The consequences of religious belief..

[collins anyiam]

With due respect to all the ''jehovah Witness" believers here...

i lost a patient today. He was diabetic, he had grade 3 foot ulcer that polluted the ward even after dressing. The only remedy to his problem was amputation. He actually accepted amputation but he had a very low PCV level, when the Dr told him he was going to be transfused, he strongly refused, saying "they dont receive blood" in our church. People! I watched this man die slowly and helplessly. What do u my fellow nurses have to say about this? Do u guys experience the same thing?:crying2:

[rn/writer, RN]

While it might be interesting to hear what another JW might do, that doesn't have any direct bearing on this man's choice. He made an informed decision and stayed true to the doctrine of his church. We can mourn the loss of a vital young person, and we can each be glad that we have the freedom to make a different choice (or not), but it isn't up to us to decide for another capable adult.

I do have a couple of questions. How did he end up with a grade 3 foot ulcer before coming in? Not putting you on the hot seat. Just wondering why he didn't get treatment before it got to this point.

Also, why didn't the doc perform the amputation anyway? With volume expanders, the patient might have had a chance. A foot amputation doesn't necessarily mean a large blood loss. In fact, I would venture to guess that with a cell saver, the loss would have been minimal. His chances with gangrene and septicemia were slim to none. Seems like he could have had a better outcome with the amputation.

Regardless of whether I agree with this man's (or his church's) reasoning, I do have to recognize the courage that it takes to stick to one's beliefs, even in the face of death. In an age of collapsing convictions, I have to admire that kind of tenacity, even when I don't support the underlying premise.

[rn/writer, RN]

How do you think you would have reacted if this had been a child and the parents refused?

Staff note: There have been a number of threads on this subject. They usually start out okay but go downhill before long. Please, limit this discussion to capable adults making the decision to refuse blood products.

Thank you.

[hsienko]

rescinded.

[collins anyiam]

http://www.stgeorges.nhs.uk/docs/patient/JehovahsPatInfoBooklet.pdf may be helpful.

Interesting, dint know abt the cell salvage machine. unfortunately we dont have them here. thanks

[rn/writer, RN]

Thanks for posting the link.

[collins anyiam]

"While it might be interesting to hear what another JW might do, that doesn't have any direct bearing on this man's choice. He made an informed decision and stayed true to the doctrine of his church. We can mourn the loss of a vital young person, and we can each be glad that we have the freedom to make a different choice (or not), but it isn't up to us to decide for another capable adult.

I do have a couple of questions. How did he end up with a grade 3 foot ulcer before coming in? Not putting you on the hot seat. Just wondering why he didn't get treatment before it got to this point.

Also, why didn't the doc perform the amputation anyway? With volume expanders, the patient might have had a chance. A foot amputation doesn't necessarily mean a large blood loss".

Yes, he had grade 3 foot ulcer prior to presentation at the hospital. his PCV so so low, he couldnt afford plasma expanders, even the hematinics that were prescribed, he only bought the 1st dose and that was it.

[rn/writer, RN]

How sad.

It must have been difficult watching this patient succumb to his wound, knowing that he could have had a vastly different outcome if he'd gotten himself to the doc or hospital sooner.

Thanks for answering my questions.

[Pneumothorax, BSN, RN]

It becomes a different situation entirely with someone who may not be able to make legal decisions for themselves; in that case, you should discuss other options with the surgeon, let your manager know about the situation, and then hopefully your hospital's ethics committee would be pulled together to deliver an opinion on the case. In a situation with a child, a court injunction can be sought so that treatment can be provided if it is agreed that that would be the correct course of action. Thankfully, those situations are rarely ours to tackle alone.

But how would I react emotionally to that? I'd have to step out of the room to keep from shoving my foot so far down my throat i'd be able to walk on it. The hospitals in my area have a good relationship with the Jehovah's Witnesses and have ministers on-call who can talk to a church member about their faith and blood-free transfusion options.

