Chere Madame Quixote,
I find it difficult also to understand academic articles, interspersed with many references and technical jargon. I will do my best to summarize the second article as it refers to Jehovah’s Witnesses. The numbers refer to the order of paragraphs in the article. This is how I see it, and it may not be the exact thoughts of the author.
1. Midwifery is a complex and challenging profession. It can be chaotic. By reflection on the challenging chaotic dilemmas that arise, by recognizing personal behavior, feelings and effects upon oneself and others, a learning process takes place. New alternatives in treatment can be created for the benefit of all.
2. For students to learn how to apply theory to practice it is vital to learn how to reflect on all aspects of difficult situations that arise.
3. During a previous shift of the author and her mentor, a woman in their care, after delivery, suddenly started bleeding and lost a liter and a half of blood. (Serious)
4. The next day, with the previous shift still on their minds, another situation arose with Anne, a Jehovah’s witness who had signed a health care directive stating she refuses blood and blood products. Her husband also reiterated to the two midwives that she was not to have blood. Anne also signed another form for the doctor, but she did not understand what she had signed and asked the midwives later what the doctor had said to her.
5. The author as midwife knew that there was a risk of sudden blood loss that could happen quickly. So she carefully made plans and preparations for such a contingency.
6. During the delivery, Anne started to talk about accepting blood fractions. However, she was not clear what this meant, only that she had read about it in the Watchtower magazine.
7. Anne realized that there was a necessity to receive a blood fraction after delivery, a fraction that was forbidden by Jehovah’s Witnesses. Anne’s husband, increasingly anxious, voiced, no blood in any form. Providentially, no complications arose.
8. The author reflects further on her feelings, her concern for Anne. From her previous day’s sudden and quick emergency of blood loss she and her co-workers became aware of their incredible anxiety.
9. Other midwives also were uneasy and anxious. They knew that in the previous year, a Jehovah’s Witness bled to death after delivery.
10. During Anne’s pregnancy and at time of delivery, she had changed her mind numerous times concerning the acceptance of blood derivatives. It was the husband who read the forms and told his wife to sign. Later the wife asked the midwives for clarification.
11. Both the husband and the wife demonstrated confusion concerning “fractions of blood”. The author felt that the couple were irresponsible for not knowing the requirements of their religion. She goes on to cite statistics that show that Jehovah’s witnesses women giving birth are at a 44-fold risk of maternal death.
12. The WT’s decision to tweak its transfusion policy has clearly created some confusion. AJWRB seek to educate all, regarding irrational aspects of the blood policy. Informed choice without fear of sanctions should prevail. Anne should have been counseled individually and privately
13. Anne had signed consent forms when told to do so by her husband. Consent or non consent should be based on thorough information and competence before making a voluntary and unforced decision. Consent or withholding consent is a woman’s choice. It is of note that legally the consent, and conversely the withholding of consent by a husband of a client is not recognized by law.
14. Jehovah’s Witness, as fundamental Christians, base their decisions on blood on Bible texts in Leviticus and Acts. The WT magazine is cited regarding blood components, that “each Christian, after careful and powerful meditation, must conscientiously decide for himself.”
15. When caring for clients with such religious beliefs…..remain professional and non-judgemental at all times
16. Midwifery is a profession in which ethical and moral dilemmas are commonplace.
17. In retrospect, she thinks she did her job, she planned, she prepared. If a similar situation occurred again, she would see that the expectant mother was counselled privately by a senior staff member without the presence of her husband to ensure she is not under pressure from another person. This was clearly an emotive situation and could have resulted in a high-risk obstetric emergency. If so her religious beliefs would have been respected and she would have received the best possible care.
18. Individuality must be accounted for and respected.
Question: Were secular medical misrepresentations in evidence during this trying episode or were the un-coerced choices made by the woman giving birth solely based on understandings of religious Biblical texts?