The following is the full text of the new blood video, sent to me via a blast email this morning. I will post it one page at a time, as I am not sure what the character number limit is for one post.
Full Text of New Blood Video
by grey matters 19 Replies latest watchtower medical
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grey matters
NO BLOOD
Medicine Meets
the ChallengeNarrator: Dorothy McPhee has a life-threatening
medical problem. An artery that could burst at any
time.—"The normal way of doing this operation is,
generally through the abdomen, a long vertical
incision . . . "
Leslie is a young girl with a serious spinal
deformity.—"The patient is a Jehovah's Witness, and
in a procedure of this magnitude, it's unavoidable
that some blood loss will occur.
Both patients need surgery, yet, both patients have
religious beliefs that preclude their accepting a
blood transfusion. Medical science is now providing
doctors with alternative strategies to treat
successfully patients who, for various reasons avoid
blood transfusions. These new strategies may soon
benefit all patients.
NO BLOOD
Medicine Meets the ChallengeAt the dawn of the 21st century, society is becoming
increasingly diverse. People everywhere are being
exposed to different languages, customs, cultures,
and religious beliefs. Adapting to these differences
is a challenge to all strata of human society. It is
a singular challenge for the medical community.
Prof. Timothy W. Harding: "We're living in a
pluralistic society, and the doctor has one set of
values. But, he or she will meet patients who have
their own values and their own position about certain
issues."
Eileen Yost, R.N: "There's a lot of different
cultures out there, and they have entities specific
to their own cultures, that we as health-care workers
need to understand."
Prof. Oliver Guillod: "I think the duty of physicians
is not simply to preserve life, but the first and
foremost duty of physicians is to respect the
patient."
Narrator: In the past the medical profession found it
difficult, at times, to respect the health care need
of one religious group, in particular—Jehovah's
Witnesses. This was because of their avoidance of
blood transfusions.
Alexis: "That was the easiest decision, because there
was. . . under no circumstances would I accept blood.
. . "
Jessica: "One thing I heard; he said: 'blood
transfusion,' and immediately I said: 'No! No!' . . .
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Wayne: "I just couldn't live with myself if I turned
my back on my beliefs, and my God, and . . . I wasn't
going to accept a blood transfusion."
Narrator: Their abstaining from blood transfusions
was often misunderstood by the public.
Prof. Roland Hetzer: "There was certainly a time,
years back, when Jehovah's Witnesses were looked at
by physicians, and especially surgeons, in a negative
way."
Jamie Pollard, R.N.: "I think that before I ever met
a Jehovah's Witness, I had a certain mind-set, that
they were maybe a religious fanatic-type person."
Prof. Charles H. Baron: "Part of it, I'm sure, is
prejudice, about a religious sect, which the
physician, or the judge, or the lawyer, . . . about
which they may know next to nothing."
Gene Smalley—JW spokesman: "Á lot of people nowadays
have heard of dangers, or diseases, that might be
contracted from blood and blood transfusions. But
frankly, for Jehovah's Witnesses, central to their
avoiding blood transfusions, is because the Bible
highlights the preciousness of blood."
Eugene Rosam—JW spokesman: "It's a very clear
statement, by the way. It isn't something that
takes a lot of theological study to determine, or
work out. It says very plainly in the Christian
scriptures:
"Abstain . . . from Blood."—Acts 15:20.Prof. Charles H. Baron: "From the point of view of
someone who is not a believer, it seems an irrational
act."
Prof. Edward Keyserlingk: "For some people, it seems
to be anti-medicine. It seems to be, somehow, putting
the patient in jeopardy."
Diane Mitchell C.C.M.: "I think that some of us,
myself included, was under the impression that maybe
Jehovah's Witnesses didn't want the best medical
treatment, that they were sort of against medical
care."
Alec: "There's no question, it mattered to me whether
she lived or died. I brought her to the hospital in
the first place, to help her recover."
Cynthia: "I didn't want her to die, and I don't think
anybody wants that to happen."
