No Bad Blood—Surviving Severe Anemia Without Transfusion

Abstract

A 51-year-old female Jehovah's Witness with a history of uterine fibroids traveled from her home country of Colombia to the US for a 2-month visit to assist her daughter in caring for her newborn baby. Soon after arriving in the US, she experienced heavy vaginal bleeding that continued for 2 weeks. She developed dyspnea with exertion, chest pain, and fatigue. She went to an urgent care center for evaluation and was found to have a hemoglobin level of 4.6 g/dL (range, 11.0-14.5 g/dL; to convert to g/L, multiply by 10.0); she was then referred to a local hospital for further care. The patient recalled that on a recent laboratory test, her hemoglobin level was 14 g/dL.The patient, who speaks no English, described through an interpreter her reaction upon learning that she required hospitalization in the US: I was very afraid. I had already been in a situation once in Colombia where the doctor put so much pressure on me. She told me transfusion was my only option. My daughter said, "We know of other treatments that can be used." The doctor said, "There are no other treatments." I imagined that I would be in that situation again.

Jehovah’s Witness survives severe favism complications: Advance provisions of treatment and new challenges for the physicians

“…From a medical point of view, the treatment of a patient without blood transfusion has always been an ethical problem that afflicts the physician, who may feel that complying with the patient's wishes will force them to provide suboptimal care. 9,10 On the other hand, clinicians can create opportunities to provide quality care for all patients, if they accept the challenges of learning how to treat patients safely and successfully without the traditional treatment of blood transfusion. [11][12] From a legal point of view, the value given to anticipated medical provisions in many Countries represents a fundamental milestone and a defense for healthcare providers who, by complying with the patients' wishes, are no longer liable for failure to render assistance.…”

The Use of Hyperbaric Oxygen Therapy in the Management of Severe Radiation-Induced Hemorrhagic Gastritis in a Pediatric Patient

“…Additionally, while HBOT is available in approximately 1300 medical facilities in the United States, not all HBOT locations are capable of treating pediatric patients. 10 Fortunately, in the United States, major insurance carriers consider HBOT to be a medically necessary and reimbursable treatment for patients with delayed radiation injuries.…”

“…Prospective randomized trials of HBOT in patients with RIHG are an ideal way to assess the effectiveness of this treatment in this patient population, although this is unlikely to be feasible given the rarity of this clinical condition. Additionally, while HBOT is available in approximately 1300 medical facilities in the United States, not all HBOT locations are capable of treating pediatric patients 10. Fortunately, in the United States, major insurance carriers consider HBOT to be a medically necessary and reimbursable treatment for patients with delayed radiation injuries.…”

Bloodless Management of the Anemic Patient in the Emergency Department

“…The Hospital Liaison Committee are community-based Jehovah's Witness ministers who volunteer in hospitals worldwide. 9 A primary role of the Hospital Liaison Committee is to assist hospitalized Jehovah's Witness patients by facilitating nonconfrontational and evidence-based communication between the patients and their physicians; Hospital Liaison Committee members can also suggest clinical strategies for the management of patients without blood transfusion and provide spiritual support to hospitalized Jehovah's Witness patients. The Hospital Liaison Committee network is widespread; even in hospitals that lack dedicated bloodless medicine programs, it is likely that Hospital Liaison Committee members are available.…”

“…8 Members of this religion interpret the Bible's command to abstain from blood (Acts 15:20) as avoiding transfusion of blood products, including packed red blood cells, platelets, and fresh frozen plasma. 9 Jehovah's Witnesses believe that acceptance of blood transfusions will damage their relationship with God; because of this, their avoidance of blood product transfusions has been described as a religious obligation, not an option. 10 Jehovah's Witnesses may also decline the administration of plasma-derived proteins, such as albumin, coagulation factors, and fibrin sealants such as Gelfoam, as these are derived from blood.…”