness, the daughter probably knows this and she might be aware that her parents are going to do it and while the daughter would still not want the blood transfusion for her mother unless her mother had a POA or a DPA there was nothing she can do. If the hospital has informed consent that is all they need. If they don't however, they could be in trouble.

As for the privacy of procedure, I don't think this is necessary because from what I can read you haven't even talked to her.

I wouldn't jump the gun if I were you. She might more understanding then you give her credit for.

Witness or not it just goes to show that you have to have a living will in case you end up in this type of situation. A lesson for everyone.

Actually not too long ago we had a case similar to this one except it was the dad that was ill. He accepted a blood transfusion and his daughter who was a very very active witness stayed in the room the whole entire time and all she said was its between him and God and I am here to take care of my father.

Thank you everyone chicookie, you are dead on with this, I just would hate to have anyone think their religion is not being respected, and I really did not know what to expect from the daughter, I feel that at this time everyone should be praying for this family member, and not fighting about things, but I am so happy things are coming together, and I hope and pray she dosnt view her parents any different with all this happening.

VegRN

303 Posts

Hi...Still a new nurse under a year. Finally experience my 1st patient who refused to have a blood transufion even though her H/H came back with panic levels. Because of her refusal, the doctors are basically treating her with iron and oxygen. I did give one dose of Procrit 10,000 units sq. The family has threatened to call the head of the hospital, etc. because they feel that the docotors aren't doing enough. The hematologist is the one that ordered the iron and oxygen, and stated it would be a long process before her H/H would come up. What more can be done? Thanks...everyday is a learning experience.

Honestly, I would encourage the family to contact the head of the hospital. The pt is refusing the one treatment that would help her get better quickly. What more can they do? I think that the pt should have the right to refuse but, the pt should not expect miracles to happen when they refuse the most effective (but not acceptable to them) treatment.

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