scholarly journals Major abdominal surgery in Jehovah’s Witnesses

2016 ◽  
Vol 98 (8) ◽  
pp. 532-537 ◽  
Author(s):  
KE Rollins ◽  
U Contractor ◽  
R Inumerable ◽  
DN Lobo
Keyword(s):  
Abdominal Surgery ◽  
Moral Dilemmas ◽  
Major Abdominal Surgery ◽  
Major Surgery ◽  
Blood Products ◽  
Jehovah’S Witnesses ◽  
Jehovah's Witnesses ◽  
Jehovah’S Witness ◽  
Liaison Committee ◽  
Jehovah's Witness

Introduction Patients who are Jehovah’s Witnesses pose difficult ethical and moral dilemmas for surgeons because of their refusal to receive blood and blood products. This article outlines the personal experiences of six Jehovah’s Witnesses who underwent major abdominal surgery at a single institution and also summarises the literature on the perioperative care of these patients. Methods The patients recorded their thoughts and the dilemmas they faced during their surgical journey. We also reviewed the recent literature on the ethical principles involved in treating such patients and strategies recommended to make surgery safer. Results All patients were supported in their decision making by the clinical team and the Hospital Liaison Committee for Jehovah’s Witnesses. The patients recognised the ethical and moral difficulties experienced by clinicians in this setting. However, they described taking strength from their belief in Jehovah. A multitude of techniques are available to minimise the risk associated with major surgery in Jehovah’s Witness patients, many of which have been adopted to minimise unnecessary use of blood products in general. Nevertheless, the risks of catastrophic haemorrhage and consequent mortality remain an unresolved issue for the treating team. Conclusions Respect for a patient’s autonomy in this setting is the overriding ethical principle, with detailed discussion forming an important part of the preparation of a Jehovah’s Witness for major abdominal surgery. Clinicians must be diligent in the documentation of the patient’s wishes to ensure all members of the team can abide by these.

Managing Blood Loss in a Jehovah’s Witness Patient

2018 ◽  
Author(s):  
Michelle Dalton
Keyword(s):  
Blood Loss ◽  
Religious Belief ◽  
Perioperative Care ◽  
Red Cells ◽  
Blood Products ◽  
Jehovah’S Witnesses ◽  
Jehovah's Witnesses ◽  
Jehovah’S Witness ◽  
Jehovah's Witness ◽  
Witness Patient

The Jehovah’s Witnesses are a unique group of patients that can pose a challenge to the anesthesiologist given their desire to avoid transfusion of blood products. This religious belief can include refusal of red cells, white cells, plasma, as well as platelets. The perioperative care of such patients can include the use of bloodless techniques in order to respect their beliefs. Given the desire to avoid blood products, it is imperative to utilize strategies that will prevent unnecessary transfusion. It is also important to understand the ethical and or legal ramifications of overriding parental/adolescent requests for no transfusion as well as acceptance of adolescent transfusion refusal.

Use of Erythropoietin in the Severely Anemic Jehovah's Witness Patient: Case Report and Review of the Literature

1997 ◽  
Vol 13 (6) ◽  
pp. 252-257
Author(s):  
P David Rogers ◽  
David F Volles
Keyword(s):  
Religious Beliefs ◽  
Motor Vehicle ◽  
Alternative Methods ◽  
Severe Anemia ◽  
Blood Products ◽  
Jehovah’S Witnesses ◽  
Jehovah's Witnesses ◽  
Jehovah’S Witness ◽  
Jehovah's Witness ◽  
Witness Patient

Objective: To describe and discuss the use of erythropoietin as a therapeutic option for treatment of severe anemia in a patient whose religious beliefs preclude the use of blood products. Case Summary: A 23-year-old male Jehovah's Witness patient presented to the emergency department with multiple fractures and significant blood loss secondary to trauma experienced in a motor vehicle accident. The patient refused transfusion because of his religious beliefs. He was given oxygen and lactated Ringer's solution, and phlebotomy was kept to a minimum. Erythropoietin was recommended to increase production of red blood cells. Review of the product information revealed that all available erythropoietin products contain human albumin as a stabilizer. After discussion with the clinical pharmacist, the patient and his family agreed to the use of erythropoietin. The patient's hematocrit and hemoglobin improved sufficiently for him to be taken to surgery on hospital day 12, and on hospital day 23 he was discharged. Discussion: Because Jehovah's Witnesses refuse to receive blood products, alternative methods for treatment of severe anemia must be used. Although some options are clearly unacceptable, certain volume expanders can be used in conjunction with oxygen and intravenous or oral iron that do not violate the patient's religious convictions. Erythropoietin is acceptable to most Jehovah's Witnesses; however, it contains human album (2.5 mg/mL), which may be of concern to some of these patients. Conclusions: Effective communication with the patient and the patient's family regarding all treatment options is required for treatment of severe anemia in the Jehovah's Witness patient. Erythropoietin, in conjunction with iron, adequate oxygenation, and good nutritional support, sometimes is an acceptable alternative in Jehovah's Witnesses.

