Call for New Approach to Transfusion Refusals

ALISON HEALY
The Irish Times - Saturday, February 27, 2010

THERE MUST be greater coherence in the approach of hospitals to the management of patients who refuse blood transfusions, a conference at the Coombe Women and Infants’ University Hospital has heard.

Jehovah’s Witness Belinda Slator said fellow believers were frequently challenged by medical staff when they said their religion did not permit blood transfusions. “This phrase keeps coming up: ‘So you mean you’d rather die, is that what you’re saying?’ . . . ‘or you’d let your children die’,” she said. “You hear it all the time.”

Ms Slator said Jehovah’s Witnesses were also told that they were brainwashed. This was understandable coming from members of the public who might not know much about the religion, “but for someone in the medical profession to say it, it’s unreal because they have access to information that the general public wouldn’t have”.

She has three children, including a newborn baby, but said she had just one negative hospital experience. “A nurse went cold on me as soon as she heard. Her personality changed and she didn’t look me in the eye after that.”

Ms Slator was speaking after she addressed the conference which was organised to discuss the need for national guidelines for obstetrics and gynaecology,

Dr Deirdre Madden of UCC said the law was quite clear that the refusal of treatment must be respected if it is made by a competent adult. She supported the call for national guidelines for the sector. “Where possible, hospital management, clinicians and patients should engage in advance planning for the use of appropriate alternatives to blood products and carefully assess and discuss the level of risk involved,” she said.

Mark O’Malley, Jehovah’s Witness co-ordinator of hospital information services, said early consultation between patients and clinicians was crucial to avoid conflict later. While Jehovah’s Witnesses refuse transfusion of blood and primary blood components, Mr O’Malley said other decisions were up to the patient.

The conference heard of the difficulties posed to medical staff where a couple do not share religious beliefs. If an expectant mother was a Jehovah’s Witness and the father was not, Dr Madden said the woman’s wishes must be met if the decision related to her treatment.

Consultant obstetrician and gynaecologist Prof John Bonnar said patients could come under pressure from their religious elders to refuse certain treatments.

Obstetrics professor Deirdre Murphy said hospital staff often became uncomfortable when members of the Jehovah’s Witness hospital liaison committee came into the hospital. The perception was that they were putting the patient under pressure.

Mr O’Malley said the committee members only came to the hospital at the request of the patient and they never made decisions for the patient. He said patients may feel the need for spiritual support.

Call for new approach to transfusion refusals - The Irish Times - Sat, Feb 27, 2010