The consequences of religious belief..

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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::crying2:

Specializes in Hospice.
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..:crying2:

Decisions made by a parent for a minor child are a whole 'nother discussion. The process of overturning such a decision generally involves the courts and guardians. A very sticky wicket ...

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Specializes in Anesthesia.
First of all it's hardly a "tradition". The refusal of blood transfusions actually is against their doctrine. They see it as a violation of God's law, or their interpretation of it. If a member accepts a blood transfusion they will most likely be banned from the church.

True, he did make his own choice. I do see this as something that could have been avoided. This goes into the ethical dilemmas that nurses face every day.

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

Adults have the right to martyr themselves for their beliefs, but the courts in general do not allow for parents to martyr a child in the name of their beliefs.

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Specializes in Anesthesia.
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.

Depending on the surgeon the amputation would probably have been done with a tourniquet. Sometimes the surgeon worries that with already poor vascular supply that the tourniquet may cause more harm than good. A cell saver wouldn't have been appropriate in this case because of the infection.

Volume expanders will help to an extent, but when patients hgb get below 7 then only blood is going to help at that point, and that is only if the patient doesn't have heart disease or other systemic problems.

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i think i learn just as much on this forum as I do in class. I think my instructors should assign us all to have an account here

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Specializes in PICU, Sedation/Radiology, PACU.
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..:crying2:

To clarify- it was the MOTHER in this situation that bled to death, not the baby.

There are a lot of "bloodless medicine" technologies that would have helped make this surgery possible, were they available. It's very unfortunate that this patient was not able to take advantage of them.

I'll also mention that I had a 4 year old in DKA who needed a below the knee amp. Her blood loss during surgery was 50-100mls. Almost insignificant- even for a four year old.

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Specializes in ICU, Telemetry.

I've had this happen to a patient, but it was a GI bleed in a Witness. The family was saying, no blood, and everything I did was scrutinized like I was trying to somehow sneak blood in when I was just taking a temp. There's a large Witness community where I live, I've had a lot of JW patients, no problem with them but this family was just...creepy. Don't know if they were looking for a lawsuit or what.

Finally, I told them, "I understand that taking blood products is against your beliefs. If I felt I would lose all hope of heaven if I took blood then I wouldn't either. I won't give your family member blood. I wouldn't disrespect my patient that way." And then about 3 hours later, I put my patient into a body bag.

It's horrible when you feel someone's got a survivable condition, but you're not allowed to help them; you feel like you're doing something wrong, like you're committing negligence for just watching them bleed to death. But people have a right to worship as they see fit, and I did all I could to make the passing as peaceful as I could.

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Specializes in general nursing.

thats so sad..

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Specializes in general nursing.
I've had this happen to a patient, but it was a GI bleed in a Witness. The family was saying, no blood, and everything I did was scrutinized like I was trying to somehow sneak blood in when I was just taking a temp. There's a large Witness community where I live, I've had a lot of JW patients, no problem with them but this family was just...creepy. Don't know if they were looking for a lawsuit or what.

Finally, I told them, "I understand that taking blood products is against your beliefs. If I felt I would lose all hope of heaven if I took blood then I wouldn't either. I won't give your family member blood. I wouldn't disrespect my patient that way." And then about 3 hours later, I put my patient into a body bag.

It's horrible when you feel someone's got a survivable condition, but you're not allowed to help them; you feel like you're doing something wrong, like you're committing negligence for just watching them bleed to death. But people have a right to worship as they see fit, and I did all I could to make the passing as peaceful as I could.

Sometimes u wish these kinda pts never came your way 'cos you'll eventually be faced with emotional challenges. the funniest part of this whole thing is... no JW has been able to convince me about what the scripture says regarding blood transfusion, everything they say to me practically makes no sense at all. they could be misinterpreting the scripture u know? maybe someone can throw more light on that version of the bible that talks about transfusion being a "bad" thing to do

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

An interesting jump in logic but one I can't agree with.

A mentally ill person is not competent to make the decision to end their life, a competent adult can choose to refuse treatment. There is also an active/passive component, a mentally ill person committing suicide takes action to end their life, a competent adult declining treatment takes no action with the end result of death.

A competent adult declining blood products is no different than declining chemotherapy, dialysis or an organ transplant.

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I've experienced it before when I was doing CNA work in an ICU and ER. It is difficult to watch a patient go through that, but you have to realize that they hold their beliefs closely and will not diverge from them. To those of us who do not share the belief, it seems ridiculous, but to them, it is very important. I always struggle with it, but I have gotten to the place where I can better accept that this is what they want. The ones that really upset me are when the family does not share the belief, and desperately wants their loved one to take the transfusion. If the entire family is in accord, it is a lot easier to accept.

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Sometimes u wish these kinda pts never came your way 'cos you'll eventually be faced with emotional challenges. the funniest part of this whole thing is... no JW has been able to convince me about what the scripture says regarding blood transfusion, everything they say to me practically makes no sense at all. they could be misinterpreting the scripture u know? maybe someone can throw more light on that version of the bible that talks about transfusion being a "bad" thing to do

Acts 15:29

"that you abstain from things sacrificed to idols and from blood and from things strangled and from fornication; [a]if you keep yourselves free from such things, you will do well. Farewell."

Leviticus 17:10

"And any man from the house of Israel, or from the aliens who sojourn among them, who eats any blood, I will set My face against that person who eats blood and will cut him off from among his people."

Genesis 9:4

"Only you shall not eat flesh with its life, that is, its blood."

Those are the passages that shaped their doctrine. Whether it is "misinterpreted" or not is not for me to decide nor do I need to be convinced of it to accept that someone else believes it is "bad" to accept blood.

I majored in judeo-christian theology and everyone "misinterprets" scripture. It's why some people go to church on Saturday, some eat pork while others do not, some do not cut their hair, some do not let women wear pants, some do not pray to figurines while some do, and so on. There is no misinterpretation. Only interpretation.

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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

i am not a JW - but even with the tone of the original posting if i was a JW i would stay far away from this posting. if he had a grade 3 then it did not start yesterday. and you stated that he started some therapy but could not afford to cont it - be upset about that. be angry about people not getting care because they cannot afford it. be angry that a family lost member and that we do not have better medicine to help. children are different situations and hospitals will not bother stopping at the door when going to get a medical power when needed.

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