Fortunately in your case, iron treatment, EPO, and blood collection started right away, which allowed for self-transfusion later. As the noblood page says, planning ahead is a good idea.

It's unclear (privacy issues) why treatment was not administered following birth. It's possible the babies were stable (while possibly weak) at the time, so no treament was deemed necessary until they found out about the deaths. By contrast, if they had been held in neo-natal (as is the usual case with very early preemies) they would have been very closely monitored. One wonders how it got so bad that the first child died before anyone noticed considering the media attention the sextuplets got initially. I'm sure more detailed information will come out during the civil suit...

Jabrwock, please read the article linked in the first post in this thread. It stated that the Supreme Court upheld the parents rights.

Copied and pasted from the article: "And despite the fact the Supreme Court of Canada has affirmed their right to refuse treatment on religious grounds, officials out west acted before the family could launch a court challenge."

Here are a few things of interest that I found. Basically my contention is that a bllod transfusion does not guarantte survival, under any circunstances, and the lack of a bllod transfusion does not gurantee the opposite outcome. According to what I have read by Doctors who provide bloodless medicine any and all sorts of operations have been successfully performed, and though I don't know of a large study on preemies, I do know that there are successful cases of preemies treated with out blood. Given this information it is not unreasonable to allow the parents in this particular case the option to avoid the use of blood. According to something I read today the Canadian goverment has siad that a blood transfusion would not have helped the two preemies who died. The only reason then that I can think of for the doctors not to accomadate the parents wishes is typified by the responce of the Canadian public in general, and that is because of religious ignorance, bigotry, and hatred, and this entire case in one of religious persecution. I have been following the news in Canada and the United States via a google news search and it is invarably negative, and even hateful, but it is all based on ignorance; both of Jehovah's Witnesses, and of the issues involved. Sad to say this is taking up too much of my time. I wish I could quit my job and spend most of time researching and posting, and that is not hardly possible.

Caring for Jehovah's witnesses - Page 4 - Nursing - allnurses.com

#36User Profile4yrstogo vbmenu_register("postmenu_1651112", true);
Registered User

Join Date: May 2006
Location: Northern California
Age: 25
Posts: 12
Country: USA
Years Exp.: Zero.



Re: Caring for Jehovah's witnesses
I realize that it has been a while since this post has been visited, but I thought I would offer my experience...

I too am a Jehovah's Witness and my first daughter was born at 27 wks gestation and weight 1lb 9oz. I didn't go into preterm labor but, by chance, had a routine ultrasound that found that the fluid in my amniotic sac was low and during following tests they found that Kaylee's heart rate dropped substantially and was irratic and so they performed an emergency CS.

My husband and I not only had to deal with her prematurity and adjusting to the situation but had to confront our beliefs of not accepting blood under any circumstances. The first hospital she was born at said they would transfuse at about 40 hematocrit level. She was tranferred to Sunset Kaiser in LA and they said they would let it drop to 30 before tranfusion was forced. We maintained hourly contact with her doctors and nurses and hand in hand with our liason committee kept track of her status. We did what we could to find alternative procedures and was even able to organize meetings between her doctors and other MD's who had dealt with the situation before.

We assured the doctors that alternative treatments were acceptable to us and they proceeded with EPO, iron, and other blood boosters. We were able to get them to agree to minimize blood draws and focus on her status rather than just the numbers.

She was then transferred to a bloodless unit in Encino/Tarzana Regional Medical Center where they assured us they would do what they could but if all else failed the only alternative was transfusion. We held firm to our stand, but realized the doctor's did not have a choice, for their own ethical reasons, and had her best interests at heart.

She underwent a surgery to fix the PDA that medicine could not. It was during this surgery that we feared the worst. They came out and we breathed a sigh of relief when they said she made it through okay and again when they said they were able to do the surgury without blood loss. Her hematocrit dropped to 11 in that hospital... and then it started rising on it's own. The EPO and alternatives began working, along with her own body.

She suffered no brain bleeds, no brain damage, no CP, no ROP... the only signs she has of being a preemie is the scar from her surgery and asthma. All without blood. We understand that we were very fortunate and that other families, JW or not, have had to face other circumstances.

We encountered doctors that were kind... as well as those who chastized us for our beliefs. We endured threats of medical custody being taken away from us. But we will always be grateful to the doctors, nurses, administrative staff and others who were so willing to help us through the hard times.

We have kept in touch with the hospital Kaylee was born at. Since that time, they were able to write new procedures for dealing with preemies of JW parents and even held a staff conference to educate them on what to do in the event they were faced with the situation again. We can be happy that our stand will help other families in this same situation in the future.

I hope this helps...

-Lisa http://allnurses.com/forums/images/smilies/smile.gif
http://allnurses.com/forums/images/s...er_offline.gif
Children's Hospital - Bloodless Medicine Outcomes

"For children, there are unique concerns associated with the use of donated blood, specifically due to their age. Although blood is as safe as it can possibly be, that safety is only within the limits of what is known today about blood. Many pediatricians feel that we could be transfusing the diseases of tomorrow… today. The real possibility of transfusing blood borne disease that may not be known for years to come is a concern. Perhaps for an older adult patient the risk is less significant. But for pediatric patients who have a lifetime ahead of them the risk may be much more significant."
Comprehensive Blood Conservation - QA

The Center for Bloodless Medicine & Surgery at Rainbow is an innovative program that blends the individual values and interests of family with the latest medical and surgical techniques. The result is a health care environment that supports a family's desire for pediatric care without the use of donated blood or blood products, when possible.
"to date Rainbow's is currently the largest pediatric bloodless program in the nation. ..."