Dr. Mark E. Boyd: "It's not some sort of suicide
pact that they want to enter into with you. They want
to live, they want to have good health care, and I
think that you can work with them."
Diane Mitchell, C.C.M.: "I realized that they wanted
the best medical health care, but they just wanted it
without blood."
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Prof. Edward Keyserlingk: "I think the effort has to
be made to remove the perception that Jehovah's
Witnesses are somehow in a category by themselves."
Dr. Aryeh Shander: "Clearly, you can point to many
religions, they all have one issue or another, with
which you may or may not agree, but that's not the
issue."
Dr. Peter Carmel: "If this is a religious precept,
this is not illogical stubbornness. This is a
religious belief. And just as I respect the religious
beliefs of many other religions, I think I have to
respect that."
THE RIGHT TO CHOOSE TREATMENT
David C. Day, Q.C.: "All patients, as a general rule,
have the right to receive treatment or to refuse to
receive that treatment, after they've had full, open,
and candid discussion with the treating physician.
Prof. Oliver Guillod: "I believe that the basic
element of patient's rights is the right of self-
determination. That is, the right of any patient to
decide what shall be done to his or her own body."
Narrator: Patients' rights not withstanding, some
have claimed that declining, what they say, is 'life
-saving medical treatment,' is irrational.
Prof. Timothy W. Harding: "It's wrong to equate a
refusal of treatment with suicide, which is a
conscious choice to end one's life."
Prof. Edward Keyserlingk: "There is always a
legitimate question about a patient's competence. But
just the mere refusal of blood, in itself, is not any
kind of such indication."
Dr. Stephen M. Cohn: "I don't believe that refusal of
treatment is irresponsible or irrational. I think
that just because one person chooses to not to take
this pill, or that fluid, this kind of solution, is
their own personal choice."
Dr. Nicholas Namais: "We have patients who say that
they don't want to be on a mechanical ventilator,
they don't want a breathing tube."
Dr. Mark E. Boyd: "It's an everyday even, for a
patient who has a malignancy or cancer, to refuse
some treatment of other. They don't want to have
chemotherapy, they don't want to have radical
surgery, so the idea that patient's refuse treatment,
is something that I work with, not take it . . . I
don't take it as a personal insult."
Narrator: These facts are often obscured by news
stories claiming that someone died because he refused
a blood transfusion.
Dr. Aryeh Shander: "To say that one has died because
of refusal of blood, I think is a very general
misleading statement."
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Dr. Mark E. Boyd: "That's an oversimplification of
the . . . of the tragic event."
Dr. Peter Carmel: "It's rarely, if ever, the case
that a patient refused a blood transfusion and
therefore died."
Dr. Aryeh Shander: "People die because of either a
medical disease, or a consequence of trauma, or
surgery where there has been complications."
Dr. Hooshang Bolooki: "I can tell you I have done
over 200 Jehovah's Witness patients. I have never
lost a patient because I could not give the patient
blood."
Narrator: Why then does blood transfusion remain the
standard treatment for serious blood loss?
Dr. Peter Carmel: "I think that physicians have been
brought up with the idea that blood is the 'gift of
life,' and that inherently, blood is good for you."
Dr. Avroy Fanaroff: "The refusal to accept a blood
transfusion bothers and concerns many physicians
because they're worried that without the transfusion,
the well-being of the patient is jeopardized."
Narrator: To appreciate fully why physicians feel
this way, one needs to understand a little about
blood and why transfusions are given.
THE FLUID OF LIFE—BLOOD
Blood circulates through the body by means of an
amazingly intricate system of conduits called veins
and arteries. Arteries carry oxygenated blood away
from the heart, eventually branching into tiny
vessels called capillaries. These deliver the oxygen
-rich red blood cells to every part of the body.
Nutrients and oxygen are exchanged for carbon dioxide
and other wastes at the cellular level. Veins then
transport the oxygen-depleted blood back to the heart
which pumps it to the lungs. There the carbon dioxide
is exchanged for oxygen and the cycle begins anew.
