ENT surgery, blood and Jehovah's Witnesses

2006 ◽  
Vol 121 (5) ◽  
pp. 409-414 ◽  
Author(s):  
S L Woolley ◽  
D R K Smith
Keyword(s):  
Blood Transfusions ◽  
Reduce Blood Loss ◽  
Blood Products ◽  
Homologous Blood ◽  
Jehovah’S Witnesses ◽  
Surgical Strategies ◽  
Jehovah's Witnesses ◽  
Life Saving ◽  
Patient Groups ◽  
The Right

Surgical procedures in otolaryngology are often associated with the need for blood transfusions. Homologous blood transfusions carry risks and may be unacceptable to some patient groups. The Jehovah's Witness Society is known to many because of its stance on blood products. Refusal of potentially life-saving treatment creates ethical dilemmas for treating clinicians. Throughout the world, Jehovah's Witnesses have fought for the right to refuse blood products. This article examines the need for blood in otolaryngological procedures, surgical strategies to reduce blood loss, the beliefs of Jehovah's Witnesses regarding the acceptability of blood, and procedures and legal stances adopted when treating Jehovah's Witnesses.

Biomedical Ethics for Jehovah’s Witnesses and Patient Blood Management

2021 ◽  
Vol 27 (2) ◽  
pp. 49-54
Author(s):  
Sunghwan Cho
Keyword(s):  
Religious Beliefs ◽  
Biomedical Ethics ◽  
Blood Transfusions ◽  
Patient Blood Management ◽  
Blood Management ◽  
Jehovah’S Witnesses ◽  
Jehovah's Witnesses ◽  
Religious People

Jehovah’s Witnesses refuse blood transfusions according to religious beliefs, and for this reason, most hospitals and doctors have refused their treatment. There are more than 100,000 religious people in Korea, but there are few bloodless centers that can receive their treatment. So, the number of Jehovah’s Witnesses patients visiting bloodless centers in Soonchunhyang University Bucheon Hospital has been increasing every year. Despite this situation, no legal or medical countermeasure has yet been proposed against them. Therefore, I would like to take a bioethical approach based on “principles of biomedical ethics” and introduce “patient blood management” which is currently spreading in advanced medical countries.

Early Experiences With PEGylated Carboxyhemoglobin Bovine in Anemic Jehovah’s Witnesses: A Case Series and Review of the Literature

2018 ◽  
Vol 33 (3) ◽  
pp. 372-377 ◽  
Author(s):  
Sean McConachie ◽  
Krista Wahby ◽  
Zinah Almadrahi ◽  
Sheila Wilhelm
Keyword(s):  
Case Series ◽  
Stable Condition ◽  
Complex Nature ◽  
Blood Transfusions ◽  
Oxygen Carriers ◽  
Jehovah’S Witnesses ◽  
Clinical Safety ◽  
Jehovah's Witnesses ◽  
Pharmacologic Management ◽  
Oxygen Carrying Capacity

Jehovah’s Witnesses (JW) represent a complex patient population due to their refusal to accept blood transfusions on religious grounds. Pharmacologic management of anemic JW patients is limited to stimulation of hematopoiesis by iron and erythropoietin supplementation and reduction of blood loss by prothrombin complex concentrates (PCCs). Hemoglobin-based oxygen carriers (HBOCs) represent the only pharmacologic modality for JW patients capable of acutely increasing a patient’s oxygen carrying capacity in the setting of organ failure, yet clinical safety and efficacy data are lacking in this population. We report 3 cases in which the HBOC, PEGylated carboxyhemoglobin bovine (Sanguinate®), was requested under emergent circumstances for severely anemic (hemoglobin <5 g/dL) JW patients who refused blood transfusions. Two patients received PEGylated carboxyhemoglobin infusions for severe anemia, while the third patient died prior to receiving the medication. One patient who received Sanguinate died after 5 units of medication. The other patient’s hemoglobin recovered and she was discharged in stable condition. This series demonstrates the complex nature of the critically anemic JW population and highlights the clinical considerations of using HBOCs in clinical practice and the critical need for further research before they can be broadly recommended.

scholarly journals How to approach orthognathic surgery in patients who refuse blood transfusion

