1. Jehovah’s Witnesses And their refusal of Blood Transfusions in the 21 st Century. EU

2. Who/What are Jehovah’s Witnesses? Christian denomination from US late 19 th Century Forbids humans consuming human/animal blood under any circumstances  includes through intravenous Refuse blood transfusions, major blood transfusions, post/intra- operative blood salvage http://www.dkimages.com

3. Who/What are Jehovah’s Witnesses? “Only flesh with its soul-its blood-you must not eat” –Genesis 9:3,4. “[You must] pour its blood out and cover it with dust” – Leviticus 17:13,14. “abstain from…what is strangled and from blood” Acts 15:19-21 Breach these rules damages relationship with Jehovah Do seek medical care  Saline, lactated Ringer’s solution, albumin, dextrans

4. What is a Blood Transfusion? Transfer whole blood/components from donor to recipient Increase ability to carry oxygen Restore blood volume Improve clotting ability Improve immunity to infection http://health.howstuffworks.com/aspirin3

5. Ethics and Struggles “Every human being of adult years and sound mind has a right to determine what shall be done with his own body” Hospitals and doctors often petition court override patient’s decision Notions: abandonment of a child, risk of liability for the doctor and hospital

6. Ethics and Struggles Medically ethical treat a patient Physicians find it difficult to understand why Jehovah’s Witness patient would refuse a life saving procedure Ethically and legally important for a doctor to obtain informed consent from patient before treatment Failure to obtain consent lead to grave legal consequences  criminal charges (battery, assault)

7. Alternatives to Blood Transfusions Volume Expanders  Saline  Lactated Ringer’s solution  Albumin  Dextrans Growth Factors  Erythropoietin http://www.dkimages.com/discover/Home/Health-and-Beauty/Human- Body/Circulatory-System/Blood/Transfusions/Transfusions-2.html

8. Alternatives to Blood Transfusions Blood Substitues  Currently no real substitute  Hemoglobin-based Oxygen Carriers (rarely tested)  Perfluorochemical Compounds (rarely tested)

9. Resources _____.(November 28,2006). Alternatives To Blood Transfusion. Retrieved December 18, 2007 from http://www.cancer.org/docroot/ETO/content/ETO_1_4X_Alternatives_To_Blood _Transfusion.asp?sitearea=ETO ____.(June 2004). Jehovah’s Witnesses and Blood Transfusions. Retrieved December 18, 2007 from http://www.publicadvocate.vic.go v.au/media/docs/C07-Jehovahs- Witnesses-and-Blood-Transfusions-fa6b29e7-02c6-4ff1-8d4a-994f45636f2f.rt8 http://www.publicadvocate.vic.go v.au/media/docs/C07-Jehovahs- Witnesses-and-Blood-Transfusions-fa6b29e7-02c6-4ff1-8d4a-994f45636f2f.rt8 ____.(October 31, 2006). Bloot Transfusion. Retrieved December 16, 2007 from http://www.hmc.psu.edu/healthinfo/b/bloodtransfusion.htm Carbonnea, André.(2003).Ethical Issues and the Religious and Historical Basis for the Objection of Jehovah’s Witnesses to Blood Transfusion Therapy. Lewiston, New York: The Edwin Mellen Press. Van der Linden, Philippe.(2006).The effects of colloid solutions on hemostasis. Canadian Journal of Anesthesia, s30-s39. Woolston, Chris. (___). ‘Bloodless’ Surgery: new drugs and technologies may make many transfusions unnecessary. Retrieved December 20,2007 from http://www.record.wustl.edu/archive/1997/05-15-97/5393.html http://www.record.wustl.edu/archive/1997/05-15-97/5393.html