This cycle is absolutely essential to life.
Dr. Nicholas Namais: "If there's no blood to bring
the oxygen to the cells, the cell dies—the body dies!
Narrator: When someone suffers severe blood loss,
Doctors have two urgent priorities.
Dr, Edwin A. Deitch: "The most critical immediate
need is to stop the bleeding."
Dr. Nicholas Namais: "Everything takes 'backseat' to
stopping the bleeding."
Dr. Stephen M. Cohn: "And number 2, is to restore
the volume within your system."
Narrator: "What can happen when a patient looses too
much blood volume
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Dr, Edwin A. Deitch: "Then you don't deliver blood to
the brain or the other organs and a person can die."
Dr. Nicholas Namais: "And what you need to do is
restore volume, restore profusion, and restore
oxygenation."
Dr, Edwin A. Deitch: "A way of correcting that
decrease in blood volume is by giving other fluids
intravenously. This can be done using any one of a
number of fluid types, and doesn't necessarily
require blood."
CHANGING ATTITUDES
Narrator: Increasing numbers of patients are opting
to avoid blood transfusions for personal reasons.
Prof. Lawrence T. Goodnough: "If you've ever had a
conversation with a patient the night before surgery,
and you were to ask them if they had a preference,
would they prefer to avoid a blood transfusion, the
answer is always, 'Yes.'"
Prof. Roland Hetzer: "I would say that today, at
least 80 percent of the patients, would strongly
favor not to have blood transfusions."
Prof. Francesco Mercuriali: "Blood transfusion,
traditionally considered a normal adjunct to surgery,
presently is considered something that has to be
avoided."
Dr. Willem de Groot: "There are real risks as far as
transfusions are concerned."
Dr. Gerard A. Kaiser: "There are concerns about blood
bore pathogens, and certainly the concern about
AIDS."
Dr. Richard K. Spence: "It's a biological product. It
can have diseases, etc. We screen for most of them,
but there are some there we just don't know about."
Prof. Neil Blumberg: "We've certainly seen some
horrendous new diseases in the form of HIV come along
that probably didn't exist in the past. Whether the
next disease will come along in ten weeks, ten years,
or a hundred years, nobody can say."
Dr. Concha Lewand: "We have Hepatitis C, Hepatitis B,
transmitted, and the social costs of that are very
high."
Dr. Todd K. Rosengart: "There are transfusion
reactions that occur, they are very rare, but they
can potentially dangerous or even life-threatening."
Dr. Richard K. Spence: "We could mix the blood up and
cause a catastrophe. Patients have died and do die
from getting the wrong blood."
Prof. Donat R. Spahn: "It is interesting to realize
now, that during the late 90s or early 2000s that the
blood transfusion, to a certain extent, does not do
what we always used blood transfusions for."
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Prof. Neil Blumberg: "We've become persuaded, over
the years, that many of the bad things that happen to
patients after surgery, are in fact, not bad luck,
are not a lack of surgical skills, but are in fact,
the complications of transfusions."
ALTERNATIVE STRATEGIES
Narrator: These concerns have spurred a wide range of
alternative strategies, treatments that are
acceptable to many of Jehovah's Witnesses, an others
who also choose to avoid blood transfusions.
Alternative strategies can be grouped around four
organizing principles.
[Minimize Blood Loss;
Conserve Red Blood Cells;
Stimulate Blood Production;
Recover Lost Blood]Prof. Donat R. Spahn: "That involves an aesthetic
factor, it involves the use of certain substances,
and certainly involves also the surgical technique."
MINIMIZE BLOOD LOSS
Prof. Johannes Scheele: "The most important technique
to control bleeding is to avoid bleeding. . . . so
that with less bleeding during surgery, the result of
that is better, and the outcome is more likely to be
smoother."
Dr. Richard K. Spence: "Careful surgery means
preventing blood loss. Age is no factor. We have
operated on newborns, we have operated on people in
their 90s."
