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Blood transfusions?

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Old 11 January 2010, 04:31 PM
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Blood transfusions?

Namaste

A few days ago, during one of my current academical praticals for this semester - General/Vascular Surgery - we came across something I thought was rather interesting. I'm wondering what are the views in Sanatana Dharma about this issue, and a similar one I also heard about at the time. Both are real cases.

Case A: A 60-year-old woman is due for surgery for gastric cancer. She suffers from anaemia (low red blood cell count). She's a Jehovah's Witness and refuses any sort of blood transfusion whatsoever, based on religious grounds. This, of course, makes the whole surgery a lot trickier - and not all doctors are willing to take up on it. She went into the operation room for her scheduled surgery, but after "exploring" (I'm afraid I can't thing of the proper word right now) the doctors decided the tumour was not resectable due to unexpected invasion of adjacent areas; bearing in mind she would most likely bleed out if they attempted to remove the tumour, which wouldn't otherwise happen if she consented on a blood transfusion. Chemo/radiotherapy aren't at all an option either, because of her anaemia.

Case B: Someone was involved in a major traffic accident and comes into the Accident & Emergency room with a severed femoral artery. Reconstruction might be possible but it's very difficult without making use of a blood transfusion, but this person has already bled out a lot. He/she is also a Jehovah's Witness and won't accept any blood transfusions (or his/her family/partner won't, if the person is unconscious). This person will have bleed out to death.

I'm a bit torn on both cases. In either of them, the patient most likely ends up dead - slowly/painfully in case A, (fairly) quickly in case B. Of course, everyone's very well entitled to their her religious choices, and one must understand and accept that. But I can't help but feel if this were "my" patient, I would still feel "guilty" if/when she died...

What do you think?

PS: I hope I didn't bore you.

Last edited by Star : 11 January 2010 at 04:32 PM. Reason: Spelling mistake (my spelling is terrifying tonight!).
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Old 11 January 2010, 05:21 PM
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Re: Blood transfusions?

Star: This is not boring at all. I would be a lot like you. I think it boils down to religious freedom versus common sense. There have been quite a few cases in America or Canada that were simlar. Sometimes even a child is involved and only one of the parents is a Jehovah's Witness. Governments have a hard time making a law forcing people to have mandatory blood transfusions because they think it opens up a slippery slope. A similar example here in Canada is that although polygamy is illegal, the 'Freedom of Religion" argument comes into place, so it is rarely prosecuted. Until governments take a stronger stance, the issues will remain. Euthanasia is another one.

In Sanatana Dharma there are certain things that come into play, several views if you will:
It is the karma of that individual to be born in Jehovah's Witnesses.

It is also our compassionate duty to help where needed. So if we could help we should help. From this view, if it isn't a Jehovah's witness, donating blood is obvious.

There is also the mystical view that by taking on the blood of someone else, you take on part of them, their feelings, perhaps their karma, etc. I'm not a JW expert so I don't know the 'logic' that supports this belief.

Some westerners would be saddened to see me or my wife get tonsured.

So you're kind of out there on your own. I doubt that Hindu scripture deals with it as the whole concept is so modern. There wouldn't be blood transfusions when scripture was written.

Aum Namasivaya
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Old 11 January 2010, 05:46 PM
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Re: Blood transfusions?

This isn't a boring issue at all. On the contrary, it's very relevant in today's multi-religious society.

It seems to me that preserving life should supercede any religious ritual. Performing a blood transfusion doesn't harm anyone, and will only save lives. When Arjuna had the opportunity to kill Karna on the Kurukshetra battlefield, he hesitated because it was considered dishonorable, i.e. adharmic, to kill an unarmed person. Sri Krishna quickly told him not to waste his moralizing on a man who cared nothing for dharma, and had just the previous day led a group of assassins to kill Arjuna's brother. And so he availed himself of the opportunity to make the kill. Though it isn't the most obvious point of the story, I perceive from this that there is no point in arguing morality with people who have inconsistent moral practices. The JW belief concerning blood transfusions contradicts even their own Bible's rhetorical question "is it a sin to do good on the Sabbath?" Thus I'd conclude that it is not wrong to perform a blood transfusion on a person simply because his or her religious community calls it a sin to preserve life.

