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15-year-olds?
When I read responses such as those from participant Adamah on this thread it amazes me the wrongheadedness folks can let themselves be entrapped.
Adamah thinks it important to my conclusions that 15-year olds were included in the Beliaev study because 15-year olds are, under New Zealand law, unable to refuse treatment when refusal may threaten their life or health. This complaint from Adamah is nonsense. Here’s why:
- For 15-year olds refusing blood to be a factor to increasing mortality in the Beliaev study means a 15-year-old would have had to die the result of refusing blood.
According to Adamah, that can’t be the case, yet that is the only way including a 15-year-old in the study could inflate mortality!
What Adamah apparently fails to consider is that otherwise healthy 15-year-olds can and do recover from an Hb level at 8 dL without red cell transfusion and Hb level at or below 8 dL was the threshold for inclusion in Beliaev’s study.
There is documented instances of minors in New Zealand and elsewhere suffering Hb level at or lower than 8 dL with clinicians willing to honor requests of no red cell transfusion content to instead closely monitor for symptoms of inadequate tissue oxygenation. In these instances red cells were transfused against a patients/parents wish when symptoms became evident. Otherwise the patient was not given red cell transfusion with no adverse outcome the result.
If we categorically assume that in New Zealand 15-year olds are unable to die the result of refusing blood then we are left with no alternative than no death of a 15-year-old in Beliaev’s study was the result of a 15-year-old refusing blood. Hence nothing in my extrapolation is inflated the result of 15-year-olds being in Beliaev’s study.
Marvin Shilmer