Congratulations on your upcoming graduation from Medical School. You do certainly have an ethical dilemma. As a physician, you will be responsible for directing the care of the patients under your care. In the U.S., there is generally a standard treatment protocol for every medical condition, and a physician can find themselves in big legal trouble if they do not follow this standard of care. As a new doctor, your learning experience will continue under the direction of other more experienced physicians, and the ability for you to say "no, I will not order this treatment for my patient" may be difficult, particularly if the patient doesn't have a problem with the treatment. You may want to discuss your concerns/options with some of your instructors. They may have some insight to provide you on making the best choice of which path to pursue. What does your conscience tell you is the best choice? There are JW's who are physicians, but the ones I know became JW's after completing their medical training. It's easier to work around these problems when you are more in control.

I'm a registered nurse, and while the same issue came up during my training, I was not the individual ordering the transfusion, and after school, I chose to work in an area where transfusions were rarely given. If my patient did have a transfusion ordered, one of my coworkers would initiate the transfusion and I would monitor the patient during the infusion. The doctor ordered the transfusion, and the patient consented to the treatment plan. By monitoring the vital signs, I was still caring for my patient, but not taking part in this particular aspect of their care. At the completion of the infusion, that same coworker would take the blood bag down.

Once you complete your training, I'm sure you will have plenty of Witness patients to care for, and this will not be an issue!

Is possible that the members of this forum did not understand , the crucial point of my post. What i really want to discuss in this forum , is that JW Doctors should have the same "right" (like nurses) to aprouch this issue as a "conscience matter". Because now a day what kind of profesional can have autority to go agaist standard treatment protocol. We are in the same condition than Nurses , the only diference is that perhaps , the nurse "have Doctor who order" and we have an Administration , an Area team , and universaly acepted protocols that restrain our freedom to do anything diferent. (So as you all can see we should also be under the same principles to decide Deut 14:21 ; 2Kings 5:17-19).

If anyone Think that my point off view is incorrect please Post ( if for any reason dont want to go public please post in private)

Yes. You have the same right to choose as a nurse. Depending on your field of surgery you will need to exercise your right more or less often. I know general surgeons who have rarely been faced with the need to transfuse. That is because they have focused their practice on more routine cases.

If you want to help Jehovah's Witnesses you might consider Internal Medicine with a special emphasis on hematologic issues. This would put you in position to consult on anemic patients both perioperative and medical. In fact you could carve out a practice that adds needed support to surgical colleagues.

At this point you have a great freedom to choose the course that would offer the least trouble while providing maximum support.

__________________
Mr. Jan B. Wade
Blood Management Consultant
Enhance Outcomes - Control Cost
For Information Call - 360 296-1807
Email

It is true, Argilio, that as you enter hospital training (internship, resdiency, or whatever it is called in Portugal), you will be largely be under the thumb of senior residents, fellows, and, of course, the attending physician. This does put you somewhat in a comparable position to JW nurses, who could perhaps in good conscience hang a unit of red cells knowing that that someone (a doctor) else had ordered it.

Although in practice for many years, I was recently put in a comparable position when an ER doc called me in the middle of the night to admit a patient with leukemia who was a little anemic. The ER doc said he had already spoken with a hematologist at a university hospital who advised the patient be admitted and transfused.

See:
*** w99 4/15 p. 29 Questions From Readers *** footnote
*** w75 4/1 p. 215 par. 9 Are You Guided by a Sensitive Christian Conscience? ***

I must thank everyone who until now reply at this question in ask a profesional forum.

Althought it is true that there is no profesional with less authority than a Resident , and is true that ,like nurses , lack off authority to make diferent decisions in this matter... Is'nt true , that even as attending , a doctor (JW) could' not do any anything diferent when is faced with a situation that in protocol have no diferent solution than a transfusion (e.g patient with Hb 4 with cardiac problems and with clinic off hipovolemic shock)??

personaly i think that both below aply to a JW doctor (even as attending) , because now days Doctor are obligated too act with medicine based on evidence , and if they don´t do soo generaly they respond to the Law.

once again sorry for my not to sharp english

See:
*** w99 4/15 p. 29 Questions From Readers *** footnote
*** w75 4/1 p. 215 par. 9 Are You Guided by a Sensitive Christian Conscience? ***[/quote]

[/quote]

Having spent most of the past twenty years involved with blood management in medical and surgical settings, I restate my opinion that one of Jehovah's Witnesses who wishes to enter the medical field as an MD might better serve by specializing in treatment of anemia and other blood disorders in medical and surgical settings.

Why would an MD want to become a focal point for controversy? There are plenty of surgeons offering non-blood management who can ethically, legally and morally offer blood as the last resort.

__________________
Mr. Jan B. Wade
Blood Management Consultant
Enhance Outcomes - Control Cost
For Information Call - 360 296-1807
Email