what are the alternatives of blood transfusion?

Question

we were given a scenario and we are to decide what "the right thing to do.
so the scenario is that a 27 year old woman has been brought to ER after an auto accident needing an immediate surgery. She sustained internal injuries and significant blood loss. She agreed to the surgery but refused blood transfusion because she is a JEHOVAH's WITNESS. She wants to live and ask you to do what you can to save her.
youe were give 3 options ans you must choose..
1. refuse to perform operation unless she consents blood transfusion
2. agree to perform the operation without blood transfusion.
3. agree yo perform the operation, promising to administer no blood transfusion BUT is such is necessary to save the womenm then you will do it.
so now..if you were the doctor that time, what can you do to save this women's life??
**is there aANY OTHER WAY that a doctor can save her without the contrary to the word of god?(Jehovah witness's beliefs)

please help..

Answer 1

In most places, a physician would be legally justified in pursuing either of the first two scenarios (either 1. refusing to treat a patient at all because the physician feels unqualified to do so given the circumstances; or 2. treating a patient according to informed consent).

Of course, a doctor who proceeded with a particular treatment which he well-understood to violate a patient's express refusal would expose himself to terrible repercussions legally, professionally, ethically, and (perhaps) eschatologically. In many jurisdictions, the doctor would actually be guilty of a crime similar to "assault" and in the example given it might even be prosecuted as a hate crime since the original objections were religious in nature.

A doctor who refused to treat a patient simply because the doctor disagreed with the patient's choice of treatments would seem to be a selfish cad, but could be prosecuted in far fewer jurisdictions.


Incidentally, many MULTIPLES more have died as a direct result of a blood transfusion than have died from a conscientious decision to pursue non-blood medical techniques.

Answer 2

tickdhero's answer above is right on the money. the only other thing i would add is that even though option #2 (agree to perform the operation without blood transfusion) is the "right thing to do," it still won't keep you out of trouble. there have been cases where a doctor agreed to abide by a jehovah's witness' insistence on not receiveing blood, only to have the patient die due to blood loss, and then found that the patient's family was suing because they felt the doctor should have given the transfusion to save the patient's life despite what the patient wanted!

bottom line is you need a very through discussion with both the patient as well as the family, and see if option #3 is possible. if not, then option #2 is the "right thing to do."

Answer 3

As a Jehovah's witness, she is allowed to refuse blood transfusions and the physician *must* respect that.

As she has agreed to surgery, and surgery is indicated the physician (surgeon) is *obligated* to perform the surgery to save her life.

A wise surgeon would caution the patient that her risk of mortality and morbidity are greatly increased if she refuses a transfusion.

It is also important to note that once the patient is under anesthesia, they no longer have autonomy. Therefore a surrogate decision maker can in certain instances override the patient's decision.

Short of transfusions, colloids and crystalloid solutions (albumin, normal saline, and Ringer's lactate) can be used to supplement the blood pressure and perfusion, but are not as effective as a transfusion.

Some patients (even JW's) will consent to the use of a "cell-saver" device. This is a closed loop suction unit that can recover a portion of blood that is suctioned out of the patient so that it can be "auto-infused". Not all JW's agree to this, but some do.

Another option is the use of eyrthopoetin alfa. This is a synthetic analog to a human hormone (erthyropoetin) that is responsible for increasing red-blood cell production. There are a few side-effects, but the main draw-back is that it takes several (3-4) weeks to reach full effectiveness and is not useful in the perioperative period.

Answer 4

I even have had 13 surgical procedures in my existence. some significant. with no blood transfusion. i did no longer have something different than non blood fluids. I recovered speedier than absolutely everyone the docs had operated on for the comparable element. I had a storage sale some weeks in the past and that i replaced into conversing to a minimum of one in each and every of my clientele. She informed me approximately her daughter. She did no longer be responsive to i replaced right into a Witness. yet her daughter replaced into born with a blood affliction. She won blood maximum of her existence however the final one killed her. the guy who had donated the blood had hepatitis and no-one knew it. The daughter did no longer have the potential to combat it. This youthful lady died at 22 from the blood transfusion. If basically she had a doctor that knew adequate to furnish her the alternative blood.

Answer 5

I would hope not to be taken to your hospital as it is clear you are not current on bloodless procedures for the growing number of people now refusing it, of which only 10% are JWs. That's more than 20 million people.

Google bloodless surgery and you will note that there are now 150 hospitals that offer bloodless options to all their patients. Perhaps it's time to update your procedures and join them.

Answer 6

the main thing is to keep the patient from becoming hypovolemic, so you would administer saline or other iv's. in some instances there are devices for blood reclamation that would recycle her own blood lost during the surgery. if at all possible, you should stick to your patient's wishes.

Answer 7

Let's be honest. The Bible doesn't say anything against blood transfusions.
Alternatives:
Did you know that the JW's had some "new light" and blood fractions are OK if administered seperately (red cells, plasma etc.)
That is certainly the best option.
Another option is to wait until the person loses conciousness and do what needs to be done.
Artificial hemoglobins are options,but they are expensive and not as good as the original.

Answer 8

There are other plasma expanders that you can use, they are not as good and as far as O2 transport, they are no better than saline. I don't remember whether the word og god allows that. But I would probably choose numberr three unless she's a lawyer, then I would choose number one.

Answer 9

A good resource:

http://watchtower.org/e/vcnr/article_01.htm