Redo cardiac surgery in a Jehovah’s Witness, the importance of a multidisciplinary approach to blood conservation

Perfusion ◽  
2000 ◽  
Vol 15 (3) ◽  
pp. 251-255 ◽  
Author(s):  
S Jovanovic ◽  
S D Hansbro ◽  
C M Munsch ◽  
M H Cross
Keyword(s):  
Cardiac Surgery ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Multidisciplinary Approach ◽  
Artery Bypass ◽  
Blood Conservation ◽  
Jehovah’S Witnesses ◽  
Jehovah's Witnesses ◽  
Jehovah’S Witness ◽  
Jehovah's Witness

Although Jehovah’s Witnesses present a particular problem when undergoing surgery because of their refusal to accept stored blood, it is now quite common to undertake uncomplicated cardiac surgery in these patients. Complex or redo cardiac surgery however, is often associated with major blood loss, and is conventionally contraindicated in Jehovah’s Witnesses. We describe the perioperative management of a Jehovah’s Witness who underwent a resternotomy for mitral valve replacement and coronary artery bypass grafting having previously had an aortic valve replacement and mitral valve repair. The importance of a multidisciplinary approach to blood conservation is discussed.

scholarly journals Major liver surgery in a Jehovah’s Witness patient: challenges for safe surgery

2019 ◽  
pp. 24-26
Author(s):  
WY Lim ◽  
L Loh ◽  
SR Desai ◽  
SL Tien ◽  
BK Goh ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Patient Autonomy ◽  
Ethical Issues ◽  
Major Surgery ◽  
Blood Products ◽  
Jehovah’S Witness ◽  
Jehovah's Witness ◽  
Safe Surgery ◽  
Patient Consent ◽  
Witness Patient

Jehovah’s Witnesses presenting for major surgery run the risk of major bleeding, which is complicated by the refusal to accept blood transfusion. We present a case of a 63-year-old woman, a Jehovah’s Witness, who was diagnosed with hepatocellular carcinoma and advised for curative laparoscopic liver segmentectomy. Due to the risk of significant intraoperative haemorrhage, her perioperative care was coordinated in a multidisciplinary manner. Informed consent requires the physician to advise on the material risks of undertaking major surgery without blood transfusion and the possible alternatives. Conflicting ethical issues of patient autonomy and beneficence related to refusal of blood products also arise. Perioperative strategies to minimise blood loss, maximise haematopoiesis and tolerance of anaemia to facilitate safe surgery in such patients are also presented. Written patient consent obtained.

scholarly journals Management of thrombotic thrombocytopenic purpura without plasma exchange: the Jehovah’s Witness experience

2017 ◽  
Vol 1 (24) ◽  
pp. 2161-2165 ◽  
Author(s):  
James N. George ◽  
Steven A. Sandler ◽  
Joanna Stankiewicz
Keyword(s):  
Plasma Exchange ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Jehovah’S Witnesses ◽  
Thrombocytopenic Purpura ◽  
Jehovah's Witnesses ◽  
Jehovah’S Witness ◽  
Jehovah's Witness ◽  
Key Points ◽  
The Future

Key Points TTP in Jehovah’s Witness patients has been managed successfully without PEX. This experience, plus new TTP treatments, may make it possible for patients who are not Jehovah’s Witnesses to avoid PEX in the future.

Cardiopulmonary bypass on a Jehovah's Witness child

Perfusion ◽  
1986 ◽  
Vol 1 (4) ◽  
pp. 293-295
Author(s):  
PA Grey ◽  
JR Crockett
Keyword(s):  
Cardiopulmonary Bypass ◽  
Ventricular Septal Defect ◽  
Septal Defect ◽  
Full Recovery ◽  
Jehovah’S Witnesses ◽  
Jehovah's Witnesses ◽  
Jehovah’S Witness ◽  
Jehovah's Witness ◽  
Membrane Lung

A four-year-old boy was admitted for closure of a congenital ventricular septal defect. As the boy's parents were Jehovah's Witnesses, transfusion of blood was proscribed. Cardiopulmonary bypass was achieved using a Variable Prime Cobe Membrane Lung (VPCML). Extreme haemodilution was experienced, during bypass the haematocrit fell to a level of 8%. The haematocrit rose over the next two days to 22% and the patient made a full recovery.

scholarly journals Outcomes of cardiac surgery in Jehovah’s Witness patients: A review

Perfusion ◽  
2020 ◽  
pp. 026765912098037
Author(s):  
Aimee-Louise Chambault ◽  
Louise J Brown ◽  
Sophie Mellor ◽  
Amer Harky
Keyword(s):  
Cardiac Surgery ◽  
Case Reports ◽  
Case Series ◽  
Long Term Outcomes ◽  
Jehovah’S Witnesses ◽  
Jehovah's Witnesses ◽  
Jehovah’S Witness ◽  
Jehovah's Witness ◽  
Literature Evidence

