Posted on Sun, Mar. 31, 2002
Medicine, religion clash in court
Jehovah's Witness pursuing lawsuit against surgeon who gave him blood
By RICK BRUNDRETT
Charlie Harvey is alive today in part because someone else's blood is coursing through his veins, his surgeon says.
But as a devout Jehovah's Witness, Harvey says God has commanded that blood is sacred and cannot be shared. He says he was horrified when he learned he received a blood transfusion after a 1997 surgery at Lexington Medical Center to unclog a blocked carotid artery in his neck.
"I cried and cried for days," said Harvey, 55, when interviewed last week. "That wasn't their decision to make. That decision was Jehovah's - a life belongs to him."
Harvey, a former Columbia resident now living in Greensboro, N.C., sued his surgeon, Dr. Glen Strickland, in 1998, claiming, among other things, that the doctor committed a "medical battery" on him by ordering a blood transfusion. Harvey contends Strickland disregarded his wishes, which he says were clearly spelled out in written forms before the surgery.
But, in a 2000 Richland County trial, a judge sided with Strickland. Harvey appealed to the state Supreme Court, which will hear the case Tuesday. A ruling is expected later.
Strickland could not be reached last week for comment. But, in court papers, he said he ordered the transfusion after Harvey suffered a stroke following the surgery. Because Harvey was unconscious and couldn't speak, Strickland said he went to Harvey's mother, Julia Harvey, the emergency contact listed on Harvey's admission form, who gave permission for the transfusion.
Strickland said the transfusion was needed to prevent a heart attack and also helped Harvey recover faster from the stroke.
"The doctor saved the patient's life," said Strickland's lawyer, Charles Carpenter Jr., in a brief to the Supreme Court. "The doctor would have been wrong to do anything different from what was done."
Carpenter declined to comment when contacted last week.
Strickland's brief says the case is about the "South Carolina law of informed consent for medical treatment," not about the "theological validity of Jehovah's Witnesses' blood view."
However, a medical ethicist questions whether Strickland considered Harvey's religious beliefs seriously enough.
"He does have an obligation not to harm and to do what he can to help the patient, but always with respect to the patient's wishes for self-determination," said Dr. Robert Sade, a surgery professor at the Medical University of South Carolina and director of MUSC's Institute of Human Values in Health Care.
Sade said he has complied when Jehovah's Witness patients requested no transfusions during surgeries.
Others have done the same.
For example, doctors at a Rock Hill hospital allowed a mother, a Jehovah's Witness, to die in 1999 after she refused a transfusion following complications from a stillbirth.
BLOOD - 'SOMETHING SACRED'
A diabetic with high blood pressure, Harvey said he didn't have a death wish when his family doctor referred him to Strickland in late 1996 for carotid artery surgery.
Harvey could have chosen a hospital that specializes in doing surgeries without transfusions. But he said he agreed to allow Strickland to do the operation at Lexington Medical Center after the doctor assured him that the "blood issue would never come about," according to court papers.
Strickland earlier had submitted a signed survey form to the Hospital Liaison Committee, which works on behalf of Jehovah's Witness patients, indicating he was willing to provide treatment to Jehovah's Witnesses without the use of blood products, even in "emergency situations," Harvey said in his brief.
When Harvey was hospitalized in November 1996 for preliminary tests, he signed two forms refusing blood products, and releasing Strickland and Lexington Medical Center from all subsequent claims due to that refusal, court papers show. He made the same requests on two more forms when he was admitted on Jan. 14, 1997, for the surgery.
MUSC's Sade said the signed forms showed a "great seriousness" on Harvey's part, and that it "really weakens, from an ethical point of view, the doctor's argument that he needed to get additional permission."
Citing verses in the biblical books of Leviticus and Acts, Harvey told The State that Jehovah's Witnesses believe that "blood is something sacred" and cannot be shared with others.
"Life belongs to Jehovah God," said Harvey, who added he was baptized into the faith in 1995. "It should be his right to call what is sacred. If he says, 'Don't use it,' then don't use it."
Harvey wasn't expecting any serious problems from the surgery; he said he would have been willing to die even if a blood transfusion were needed to save his life. "If it came down to the blood or life, I would let Jehovah handle it," he said.
The Jan. 15, 1997, surgery "seemed to go very well," Strickland said in his brief to the Supreme Court. But after Harvey was transferred to a recovery room, a nurse noticed he wasn't moving his right arm very well, and more tests were ordered - with permission from Harvey's mother, Julia Harvey, Strickland said.
The tests revealed Harvey, who was unable to speak following the surgery, had suffered a stroke and that another surgery was needed to remove clots from his neck's carotid artery, according to Strickland's brief. Harvey's mother gave permission for the second surgery, which didn't require a blood transfusion, he said.
After the second surgery, Harvey was transferred to intensive care but had trouble breathing throughout the evening and a breathing tube had to be inserted, Strickland said in court papers.
In court papers, Strickland said he became concerned the next day that Harvey was at risk for a heart attack because his heart rate was too high. Harvey also had lost about 30 percent of his blood during the two surgeries and from post-operative bleeding.
To correct those problems, Strickland decided a blood transfusion was needed. Harvey's mother initially refused, citing her son's religious beliefs, according to Harvey's brief. But after being alone with her son for about 15 minutes, Julia Harvey agreed to the procedure. Her son was given two units of packed red blood cells, Strickland said, noting "the effect of this was to immediately slow down the heart rate."
"As a result, Harvey not only was saved from a heart attack, but he had a profound recovery from a bad stroke," Strickland said in his brief.
Citing a 1984 state Supreme Court case, Strickland said he was required to seek permission from Harvey's mother for any treatments after Harvey was unable to speak for himself. But in his brief, Harvey said that while his mother was listed as an emergency contact, she wasn't authorized under state law to make decisions on his behalf, especially when he had made his wishes known in writing.
Sade, of MUSC, said he can't answer the questions of law in Harvey's case. But, from an ethical standpoint, he believes patients' rights to determine their treatment outweigh their doctors' wishes.
"I'm not saying (Strickland) did the wrong thing - it's a difficult balancing act," Sade said. "I put a great deal of weight that you really need to pay attention to what the patient says. If the patient really believes and understands the serious consequences that could result, you shouldn't give blood (transfusions)."
Citing earlier court testimony from a Jehovah's Witness elder, Strickland said in his brief that Harvey hadn't "sinned in the eyes of the church" by receiving the transfusion because he was unconscious and didn't consent to it. But Harvey told The State he felt "guilty" when he learned about the transfusion several months later after receiving his medical records.
"It tore me up," said Harvey, crying. "My rights were taken away from me. .‘.‘. I feel like I was raped."
Harvey sued Strickland, his medical practice and Lexington Medical Center in July 1998, claiming "medical battery, breach of express agreement, lack of informed consent and medical malpractice." The medical center later was dropped as a defendant.
All of Harvey's remaining claims were dismissed by Circuit Court Judge Henry McKellar in a Richland County jury trial in October 2000. McKellar decided on the malpractice and battery claims after a jury deadlocked, according to court papers. Harvey claimed the judge violated his right to a jury trial in his appeals brief.
These days, Harvey said he is drawing about $15,000 a year in disability payments, adding he no longer can use his right hand and walks with a limp. As a skilled tradesman who reconditioned machine tools, he said he made as much as $80,000-$90,000 a year.
Harvey said he's not seeking a specific damage amount in his lawsuit. He is asking the Supreme Court to send the case back to the lower court for trial.
"I want justice to be served," Harvey said. "I want him (Strickland) to know he can't just do this and get away with it."