However, nothing I've said above addresses the two cases you raised above. Here there's another issue: personal liberty. These people are making decisions for themselves, not others. So we need to ask: are their decisions motivated by religious peer pressure, or do they genuinely understand what they're doing? If the latter, I'm not sure how you can force non-emergency medical treatment on someone who needs it.
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Old 12 January 2010, 05:07 AM
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Re: Blood transfusions?

The Jehovah's Witnesses' prohibition against blood transfusions comes from the prohibition in the Bible of eating blood.

"And whatsoever man there be of the house of Israel, or of the strangers that sojourn among you, that eateth any manner of blood; I will even set my face against that soul that eateth blood, and will cut him off from among his people." (Leviticus 17:10)

"Therefore I said unto the children of Israel, No soul of you shall eat blood" (Leviticus 17:12)

This is a trick commandment - you cannot eat flesh without eating blood. Anyone remember how Portia got Antonio off in the Merchant of Venice? She claimed that Shylock was entitled to a pound of Antonio's flesh, but no blood. Shylock could not claim any of Antonio's flesh, since it is impossible to remove flesh without shedding blood (since flesh contains blood).

Because of the above Bible verse, Jewish butchers developed a way of killing the animal where most of the blood is drained from the body (but not all of it). This is called kosher meat and Orthodox Jews will only eat kosher meat.

Jehovah's Witnesses interpret the Bible verse to refer to blood transfusions as well, so that is why they refuse them. However, they do not eat kosher meat, which would seem a logical conclusion to their strict observance of this Jewish law. They don't observe any of the other commandments of the Jewish Law (Torah), and they pronounce the Name of God as Jehovah (pronoucing that name is forbidden in Judaism since the correct pronunciation is not know) which Jews do not do. They do, however, use the Jewish calendar to calculate the date on which they have their annual communion service, thus contradicting themselves yet again.

Coming back to the original topic: Jehovah's Witnesses are forbidden to have blood transfusions. If they do have one, and an elder finds out, they will find themselves "disfellowshipped", which means that they have been excluded from the community of Jehovah's Witnesses. No other Witness is permitted to speak to them, even if they are a family member. Speaking to a disfellowshipped person means that the person who spoke to the disfellowshipped person will be disfellowshipped themselves. Disfellowshipping has been given for a blood translation even when a court order was obtained to administer the blood.
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Old 12 January 2010, 12:53 PM
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Re: Blood transfusions?

Thanks everyone, for your thoughts.

ScottMalaysia, thanks - I didn't know exactly where Jehovah's Witnesses' blood prohibition came from. At first it would be like some sort of "extreme vegetarianism", if that makes sense, but obviously when it gets to the point that if it's literally a matter of life or death they're still not allowed blood, it's obviously a lot further than I thought... Seems strange to me, though, they're so on the verge(?) of fanatical, yet they seem to contradict the Jewish law so much, as you explain. Makes them seem sort of inconsistent to me...

Sanjaya,

Quote:
However, nothing I've said above addresses the two cases you raised above. Here there's another issue: personal liberty. These people are making decisions for themselves, not others. So we need to ask: are their decisions motivated by religious peer pressure, or do they genuinely understand what they're doing? If the latter, I'm not sure how you can force non-emergency medical treatment on someone who needs it.
The woman in case A is someone we collected a clinical history from. She is 60 years old (or more), had lived as a housewife in a faw away place in the countryside all her life and is a rather easygoing and "simple" person. As I see it, the moment someone knocked on her door promising her heaven, etc. etc., she was probably amazed by it all. I doubt she understands the true implications of her decision. She carries a letter from a JW "council" with her at all times, and whenever a doctor/nurse tries to talk to her about this, she just shows them the letter and says she "can't".

In the event of case B, I suspect the person would be unconscious. We asked our teacher "well, if the family says no, you can't give them a blood transfusion", but the person is unconscious, can't we give them blood anyway?". He said we couldn't, because - at least in this country (but I'm guessing others too?) - they have JW "sentinels" placed around in hospitals, to monitor whether any transfusions are given to JW without their/their families' consent. Apparently it has happened before and the medical team who did it got sued by the person (who only survived because of their action!) and his family. So it seems that the Hippocratic Oath we'll have to swear by at the end of our degree is not valid in this instance (JW). Never mind the "I will apply, for the benefit of the sick, all measures that are required" nor the "I will not allow for considerations about age, disease or disability, religion, ethnic origin, gender, nationality, political party, race, sexual orientation or social status to interphere with my duty to the sick"... *sigh*
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