11/10/2023 0 Comments Jehovah witness religion short![]() This document should be accessible from the electronic medical record and serves as a legal document of the patient’s wishes in the event of incapacitation. Patient acceptance or refusal for each should be documented ideally prior to major surgery or at the start of hospitalization. Hospital transfusion services/bloodless medicine programs should create a standardized form that lists each blood product, derivative (plasma-derived and recombinant), procedure, etc. †, autologous red blood cells (RBCs) are considered acceptable by many Jehovah’s Witnesses when they are kept in circuit and without storage. This table is used with permission from our previous publication ( 6). Anonymous surveys of Jehovah’s Witness patients reveal a willingness to accept blood transfusion in life-threatening situations in a minority of patients (~10%) ( 9, 10). Furthermore, the consenting physician should seek to develop rapport, avoid confrontation, and refrain from assumptions. To avoid possible coercion, this discussion should take place in private in the absence of family members and elders. Informed consent/refusal entails an individualized, confidential discussion of risks and benefits of permitted and prohibited blood products, derivatives, procedures, and alternatives. The decision to accept these measures is left to the individual and subject to heterogeneity ( 8). In an emergency if there are any concerns regarding the current validity of the advanced decision card of an unresponsive patient, physicians should transfuse potentially life-saving blood products ( 5).Īpproach to the patient when transfusion is not an optionĪlthough whole blood and its major components (red blood cells, platelets, plasma) are generally prohibited ( Table 1), Jehovah’s Witnesses may be unfamiliar with the ever expanding array of components, derivatives, and procedures to control bleeding and treat anemia ( 7). Competent adult Jehovah’s Witnesses have the autonomy to decline blood transfusion and may carry an advanced decision card documenting this ( 4). A member of the Jehovah’s Witness faith who accepts blood transfusion faces severe consequences (e.g., sanctions, disfellowshipping) ( 3). The basis for the ban on blood transfusion is centered upon the interpretation of several Bible passages that prohibit “eating blood” ( 2). Medical care of Jehovah’s Witness patients poses unique challenges and opportunities because these patients do not accept blood products owing to religious beliefs. While Jehovah’s Witnesses constitute less than 1% of the world’s population, there are 1.2 million active members in the United States and approximately 8.7 million followers worldwide ( 1). Received: 28 August 2021 Accepted: 11 October 2021 Published: 30 June 2022. Keywords: Anemia bloodless patient blood management (PBM) Herein we review management strategies and alternatives to blood component therapy in the perioperative setting and in the setting of critical anemia. Ongoing experience with artificial blood substitutes such as hemoglobin-based oxygen carriers (HBOC) in this patient population has generated renewed interest for clinical use despite the initial safety concerns and lack of Food and Drug Administration (FDA) approval at this time. Targeted treatment of anemia with intravenous iron preparations and erythropoiesis stimulating agents and treatment of coagulopathy with factor concentrates and antifibrinolytics has shown promise in reducing the need for transfusion in the perioperative setting. ![]() This involves, but is not limited to, timely diagnosis and treatment of anemia and coagulopathy, constant vigilance for iatrogenic blood loss, and optimization of patient physiologic tolerance of anemia. In order to respect patient autonomy and avoid critical anemia with its well-documented morbidity and mortality, a proactive, multifaceted, and individualized approach implementing the principles of patient blood management (PBM) is necessary. In general, whole blood and its major fractions are prohibited however, the decision to accept certain components, derivatives, procedures are subject to individual conscience. ![]() Policy of Dealing with Allegations of Research MisconductĪbstract: Patients who decline blood transfusion on the basis of religious belief, such as Jehovah’s Witnesses, pose unique management dilemmas and opportunities for healthcare.Policy of Screening for Plagiarism Process.
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