scholarly journals Revised Medical Care Guidelines of Jichi Medical University Hospital for Jehovah's Witness Patients Who Refuse Primary Blood Components: Lifesaving Blood Transfusions Surpass Religious Convictions

2008 ◽  
Vol 28 (3) ◽  
pp. 498-512
Author(s):  
Norimasa SEO
2018 ◽  
pp. bcr-2018-226486
Author(s):  
Sayaka Tachi ◽  
Noriko Yoneda ◽  
Satoshi Yoneda ◽  
Shigeru Saito

A 35-year-old Jehovah’s Witness patient with total placenta previa was referred to our hospital at 30 weeks of gestation. She refused autologous and allogeneic blood transfusions, but agreed to receive acute normovolaemic haemodilution, intraoperative blood salvage and biological products. At 35 weeks, she underwent emergent caesarean delivery because of labour pains. Multidisciplinary therapy, including the insertion of balloon catheters into the bilateral common iliac arteries, acute normovolaemic haemodilution and intraoperative blood salvage, avoided hysterectomy; however, blood loss included amniotic fluid which was estimated to be 1910 mL. These treatments may be effective for total placenta previa in blood-refusal patients.


Author(s):  
José Ramón Díez Rodríguez

El paciente testigo de Jehová y su rechazo a determinados tratamientos médicos, en concreto a las transfusiones de sangre, constituye uno de los problemas fundamentales con el que históricamente se ha tenido que enfrentar el derecho sanitario. La actual Ley 41/2002 de autonomía del paciente parece dejar claro el supuesto del paciente mayor de edad y la posibilidad de rechazar tratamientos médicos, pero mayores problemas plantean los supuestos del menor de edad, y especialmente la figura del menor maduro, y el supuesto de la mujer embarazada testigo de Jehová. Será necesario atender a la proporcionalidad de derechos en conflicto para determinar los criterios que en cada caso nos permitan inclinar la balanza a favor de una u otra posición.The Jehovah’s Witness patient and their rejection of certain medical treatments, namely blood transfusions, is one of the fundamental problems with which historically had to face the health law. The current Law 41/2002 of patient autonomy seems to clarify the adult patient’s adult and their possibility of refusing medical treatment, but major problems posed minor assumptions, especially the mature minor figure, and the course pregnant woman Jehovah’s Witness. It will be necessary to address the proportionality of conflicting rights, and determining criteria in each case allow us to tip the balance in favor of one position or another.


2015 ◽  
Vol 61 (4) ◽  
pp. 355-361
Author(s):  
Sydney Correia Leão ◽  
Mariana Araújo Bezerra Gomes ◽  
Mila Cintra de Azevedo Aragão ◽  
Iza Maria Fraga Lobo

SummaryObjective:to produce improvements in transfusion practices through the implementation of an educational program for health professionals in a university hospital.Methods:this is an interventional and prospective study, with pre- and postanalysis of an educational intervention. The research was developed at the University Hospital of the Universidade Federal de Sergipe, involving participation of health professionals in the stage of training, during the month of February 2011, in addition to the monitoring of blood transfusions performed in the preand post-intervention periods. Transfusion practices were investigated upon request for transfusion or devolution of unused blood components. Knowledge of health professionals was assessed based on the responses to a questionnaire about transfusion practices.Results:during the educative campaign, 63 professionals were trained, including 33 nurses or nursing technicians and 30 physicians. Among the doctors, there was a statistically significant gain of 20.1% in theoretical knowledge (p=0.037). Gain in the nursing group was even higher: 30.4% (p=0.016). The comparative analysis of transfusion request forms showed a non-significant decrease from 26.7 to 19.5% (p=0.31) in all forms with incomplete information. We also observed a statistically significant improvement in relation to the filling of four items of transfusion request.Conclusion:there was a significant improvement of the entire process related to blood transfusions after interventional project conducted in February 2011.


2020 ◽  
Vol 11 (1) ◽  
pp. 10-22
Author(s):  
Henrique de Paula Bedaque ◽  
Rodolfo Daniel de Almeida Soares ◽  
Carolina Lemos de Brito ◽  
Gabriela Lia de Aquino Revoredo

Objective: The present study aims to analyze implementation consequences on active search for incidents related to blood transfusion at Onofre Lopes University Hospital (HUOL) and establish a blood transfusion profile in this facility. Methods: Blood transfusion and TIs registered on Hemotherapy Core at HUOL were counted through SPSS 20, comparing IT/1000 blood transfusion averages between 2012 and 2014. T Test of Student was used to compare data and chi-square (X²) and relative risk calculation to associate the use of blood components and risk to develop TI. Results: An increase of TI numbers at HUOL was shown by active searching and its equivalence to reference French and Brazilian services, liked to ANVISA sentinel network. Thus, there was a change in the average rate from 1.86 TI/1000 blood transfusions in 2012 to 5.36 TI/1000 blood transfusions in 2013 and 5.86 TI/1000 in 2014 (p = 0.001). It was also observed that the red blood cell concentrate is the fraction with the highest risk of occurrence of TIs (p = 0.003) and the greatest chance of causing any type of TI in relation to the other blood products, RR = 1.848 (95% CI; 1.042 - 3.266). It was also seen that the infusion of platelet concentrate is related to the allergic reaction (p <0.01), and greater risk compared to other blood components, RR = 2.746 (95% CI; 1.477 - 5.107). Conclusion: This study demonstrates active Hemovigilance importance on Tis subnotifications decrease.


1995 ◽  
Vol 2 (6) ◽  
pp. 552-556 ◽  
Author(s):  
Kaaron Benson

Due to refusal of blood component transfusions, Jehovah's Witness patients with cancer present a challenge to oncologists who must find appropriate and acceptable treatments. In order to assess the morbidity and mortality that these patients suffer, a retrospective review was conducted of all 58 Jehovah's Witness patients treated at our center from October 1986 through February 1994. This study showed that (1) younger Jehovah's Witness patients or their parents were more likely to accept blood transfusion than older Jehovah's Witness patients, (2) considerable risk of acute morbidity and mortality occurred in patients who refused blood when blood transfusions were indicated, and (3) long-term prognosis may be worsened for some Jehovah's Witness patients due to limited treatment provided in those with anemia or with anticipated anemia.


2018 ◽  
Vol 34 (2) ◽  
pp. 165-170
Author(s):  
Patrick Kishi ◽  
Eric vanSonnenberg ◽  
Misa Stroker

Blood transfusions in anemic patients frequently are used for critically ill patients as a life-saving therapeutic maneuver. Jehovah’s Witness (JW) patients typically refuse blood transfusions due to religious beliefs. Numerous clinical reports, in a wide spectrum of medical specialties, have shown no greater morbidity or mortality in JW patients or others who refused transfusions compared to those patients who accept transfusions. We report our experience with two JW patients who presented with severe anemia and life-threatening pancreatitis. Despite undergoing percutaneous drainages by interventional radiology (IR) for complex pancreatic collections (and other IR drainages), neither patient suffered any adverse effect from the IR procedures, even though they refused blood transfusions. Our experience suggests that IR procedures also may be successful with this more limited blood product protocol.


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