While doing a medical literature search on JWs and blood transfusion, I came across the following remarkable letter in a 1999-edition of "The Lancet".
A rare and bloodless
situation.
Sir, I recently came across an
interesting and rare situation while
working overseas for the medical aid
organisation Médecins Sans Frontières.
One day, just before anaesthetising an
otherwise healthy young woman for a
laparotomy, I was told by one of the
other surgeons that my surgeon was a
Jehovah s Witness, who would not
allow blood to be given to his patients.
I was stunned by this restriction.
The extent of surgery was not clear
from the onset. Routine haemoglobin
estimations were not done in this
hospital before surgery and blood was
difficult to obtain. I was not unduly
worried, but the warning could not be
ignored. Since I was the only
anaesthetist in the hospital and I was a
guest in the country, I decided to
postpone surgery to discuss the
situation with the senior surgeon. The
problem was well known to his
colleagues but efforts to come to a
solution seemed to have failed in the
past. I then discussed the situation
further with my surgeon.
His argument consisted mainly that
the patient and her family were
aware of the fact that he was a
Jehovah s Witness and that she had
agreed not to be given blood. He said
that as the consultant surgeon he
decided that she would not be given
blood. I countered that as the
consultant anaesthetist I would give
blood whenever I felt it necessary
without reference to the surgeon. He
smiled at me and said that he respected
my point of view, and added that in
that case he would have to leave theatre
for the duration of the blood
transfusion. This amused me greatly. I
decided not to delay any further and I
anaesthetised the patient without
difficulty and the operation proceeded
without blood loss.
Eric Vreede
Médecins Sans Frontières, London EC1R5DL,
UK
(e-mail: [email protected])
THE LANCET Vol 354 November 13, 1999