I've been wanting to make this post for a while but life's been crazy. But finally! Sorry if it's poorly written

We've been going through some clinical cases with a variation of ethical dilemmas, being one of them JW and it got me interested.

As known, they do not accept blood transfusion - they do not use white and red blood cells, platelets or plasma, however, each JW can choose wether or not they will accept the fractions of those blood component, like hemoglobins, antibodies, fibrinogen etc.

In emergency care, there are alternatives to avoid blood transfusion: take out the patient's blood before surgery so they can use it in case they need it and replace the blood that was taken out with solutions with water and other necessary electrolytes; exploratory surgery for internal bleeding and damage control surgery; extracorporeal circulation (which not every hospital may be able to do) etc.

On the other hand, it may be a bit more difficult when it comes to children. There are certain conditions like Hemophilia (blood doesnt clot naturally, which cause excessive bleeding even with small injuries and can be very debilitating) that need blood transfusion. Adults who live with such a disease and chose to become a JW and refuse blood transfusion live with constant total bed rest, immobilization, ice baths and hospitalization if the pain doesnt stop with pain killers, and in the long term can cause joint problems too.

Also, a more known condition is fetal erythroblastosis, when due to a 'mismatch' of mom's and baby's blood, the red cells of the fetus are destroyed and it's prevented with the injection of RH factors, which is still a blood fraction and not every JW accepts to receive them. When baby is born with such a condition, there's big controversy on what's the best treatment - induce labor earlier, phototherapy for the jaundice and exchange transfusion are some of them, which is why the best alternative is to prevent it before it even happens.

Some questions already have a answer legally speaking, but do not let it affect you and answer it as you feel it should be, not how it is:

When it involves children, do you think that the parent's religion should interfere with their treatment when it implies in a decrease in the child's quality of life or a decrease in the survival rate? Should courts be able to tell parents what they should or should not allow transfusion? Should healthcare workers be able to go agaisnt the parent's beliefs if blood transfusion is the last and final option to save a child's life?

Source:

Chand NK, Subramanya HB, Rao GV. Management of patients who refuse blood transfusion. Indian Journal of Anaesthesia. 2014;58(5):658-664. doi:10.4103/0019-5049.144680.

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