noblood - View Single Post - B.C. Seizes Sextuplets From Jehovah's Witness Parents For Forced Blood Transfusions

Jan B. Wade · #65 (**permalink**) 02-10-2007, 02:36 PM

There are times when only a transfusion of RBC's given immediately will save a life. There are times when only a transfusion of platelets given immediately will save a life.

From a medical point of view transfusions of blood components are not always good and they are not always bad. In the 1990's the balance of risk vs. benefit weighed heavily toward the risk side. Physician's really were using blood as a pre-ordered item on their treatment algorithm. Today due to the dedicated work of professionals like Shander, Spence, Goodnough, Hannon, Estioko, Spahn, Ford and Speiss physician's are more often questioning and challenging blood transfusion as a theraputic option. The rule "question every unit" is becoming more common.

To take the side of zero tolerance in the blood transfusion debate offers zero possibility of winning the point. The debate should not be No Blood vs. Blood. It should be When Blood vs. When Alternatives. The protagonists in this thread are as far as can be discerned from a glance at their username profiles NOT qualified to debate the When vs. When. The news articles I have reviewed do not provide clinical values time-lines or co-morbidities. Blood count was mentioned but that isn't enough to determine efficacy of treatment decisions. Even if the chart were opened medical opinion on treatment opinions would vary. To portray the physicians working for the interests of the infants as "bad" is shortsighted, naive and not at all fair. To portray the family or their religion as unconcerned with the life and safety of their children would be equally unfair and simplistic. Having spent many years working in hospitals I am certain both sides agonize over their course of action.

At the bottom of this debate and what should not be discussed on this website is the issue of belief and faith as they influence clinical choice and how far health care providers should go to accomodate these in their patient population.

As usual JulieM has nailed the ethical and legal issues. However, is man and his body of laws in harmony or out of harmony with God and his laws? Should man's body of representatives ever allow citizens to impress their choices however sacred on children who are incapable of informed decision? These questions at the root of the case in discussion are necessarily left to another forum.