Major abdominal surgery in Jehovah’s Witnesses

Introduction Patients who are Jehovah’s Witnesses pose difficult ethical and moral dilemmas for surgeons because of their refusal to receive blood and blood products. This article outlines the personal experiences of six Jehovah’s Witnesses who underwent major abdominal surgery at a single instit...

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Main Authors: Rollins, Katie E., Contractor, U., Inumerable, R., Lobo, Dileep N.
Format: Article
Published: Royal College of Surgeons of England 2016
Subjects:
Online Access:https://eprints.nottingham.ac.uk/51205/
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author Rollins, Katie E.
Contractor, U.
Inumerable, R.
Lobo, Dileep N.
author_facet Rollins, Katie E.
Contractor, U.
Inumerable, R.
Lobo, Dileep N.
author_sort Rollins, Katie E.
building Nottingham Research Data Repository
collection Online Access
description Introduction Patients who are Jehovah’s Witnesses pose difficult ethical and moral dilemmas for surgeons because of their refusal to receive blood and blood products. This article outlines the personal experiences of six Jehovah’s Witnesses who underwent major abdominal surgery at a single institution and also summarises the literature on the perioperative care of these patients. Methods The patients recorded their thoughts and the dilemmas they faced during their surgical journey. We also reviewed the recent literature on the ethical principles involved in treating such patients and strategies recommended to make surgery safer. Results All patients were supported in their decision making by the clinical team and the Hospital Liaison Committee for Jehovah’s Witnesses. The patients recognised the ethical and moral difficulties experienced by clinicians in this setting. However, they described taking strength from their belief in Jehovah. A multitude of techniques are available to minimise the risk associated with major surgery in Jehovah’s Witness patients, many of which have been adopted to minimise unnecessary use of blood products in general. Nevertheless, the risks of catastrophic haemorrhage and consequent mortality remain an unresolved issue for the treating team. Conclusions Respect for a patient’s autonomy in this setting is the overriding ethical principle, with detailed discussion forming an important part of the preparation of a Jehovah’s Witness for major abdominal surgery. Clinicians must be diligent in the documentation of the patient’s wishes to ensure all members of the team can abide by these.
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spelling nottingham-512052020-05-04T20:00:15Z https://eprints.nottingham.ac.uk/51205/ Major abdominal surgery in Jehovah’s Witnesses Rollins, Katie E. Contractor, U. Inumerable, R. Lobo, Dileep N. Introduction Patients who are Jehovah’s Witnesses pose difficult ethical and moral dilemmas for surgeons because of their refusal to receive blood and blood products. This article outlines the personal experiences of six Jehovah’s Witnesses who underwent major abdominal surgery at a single institution and also summarises the literature on the perioperative care of these patients. Methods The patients recorded their thoughts and the dilemmas they faced during their surgical journey. We also reviewed the recent literature on the ethical principles involved in treating such patients and strategies recommended to make surgery safer. Results All patients were supported in their decision making by the clinical team and the Hospital Liaison Committee for Jehovah’s Witnesses. The patients recognised the ethical and moral difficulties experienced by clinicians in this setting. However, they described taking strength from their belief in Jehovah. A multitude of techniques are available to minimise the risk associated with major surgery in Jehovah’s Witness patients, many of which have been adopted to minimise unnecessary use of blood products in general. Nevertheless, the risks of catastrophic haemorrhage and consequent mortality remain an unresolved issue for the treating team. Conclusions Respect for a patient’s autonomy in this setting is the overriding ethical principle, with detailed discussion forming an important part of the preparation of a Jehovah’s Witness for major abdominal surgery. Clinicians must be diligent in the documentation of the patient’s wishes to ensure all members of the team can abide by these. Royal College of Surgeons of England 2016-11 Article PeerReviewed Rollins, Katie E., Contractor, U., Inumerable, R. and Lobo, Dileep N. (2016) Major abdominal surgery in Jehovah’s Witnesses. Annals of the Royal College of Surgeons of England, 98 (8). pp. 532-537. ISSN 1478-7083 Jehovah’s Witness; Abdominal surgery; Blood loss; Blood transfusion; Patient perspective https://publishing.rcseng.ac.uk/doi/full/10.1308/rcsann.2016.0210 doi:10.1308/rcsann.2016.0210 doi:10.1308/rcsann.2016.0210
spellingShingle Jehovah’s Witness; Abdominal surgery; Blood loss; Blood transfusion; Patient perspective
Rollins, Katie E.
Contractor, U.
Inumerable, R.
Lobo, Dileep N.
Major abdominal surgery in Jehovah’s Witnesses
title Major abdominal surgery in Jehovah’s Witnesses
title_full Major abdominal surgery in Jehovah’s Witnesses
title_fullStr Major abdominal surgery in Jehovah’s Witnesses
title_full_unstemmed Major abdominal surgery in Jehovah’s Witnesses
title_short Major abdominal surgery in Jehovah’s Witnesses
title_sort major abdominal surgery in jehovah’s witnesses
topic Jehovah’s Witness; Abdominal surgery; Blood loss; Blood transfusion; Patient perspective
url https://eprints.nottingham.ac.uk/51205/
https://eprints.nottingham.ac.uk/51205/
https://eprints.nottingham.ac.uk/51205/