Objective: To review current literature evidence on outcomes of cardiac surgery in Jehovah’s Witness patients. Methods: A comprehensive electronic literature search was done from 2010 to 20th August 2020 identifying articles that discussed optimisation/outcomes of cardiac surgery in Jehovah’s Witness either as a solo cohort or as comparative to non-Jehovah’s Witnesses. No limit was placed on place of publication and the evidence has been summarised in a narrative manner within the manuscript. Results: The outcomes of cardiac surgery in Jehovah’s Witness patients has been described, and also compared, to non-Witness patients within a number of case reports, case series and comparative cohort studies. Many of these studies note no significant differences between outcomes of the two groups for a number of variables, including mortality. Pre-, intra and post-operative optimisation of the patients by a multidisciplinary team is important to achieve good outcomes. Conclusion: The use of a bloodless protocol for Jehovah’s Witnesses does not appear to significantly impact upon clinical outcomes when compared to non-Witness patients, and it has even been suggested that a bloodless approach could provide advantages to all patients undergoing cardiac surgery. Larger cohorts and research across multiple centres into the long term outcomes of these patients is required.

scholarly journals A Jehovah’s Witness with Acute Myeloid Leukemia Successfully Treated with an Epigenetic Drug, Azacitidine: A Clue for Development of Anti-AML Therapy Requiring Minimum Blood Transfusions

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Yumi Yamamoto ◽  
Akihito Kawashima ◽  
Eri Kashiwagi ◽  
Kiyoyuki Ogata
Keyword(s):  
Acute Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Supportive Therapy ◽  
Blood Transfusions ◽  
Jehovah’S Witnesses ◽  
Jehovah's Witnesses ◽  
Jehovah’S Witness ◽  
Jehovah's Witness ◽  
Epigenetic Drug ◽  
Acute Myeloid

Therapy for acute leukemia in Jehovah’s Witnesses patients is very challenging because of their refusal to accept blood transfusions, a fundamental supportive therapy for this disease. These patients are often denied treatment for fear of treatment-related death. We present the first Jehovah’s Witness patient with acute myeloid leukemia (AML) treated successfully with azacitidine. After achieving complete remission (CR) with one course of azacitidine therapy, the patient received conventional postremission chemotherapy and remained in CR. In the case of patients who accept blood transfusions, there are reports indicating the treatment of AML patients with azacitidine. In these reports, azacitidine therapy was less toxic, including hematoxicity, compared with conventional chemotherapy. The CR rate in azacitidine-treated patients was inadequate; however, some characteristics could be useful in predicting azacitidine responders. The present case is useful for treating Jehovah’s Witnesses patients with AML and provides a clue for anti-AML therapy requiring minimum blood transfusions.

Studi Eksegetis Yohanes 1:1-18 Sebagai Apologetik Terhadap Kristologi Saksi Yehuwa

2016 ◽  
Vol 1 (2) ◽  
pp. 1-41
Author(s):  
Pangeran Manurung
Keyword(s):  
Striking Difference ◽  
Human Being ◽  
John 1 ◽  
Jehovah’S Witnesses ◽  
Jehovah's Witnesses ◽  
Jehovah's Witness ◽  
Search Results ◽  
The Bible ◽  
God The Father ◽  
The Difference

Eksegesa John 1 : 1-18 shows that the Jehovah's Witness teachings deviate from the truth of the Bible and dangerous for Christians . The danger Christology of Jehovah's Witnesses should be bringing us to the prudence and discretion to reject it . It can be said that Jehovah's Witnesses do not include Christianity in accordance with the search results against their teachings . first ; they do not recognize the Bible that has been issued by the Indonesian National Bible Institute and consider if the Bible has too much harm to use their own New Translation of the Holy Scriptures that have been proven not a translation , but just a collection of interpretations and teachings of their leader alone . second ; Jehovah's Witnesses do not acknowledge Jesus as Lord and Savior only . They simply believe that salvation is obtained through belief in Jehovah and his kingdom and perform service message and follow the trial associations .                Before errors interfere Christology Christology of Jehovah's Witnesses Bible , please note that the topic of Christology is the difference between Christianity and other religions . This discussion has also become one of the topics that face many attacks from the outside or from within Christianity , either in the form of religion , philosophy , and ideology . The debate on this topic appeared since the beginning of Christianity , and give rise to a long and complex debate for nearly three centuries ( 300 years ) !! . Such debates will continue to exist throughout the period and just a rehash issues that had once appeared . And Christians should study the various debates and views of the ever emerging that are not easily fooled by the views back to this era .Eksegesa John 1 : 1-18 has been done and produce a biblical Christology and biblical correct . The truth is not in doubt because of the analysis conducted in accordance with the procedures and rules that apply in general . Now if Christology Christology of John compared with Jehovah's Witnesses, it will show a striking difference . Once observed , Christology Witnesses builds upon the interpretation of individuals who previously have had a negative Christological doctrine .                Conclusion those who think that Jesus is the firstborn of Creation ; Jesus was a human being ; Jesus is God in creating a peer ; Jesus lower than God , Jesus is the Angel Gabriel , and other Christological doctrine which basically degrading nature of Christ is a form of insult to the majesty of Christ . The Bible clearly and emphatically teaches that Christ is God incarnate , private alpha and omega , the creator of all that exists , and the equivalent of God the Father . Summing Christ as superior human or clear eldest creation is false teachings . The followers of Jehovah's Witnesses must repent. Amen

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