2020 ◽  
Vol 47 (5) ◽  
pp. 404-410
Author(s):  
Sang Hwan Lee ◽  
Dong Gyu Kim ◽  
Ho Seong Shin
Keyword(s):  
Blood Transfusion ◽  
Orthognathic Surgery ◽  
Blood Transfusions ◽  
Recombinant Erythropoietin ◽  
Jehovah’S Witnesses ◽  
Jehovah's Witnesses ◽  
Hypotensive Anesthesia ◽  
Normovolemic Hemodilution ◽  
Surgery Center ◽  
Bloodless Surgery

Background Some patients who need surgery refuse a blood transfusion because of their religious beliefs or concerns about blood-borne infections. In recent years, bloodless surgery has been performed successfully in many procedures, and is therefore of increasing interest in orthognathic surgery.Methods Ten Jehovah’s Witnesses who visited our bloodless surgery center for orthognathic surgery participated in this study. To maintain hemoglobin (Hb) levels above 10 g/dL before surgery, recombinant erythropoietin (rEPO) was subcutaneously administered and iron supplements were intravenously administered. During surgery, acute normovolemic hemodilution (ANH) and induced hypotensive anesthesia were used. To elevate the Hb levels to >10 g/dL after surgery, a similar method to the preoperative approach was used.Results The 10 patients comprised three men and seven women. Their average Hb level at the first visit was 11.1 g/dL. With treatment according to our protocol, the average preoperative Hb level rose to 12.01 g/dL, and the average Hb level on postoperative day 1 was 10.01 g/dL. No patients needed a blood transfusion, and all patients were discharged without any complications.Conclusions This study presents a way to manage patients who refuse blood transfusions while undergoing orthognathic surgery. rEPO and iron supplementation were used to maintain Hb levels above 10 g/dL. During surgery, blood loss was minimized by a meticulous procedure and induced hypotensive anesthesia, and intravascular volume was maintained by ANH. Our practical approach to orthognathic surgery for Jehovah’s Witnesses can be applied to the management of all patients who refuse blood transfusions.

A Child has a Right to Blood Transfusion Services in Nigeria, despite the Religious Status of the Parents or Guardians

2021 ◽  
Vol 4 (4) ◽  
Author(s):  
Uchejeso M Obeta
Keyword(s):  
Intensive Care ◽  
Blood Transfusion ◽  
Blood Cell ◽  
Neonatal Intensive Care ◽  
Healthcare Providers ◽  
Red Blood Cell Transfusion ◽  
Blood Transfusions ◽  
Blood Products ◽  
Serious Illness ◽  
Life Saving

Red blood cell transfusion is an important and frequent component of neonatal intensive care. Whereas blood and blood products transfusion can help a patient (child) recover from a serious illness, surgery or injury, because of the religious beliefs of some parents or guardians, a child may be denied the benefit of this life-saving service. Several legal statutes and precedents exist to protect the rights of children in need of life-saving blood transfusions where denied this opportunity to be transfused and survive. The awareness of these extant laws and statutes are critical for the empowerment of healthcare providers in the performance of their role within the provisions of the law and medical ethics.

A Jehovah's Witness with Complex Abdominal Trauma and Coagulopathy: Use of Factor VII and a Review of the Literature

2005 ◽  
Vol 71 (5) ◽  
pp. 414-415 ◽  
Author(s):  
James Haan ◽  
Thomas Scalea
Keyword(s):  
Blood Loss ◽  
Factor Viia ◽  
Factor Vii ◽  
Jehovah’S Witnesses ◽  
Acute Bleeding ◽  
Jehovah's Witnesses ◽  
Life Saving ◽  
Surgical Bleeding ◽  
Dilutional Coagulopathy ◽  
Real Challenge

Management of acute bleeding in patients who are Jehovah's Witnesses remains a challenge. Clearly, the most important concept is meticulous and early hemostasis to minimize ongoing blood loss. This is generally followed by supportive measures. Dilutional coagulopathy can present a real challenge, as therapeutic options are quite limited in this group of patients. We present a patient who arrived in hemorrhagic shock, and despite early surgical therapy, his significant blood loss caused dilutional coagulopathy that we treated with activated factor VIIa. While use of factor VIIa after injury is gaining popularity, data on its use in patients who are Jehovah's Witnesses is quite limited. In this case, we believe the product was life-saving. Most importantly, there were no religious objections to its use. In appropriate patients, when surgical bleeding is controlled and there is still evidence of dilutional coagulopathy, factor VIIa may have a real role in patients, particularly those who are Jehovah's Witnesses.

Sign in / Sign up

Export Citation Format

Share Document