^^^ these scenarios are my worst nightmare..i wouldnt be able to stand seeing a kid pass.. for something that may be easily solved.

Im also curious to hear from any JW members we have. I can repect any adults decision to uphold their faith.... but I have to admit that if it had been a child that needed blood and the parents refused and said child died I would have been an absolute basket case. I do realize that its not for me to judge and I would have fought hard to keep my opinions to myself..... it would just be a very tough pill to swallow

While it might be interesting to hear what another JW might do, that doesn't have any direct bearing on this man's choice. He made an informed decision and stayed true to the doctrine of his church. We can mourn the loss of a vital young person, and we can each be glad that we have the freedom to make a different choice (or not), but it isn't up to us to decide for another capable adult.

I do have a couple of questions. How did he end up with a grade 3 foot ulcer before coming in? Not putting you on the hot seat. Just wondering why he didn't get treatment before it got to this point.

Also, why didn't the doc perform the amputation anyway? With volume expanders, the patient might have had a chance. A foot amputation doesn't necessarily mean a large blood loss. In fact, I would venture to guess that with a cell saver, the loss would have been minimal. His chances with gangrene and septicemia were slim to none. Seems like he could have had a better outcome with the amputation.

Regardless of whether I agree with this man's (or his church's) reasoning, I do have to recognize the courage that it takes to stick to one's beliefs, even in the face of death. In an age of collapsing convictions, I have to admire that kind of tenacity, even when I don't support the underlying premise.

there are many extremes to religion that each individual prescribes to.so what someone would post may not be what this guy felt the same way about.

Yes, we have to respect our patients right to refuse treatment no matter how bad we know it is for them (if they are of sound mind to do so), but it hurts when we know we can possibly or even resolve their problem or prevent them from dying and they dont act on it. It makes me sad knowing that as a nurse i will have to allow patients to do such things to themselves and can do nothing about it but watch =[

[MN-Nurse, ASN, RN]

I don't think I could improve upon this. We all make our own choices in life, he made his. Not for you or me to judge.

If the above is not true for people who commit suicide because of mental illness, it is not true in this situation either.

[heron, ASN, RN]

I think we'll always have trouble with patients' decisions that decline what we think of as lifesaving or life enhancing treatment.

I remember years ago reading of a case in which a man was involved in a traffic accident that transected his spinal cord high on the cervical spine resulting in instant irreversible quadriplegia. He declined any and all treatment at the emergency dept. and had his companions take him home after he was fully informed that lack of acute care would probably cause his death.

As a hospice nurse, I come at this kind of question from the "back end" so to speak. There truly are some fates worse than death (and I've seen a few of them). What that might be is different for each individual. Perhaps the chronic condition that resulted in the ulcer was more than the pt. in the OP wanted to endure.

In any case, he clearly felt that death was preferable to being at odds with his Lord and made his decision accordingly.

It's my hospice background that's convinced me that everyone gets to die in his own time and in his own way ... once the decision is made, my job is to honor his choice and do my best to facilitate whatever peace, serenity and comfort is possible.

[Al.ginger]

Our instructor told us a story.

There was a JW mother having a baby. After she delivered healthy baby she started hemorrhaging. Well, she refuses blood transfusion and died. That was her choice. But how sad is watching the new baby who will never see his mother!

[Pneumothorax, BSN, RN]

Our instructor told us a story.

There was a JW mother having a baby. After she delivered healthy baby she started hemorrhaging. Well, she refuses blood transfusion and died. That was her choice. But how sad is watching the new baby who will never see his mother!

now, heres the thing with this, is the mother allowed to do such a thing, a refuse treatment to a minor, furthermore someone who is completely incapable of consenting or making the decision on their own?

yes, i understand its their religion, but its the MOTHERs religion at that point in time, the baby isnt prescibing to JW..its bleeding to death.. sigh..