scholarly journals Jehovah’s Witnesses and Their Compliance with Regulations on Smoking and Blood Treatment

2021 ◽  
Vol 19 (1) ◽  
pp. 387
Author(s):  
Barbara Pavlikova ◽  
Jitse P. van Dijk
Keyword(s):  
Blood Transfusion ◽  
Tobacco Control ◽  
Real Life ◽  
Legal Regulations ◽  
Group Influence ◽  
Jehovah’S Witnesses ◽  
Jehovah's Witnesses ◽  
Standard Methods ◽  
Life Saving ◽  
Health Laws

Jehovah’s Witnesses (JWs) are known as a religious group compliant with the national laws in the case of smoking, but not-compliant when it comes to blood treatment. Their beliefs prevent them from taking part in a blood transfusion, which is widely included in standard methods of a life-saving treatment. The aim of this study was to compare the behavior of JWs regarding their approach to blood treatment and to smoking in relation to legal regulations in the field of health. We measured JWs’ compliance with health laws regarding blood treatment and smoking (the Framework Convention on Tobacco Control—FCTC). We used the concept of a semi-autonomous social field by Moore and the theory of planned behavior developed by Ajzen. Our findings show that in the case of JWs, the group rules often prevail over state rules contained in generally-binding legislation. In the case of smoking, this means that they seem compliant to the FCTC and to their group rules. In the case of blood treatment, it seems that they are breaking the national rules, because of their group rules. Breaking the latter can result in exclusion from the JWs community. JWs are compliant with national laws as long as these are congruent with their own group rules. If this is not the case, the group influence is very strong and the fear of exclusion from the JW group is often greater than the potential negative health consequences in real life.

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.

Bloodless surgery and gynecological patients among Jehovah’s Witnesses

2021 ◽  
Vol 86 (2) ◽  
pp. 110-113
Author(s):  
Milan Kudela ◽  
◽  
Radovan Pilka ◽  
Petr Dzvinčuk ◽  
Radim Marek ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Blood Loss ◽  
Gynecologic Surgery ◽  
Jehovah’S Witnesses ◽  
Ethical Problems ◽  
Jehovah's Witnesses ◽  
Estimated Blood Loss ◽  
Risk Patients ◽  
Bloodless Surgery ◽  
Excessive Blood Loss

Overview Objective: The aim of this research is to present our experiences with the surgical treatment of gynecological patients among Jehovah’s Witnesses. Moreover, the medical, moral, and ethical problems in this regard have been highlighted. Methods: 75 Jehovah’s Witnesses patients were operated on for various benign and malignant gynecological diseases between 2007 and 2018. All of these patients were operated on according to the rules of blood-sparing surgery. Results: The operations were assessed according to the dia­gnosis, mode of surgery, estimated blood loss, and disease outcome. Excessive blood loss did not occur during any of these operations, and the estimated blood loss for the same procedure was 10 to 550 mL. Conclusion: Jehovah’s Witnesses gynecological patients is a group of high-risk patients because they refuse to undergo blood transfusion. Nevertheless, the principles of blood-sparing surgery should be applied to not only Jehovah’s Witnesses patients but also to all patients in general. Even if a blood transfusion is the last resort to solve issues pertaining to excessive blood loss during complicated operations, the said procedure always carries certain risks. Therefore, blood transfusion should be performed only on rare occasions. Jehovah’s Witnesses patients categorically refuse blood transfusion even if it is the only way to save one’s life. Even though the legislation of the Czech Republic deals with this problem, there are other moral and ethical aspects that need to be addressed in this regard. Keywords: bloodless surgery – Gynecologic surgery – Jehovah’s Witnesses – legislation – moral and ethical problems

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.

scholarly journals Blood transfusion refusal by pregnant and puerperal Jehovah's witnesses

2015 ◽  
Vol 19 (4) ◽  
Author(s):  
Ana Paula Araujo Bezerra ◽  
Mônica Bimbatti Cesar ◽  
Sônia Regina Godinho de Lara
Keyword(s):  
Blood Transfusion ◽  
Jehovah’S Witnesses ◽  
Jehovah's Witnesses
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