Dr. Mark E. Boyd: "The surgeon who operates without
losing large amounts of blood, is almost invariably a
good and careful surgeon. One who loses large amounts
of blood is most often, the reverse."
Narrator: A variety of instruments are now available
to help surgeons minimize bleeding.
Dr. Nicholas Namais: "There are strategies for inter
-operatively using electrocautery instead of
scalpels."
Prof. Johannes Scheele: "If there is some bleeding
persisting, there are coagulation techniques. The
best of which is, at the moment, Argon-Beam
Coagulator."
Narrator: There are non-invasive tools that enable
the surgeon to see inside the body, minimizing
surgical incisions.
Dr. Richard K. Spence: "You can use drugs, topical
application of different products that will help
prevent blood loss."
Prof. Roland Hetzer: "We have now, several methods
available, like the 'fibrin glue' . . .
Narrator: Fibrin glue made from blood fractions
stimulates coagulation upon contact.
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Prof. Johannes Scheele: "The fibrin tissue adhesive
is certainly very, very useful because it does not
harm the tissue."
Dr. Nicholas Namais: "In a Jehovah's Witness, where
the blood loss is so, so, so critical, I think you
have to be very, extremely meticulous not to lose
even a drop of blood."
CONSERVE RED BLOOD CELLS
Dr. Peter Carmel: "There are new technologies of
hemodilution and reinfusion, that make the operation
easier, and which are acceptable to people who have a
religious precept against blood transfusion."
Dr. Linda Shehling: "The principles of hemodilution,
in terms of reduction of blood loss, are really quite
simple."
Dr. Concha Lewand: "Basically, we do the closed
circuit on the patient. We draw off blood from the
patient—keep it in contact with the patient—and
substitute it with fluids."
Prof. Donat R. Spahn: "That results in a diluted
blood, and therefore, the patient looses only diluted
blood, rather than native, or concentrated blood."
Dr. Linda Shehling: "When the patient bleeds
interoperatively, the red cell lose is less."
Dr. Herbert Dardik: "It would be like taking a quart
of milk and turning it. . . or adding water so that
you have 3 gallons of it now, but the original quart
is still in there. But if you were to spill it into
something, it would be a lot of water—and a fraction
of the milk—then at the end, you get rid of the
water, and then you're back where you started."
Dr. Aryeh Shander: "And we use that routinely in
this institution, especially for those patients who
have anticipated significant blood loss."
Dr. Concha Lewand: "I think that's nowadays,
besides—I think that for Jehovah's Witnesses it’s a
pretty good standard of care for large volume loss
surgery."
RECOVER LOST BLOOD
Dr. Richard K. Spence: "If we do loose blood, this
is the kind of case where we'll use a cell saver. We
will suction up any blood that's lost—we wash it, we
clean it, we process it, we filter it—and then we'll
give it back to you."
Prof. Donat R. Spahn: "Cell salvage is a very
important technique, because when you use cell
salvage, the blood lost by the surgeon is not lost
for the patient."
Prof. Johannes Scheele: "In any trauma patient with a
significant blood loss, I would, always, prepare the
cell saver system."
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STIMULATE BLOOD PRODUCTION
Narrator: "A key element in stimulating the body's
ability to replenish its own blood supply is a
hormone called erythropoetin.
Dr. Blair Siefert: "Erythropoetin is a natural
substance. It is formed in the kidneys, other organs
as well, but primarily the kidney, to help our bone
marrows to form the red blood cells that are going to
carry our oxygen."
Narrator: Blood cell production takes place primarily
in the sternum, the ribs, the vertebra, and the
pelvis. Recombinant Erythropoetin boosts the body's
natural production of red blood cells.
Dr. Nicholas Namais: "So if I know the patient is
going to be in the hospital a long time, I may start
them on some recombinant erythropoetin so they can
start building up their own blood storage."
Prof. Francesco Mercuriali: "This can be a very cost
effective strategy, to reuse the utilization of
allergenic blood transfusion."
