This is the fourth thread reviewing the Australian WTS publication " JEHOVAH'S WITNESSES Guidelines for their non-blood medical management "
http://www.jehovahs-witness.com/forum/thread.aspx?id=43275&site=3
http://www.jehovahs-witness.com/forum/thread.aspx?id=43296&site=3
http://www.jehovahs-witness.com/forum/thread.aspx?id=43449&site=3
Following is a brief review of the publication:
Chapter 1 "Treating the JW patient: communication rather than confrontation"
This chapter describes, amongst other things, the Hospital Liaison Committees which "function in over 20 major cities".
It lists those 20 major cities as:
Perth (WA)
Darwin (NT)
Adelaide (SA)
Cairns, Townsville, Mackay, Rockhampton, Bundaberg, Brisbane (Qld)
Dubbo, Orange, Lithgow, Griffith, Wagga Wagga, Sydney, Newcastle, Albury (with Wodonga) (NSW)
Melbourne, Wodonga (with Albury) (VIC)
Launceston, Hobart (TAS)
I made this comment before: Among the cities not represented is Tamworth in northern New South Wales. This large country city has a Base Hospital, as does Dubbo, Orange, and Wagga, yet has no HLC representation.
Presumably it's not considered necessary, but I wonder why not?
Second Section: "Hospital Protocol for Treating Jehovah's Witnesses"
1. Review non-blood medical alternatives and treat the patient without using homologous blood.
2. Consult with other doctors experienced in non-blood alternative management at same facility and treat without using homologous blood.
3. Contact local Hospital Liaison Committee of Jehovah's Witnesses to locate cooperative doctors at other facilities. They may be willing to be consulted on alternative care.
4. If necessary, transfer patient to cooperative doctor or facility before patient's condition deteriorates.
5. In the rare situation where a doctor is treating a child and feels he has no alternative but to use blood, the parents should be notified as soon as possible of such intended action. This will allow them to obtain the needed second opinion from a doctor of their choice.
6. If court action is deemed necessary, the patient, the parents, or the guardian should be notified as soon as possible of such intended action. This will allow for due process of law and for the court to hear both sides so as to weigh all factors in reaching a decision, including alternative non-blood management of the case.
Issues of privacy seem to be involved here. Contacts with some legal experience seem to think so.
Section 3 "Emergency Protocol involving Jehovah's Witnesses"
1. Check wallet/purse for MEDICAL DIRECTIVE* (carried by most Witnesses). This identifies whom to contact in case of emergency, usually a family member or a congregation elder. It also lists any allergies, current medication, or medical problems. IT CLEARLY STATES THE PATIENT'S VIEW ON THE NON-USE OF BLOOD TRANSFUSION.
2. Make appropriate notation of the above on patient's hospital records, etc.
3. If patient is conscious and able to write, arrange for him to enter his wishes concerning blood on the Hospital Admission form, etc. If time permits, a family member, congregation elder, or Hospital Liaison Committee member can bring a REFUSAL TO PERMIT BLOOD TRANSFUSION form to the Hospital for patient and doctor/surgeon to sign.
4. Endeavour to contact persons named on MEDICAL DIRECTIVE.* If unable to do so, contact Hospital Liaison Committee.
5. If patient is conscious but does NOT have a MEDICAL DIRECTIVE,* but you have reason to believe he is a Witness, contact a family member, congregation elder, or Hospital Liaison Committee member.
6. If patient is unconscious and does NOT have a MEDICAL DIRECTIVE,* but you have reason to believe he is a Witness, contact the Hospital Liaison Committee.
_________________
* Sample of the MEDICAL DIRECTIVE is included in this folder.
As I mentioned before: instructs all hospital doctors and nurses to check each casualty's wallet/purse for a Blood Card in case the patient is a JW. Yeah, right! It also states: "6. If patient is unconscious and does NOT have a MEDICAL DIRECTIVE, but you have reason to believe he is a Witness, contact the Hospital Liaison Commmittee." One wonders how hospital staff in emergency departments would have "reason to believe he (the unconscious patient) is a Witness.
There are five different cards being used in Australia this year. (See below)
Other sections:
ACCEPTABLE/UNACCEPTABLE TREATMENT; CONSCIENCE MATTERS
I.V. FLUIDS ACCEPTABLE TO JEHOVAH'S WITNESSES
JEHOVAH'S WITNESSES' RELIGIOUS POSITION ON MEDICAL THERAPY
JEHOVAH'S WITNESSES Religious and Ethical Position on Medical Therapy, child care and Related Matters
STRATEGIES
Various magazine articles, both medical and Watchtower published.
Copies of forms used by Jehovah's Witnesses in Australia i ncluding MEDICAL DIRECTIVE forms:
Form md-E - for Australian Capital Territory, Northern Territory, South Australia, Tasmania, and Western Australia
Form md-E (Q) - for Queensland
Form md-E (V) - for Victoria
Form md-E (N) - for New South Wales
Form md-E (N/Q) - for Northern New South Wales
What differences are there between each card?
Form md-E is the regular one that we have traditionally been used to.
Form md-E (Q) carries a declaration by the bearer that is witnessed by a "Qualified witness" as well as a separate statement by the bearer's doctor. The two emergency contacts "Holds my enduring power of attorney for personal/health matters as appointed in Form 4-Advance Health Directive which I have completed persuant to the P owers of Attorney Act 1998 (Qld) ."
Form md-E (V) is the same as form md-E except that it requires the emergency contact person to be a person who "Holds Enduring Power of Attorney (Medical Treatment)"
Form md-E (N) is the same as form md-E except that it requires the emergency contact person to be a person who is "Appointed as my enduring guardian under the Guardianship Act 1987 (NSW) "
Form md-E (N/Q) is similar to the Queensland form except that the emergency contact is appointed as the enduring guardian under the Guardianship Act 1987 (NSW).
All forms carry the date of June 2001.
Form: DOCTOR'S SURVEY REPLY (Doctor asked to complete with his own details and answer these questions:
Are you willing in principle to offer treatrment without the use of blood or blood products:
a) in non-emergency or elective situations? Adults? Children?
b) In emergency situations? Adults? Children?
Hope you find this helpful.
Cheers, Ozzie