JEHOVAH'S WITNESSES THE SURGICAL/ETHICAL CHALLENGE

Physicians face a special challenge in treating Jehovah's Witnesses.  Members of this faith have deep religious convictions against accepting homologous or autologous whole blood, packed RBC's [red blood cells], WBC's  [white blood cells], or platelets. Many will allow the use of (non-blood prime) heart-lung dialysis, or similar equipment if the extracorporeal circulation is uninterrupted.  Medical personnel need not be concerned about liability, for Witnesses will take adequate legal steps to relieve liability as to their informed refusal of blood.  They accept non-blood replacement fluids.  Using these and other meticulous techniques, physicians are performing major surgery of all types on adult and minor Witness patients.  A standard practice for such patients  has thus developed that accords with the tenet of treating the "whole person." (JAMA 1981; 246:2471;2472)

PHYSICIANS face a  growing challenge that is a major issue.  There are over half a million Jehovah's Witnesses in the United States who do not accept blood transfusions.  The number of Witnesses and those associated with them is increasing. Although formerly, many physicians and hospital officials viewed refusal of a transfusion as a legal problem and sought court authorization to proceed as they believed was medically advisable, recent medical literature reveals that a notable change in attitude in occurring.  This may be a result of more surgical experience with patients having very low hemoglobin levels and may also reflect increased awareness of the legal principle of informed consent. 

Now, large numbers of elective surgical and trauma cases involving both adult and minor Witnesses met with surgical and administrative personnel at some of the largest medical centers in the country.  These meetings improved understanding and helped resolve questions about blood salvage,  transplants, and the avoidance of medical/legal confrontations.  

Next time: JEHOVAH'S WITNESSES THE SURGICAL/ETHICAL CHALLENGE - WITNESS POSITION ON  THERAPY

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