Jabrwock,
My point was just the opposite: it was the parents who were trying to beat the odds, but not the doctors. The parents wanted all the babies to survive, against the advice of the doctors who twice encourage then to abort two of the babies. After the babies were born the parents still desire for all to live, but the conflict arose because they asked for bloodless medicine in Canada; whereas if they had been in the United States they could have been accomadated whithout any contraversy in one of the bloodless centers, such as at Rainbow. The public autamatically assumed that two of the babies died because they were denied blood transfusions, but according to what I read today a goverment source siad that it wouldn't have helped. The point I was trying to make eariler was that I personally thought that it was ironic that the doctors initailly made a suggestion which would have resulted in the death of two of the children before they were born, but the parents tried to beat the odds and hope for the survival of all six, but then when two of them died anyway shortly after their birth the parents were blamed. That seems illogical to me but understandable when you consider both the media bias, as well as a widespread public prejudice. Is that clear enough?

I've come to the conclusion that CityNews has bad writers.

What they are talking about is a 1995 ruling by the Supreme Court which allows parents to attend a hearing when the state is requesting custody of the children for the purposes of medical treatment. The article is misquoting that ruling to give the impression that the Supreme Court allows parents to refuse treatment. The SC did no such thing. Instead they just allowed parents to argue their case before the court responsible for issuing the seizure order. It's unclear why the provincial judge did not have a hearing, and that's why the parent's appealed to the BC provincial Supreme Court.

So the court can still override parent's wishes, but in this case, there was an error in procedure that will likely allow the parents to request compensation. Had the court allowed a hearing but still seized the children for treatment, the Supreme Court would likely have upheld the provincial judge's ruling...

I'll have to disagree with you there, but merely through my own beliefs. I believe the doctors acted in the best interest of the children's well being both before and after birth, and I believe the parents, while mostly doing the same, are constrained by religious doctrine to refuse certain medical procedures no matter what.

In the end, I feel more sorry for the children, who will now be regarded as "tainted" by their family and community.

There I am in agreement, but I find that both sides have expressed their bias. Some in support of the doctors are jumping to the conclusion that the parents are murderers (without knowing all the facts), and some in support of the parents are jumping to the conclusion that the doctors are cruel and inhumane (I still can't believe that guy on the CBC website who claimed it was all a conspiracy to prop up the blood transfusion industry...)

If they survive the dangers of these transfusions then they and their family will be consoled as the victims they feel they are. Sadly this is not the first time this sort of thing has happened and therefore there is plenty of evidence to demonstrate that your comment is not the way such ones are treated. Therefore could I ask what you mean by that statement, please?

We look forward to progressive steps away from the sorts of authoritarianism that prefers to use a blanket treatment as they have here in the face of burgeoning information indicating that (1) officialdom neglected due process and (2) the transfusion really wasn't necessary.

I look forward to hearing the complete official story on this case and therefore then exploring the details.

They may be treated as victims, but they will still be regarded as "tainted". I've spoken to JWs who tell me that I cannot become one if I have had a blood transfusion in the past (whether by choice or not), because I am no longer "pure" of blood. So what do you do if you ARE a JW, and you get a blood transfusion (whether by choice or not)?

You are correct about #1, but #2 is speculation on your part. I've been following this case pretty closely, and NO mention from the court documents has provided any new information about whether the treatment was necessary, or avoidable, because they haven't discussed the health of the infants prior to the court order, beyond the initial "two died" and "they were severely anemic" mentioned in the father's appeal. Until that time, neither of us can say that the doctors were completely wrong or right in using the treatment they did. There just isn't enough information about the situation.

Same here, which is why I've never commented on the necessity of the transfusion one way or the other, as I don't have enough info about the infants' condition when they were seized for treatment. That info is unlikely to be forthcoming, as the lawsuit before the court is about the error in application of the law, not an error in the treatment.

Rumors are an occupational hazard to the well-known. I know of an elderly lady who nervously believed that we were only allowed to eat Jam Sandwiches. (don't know what you call them but they are a sort of fruit preserves spread on bread) I must admit that personally I do like Jam Sandwiches, but believe me, I do have a very varied and wholesome diet - my wife is an incredible cook. If anyone wanted query that then I'd invite them around for a meal.

If this doesn't give you enough information then I can't say more as these forums are for discussing factual medical information. People aren't here to be preached to but to discuss salient medical matters on factual grounds revolving around non-blood medical management.

The JWs I was talking to are the Watchtower reps who visit door to door. One would expect them to be better knowledged about it than just rumors, and they seemed pretty firm that transfusion makes you ineligible to be a JW. Perhaps it's just the views of the JWs in Saskatchwan/Canada (btw, we also call it jam, or jelly, or preserve... )

True. And I realise now I should not have brought it up here.

Back to our discussion at hand then. Here are the problems I see so far with this case:

a) they did not receive treatment of iron or EPO or blood thickeners following their birth;
b) they did not start a regime of blood-collection to allow self-transfusion once problems developed;
c) hyperbaric treatment seems impractical since if their condition worsens it's difficult and time-consuming to get them out of the hyperbaric chamber and into the OR, as well they can't be in such treatment while in the OR itself (I'm unaware of OR-sized HB chambers in BC...); and
d) their condition was severe anemia (half the hemoglobin count as normal), and appeared to be quickly worsening.

I'm working under the assumption that the infants were fine when released from hospital, and problems were only noticed when the first one died. (Otherwise they would likely have been kept in neo-natal rather than sent home...) And that their condition was worsening quickly enough to prompt the judge to make the error in law that he did (not allowing a hearing) before issuing the emergency seizure order (perhaps the 2nd death convinced him that something was seriously wrong considering their condition on leaving the hospital, unsure at this time)

Are there any treatments that would have dealt with the issues listed above?