Dr. Richard K. Spence: "One of the most exciting
things about this whole field, is that the majority
of things that we talk about is within the reach of
physicians and hospitals around the world."
Dr. Peter Carmel: "There are now available,
techniques in almost every sub-specialty of surgery
and medicine that allow bloodless treatment."
Major Spry—JW spokesman: "Alternatives, like any
other therapy, are not necessarily, free from risk.
So a patient, a Witness patient in particular, may
want to become informed about the benefits and the
risks that are associated with any particular
treatment."
Dr, Edwin A. Deitch: "They should be a prudent
consumer."
Narrator: How effective are these alternative
strategies in helping doctors treat patients who do
not want blood transfusions?
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CASE HISTORIES
Leslie Lacks had just begun elementary school when it
became apparent that she had a degenerating spinal
deformity. Doctors diagnosed Leslie's condition as a
severe form of Scoliosis.
Dr. Tarek Mardam-Bey: "Scoliosis is a curvature of
the spine, so we have to correct it as much as the
spine's flexibility allows us."
Narrator: After a brace failed to correct her
condition, doctors recommended an extensive surgical
procedure.
Dr. Tarek Mardam-Bey: "We used essentially a series
of hooks and metal rods made out of stainless steel,
that are implanted in the patient's back, and are
used essentially to distract the spine and achieve
alignment."
Narrator: The Lacks wanted the surgery performed
without a blood transfusion. So they found a surgical
team that had experience using bloodless techniques.
Before the surgery, Leslie's doctors boosted her
blood through the use of iron and recombinant
erythropoetin.
Dr. Tarek Mardam-Bey: "So it was essential that we do
the surgery without excessive blood loss. The way
that we were able to achieve this is using two
techniques basically. One of them is called the cell
saver. The other technique we used is called
hemodilution. It is safer in that, it's the patient's
own blood and its has remained in continuous
circulation with the patient, so there's no chance
for contamination or blood transmitted diseases.
Narrator: The surgery was a success, and no blood
transfusion was administered! Within days, Leslie was
up and walking.
Bobbie Lacks: "She's so happy. She can completely
stand, now she says, 'Mommy, I'm almost as tall as
you now!'
Narrator: Although Leslie will have to wear a brace
for a while—doctors are confident she will lead a
normal life.
Leslie Lacks: "I'd like to skate, and skateboard,
maybe learn how to snowboard, . . .stuff like that!"
Narrator: Sometimes alternative strategies involve
new surgical techniques to reduce blood loss in
patients that don't want a transfusion. 75 year-old
Dorothy McPhee suffered an abdominal aortic aneurysm,
a life threatening condition, that traditionally
requires extensive surgery.
Dr. Herbert Dardik: "The normal way of doing this
operation is, generally through the abdomen, a long
vertical incision from the lower chest down to the
pubic area, having to work around and behind the
entire intestinal tract. Hospitalization ranging—at
best, days, 4 or 5 days, to averaging a week or even
more—presuming that there are no operative
complications."
Narrator: Since Dorothy is one of Jehovah's
Witnesses, her physicians used a surgical technique
that minimizes bleeding.
Dr. Herbert Dardik: "What we did today is called
endovascular aortic surgery. Essentially that's;
Endo—meaning we are working within the artery.
Through that artery we place our catheters, our
wires, all the instruments that we steal right up to
where the aneurysm is. And then we can visualize the
aneurysm by doing coroscopy, x-ray technology.
Narrator: Dorothy's doctors inserted a wire mesh
called a stint, and were thus able to repair her
aorta without a large surgical incision that would
have caused a lot of bleeding.
Dr. Herbert Dardik: "A small incision through the
groin, all the manipulation through that—a virtually
pain-free, complication-free, in post-operative, of
course—home, generally in 24-hours—so, everybody's a
winner!
Dorothy McPhee: "I feel fine! I never would have
believed it, but I do!"
Narrator: Two days after her surgery, Dorothy was
sent home. She recovered nicely!