I hope I'm not duplicating what someone else has already posted ...
Here is a recording of the Richard Bacon show on BBC Radio 5 Live dealing with Emma Gough's death (edited to remove news and sports, etc):
http://www.sendspace.com/file/d6v687
(Note that despite editing, the file is still 42.1 Mb.)
This is a transcript of the section of the program dealing with JWs:
[RB] At very nearly eight minutes past ten, let’s get on to our main topic then. Now tonight I’m asking if religion should stay out of medicine. A Jehovah’s Witness has died after giving birth to twins because she reportedly refused to have a blood transfusion. Twenty-two-year-old Emma Gough believed taking blood would be a sin. So in cases like these, should doctors’ be allowed to step in?
[Phone call with Peter]
Peter’s in Belfast. Hello Peter, good evening. What do you make of this?
[Peter] From my point of view, I’m a doctor and in this sort of situation we have to look at things in terms of our own ethical principles. There are three main principles I would like to talk about. The first would be, the patient’s autonomy has to be adhered to, i.e. what the patient wishes, is the foremost of our medical concerns.
[RB] Peter, if you were confronted with this situation – I assume you did read about Emma Gough – and you knew she could be saved, what would be your instinct as a doctor, even though you knew she didn’t want a blood transfusion?
[Peter] If you’d let me just finish, Richard, I was going to go on to say there are other ethical principles that we use such as beneficence, which means, first to do good for the patient at all times, and then non-malificence, which is first to do no harm at all times. So you can see where it comes from, you need to strike a balance somewhere and I have encountered similar situations in my hospital career (I’m now a GP). But discussing it with my consultant colleagues at the time when a Jehovah’s Witness did come in and say that they did not require any human blood products to be used in their care at any time no matter what the situation. It became very difficult and there were often discussions about what should we do and often sometimes a lot of hairy moments when patients were in extreme …
[RB] Peter, let me ask you, in your opinion, should a doctor be able to override a patient’s wishes?
[Peter] No.
[RB] No. Okay. Thanks for your call, Peter. Peter is a doctor from Belfast.
[Interview with Ernie Reid]
Ernie Reid joins me; he’s a Jehovah’s Witness and a member of the North London Hospital Liaison Committee. Ernie, hello.
[ER] Hello, Richard.
[RB] Now, terribly sad story, this, just so we can all understand the basis of this discussion, can you explain why it is that your faith does not allow blood transfusions?
[ER] Yes, I agree with you it’s a very sad situation and I think that’s the primary thing we should keep in mind in any discussion this evening: the family and the little ones involved. But as far as we’re concerned as Christians, this is not a medical question, Richard, it’s a religious question, from our point of view. We have grown in faith in God and in the Bible as his provided guidance to us so we don’t pick and choose what we follow, we accept all of God’s Word, the Bible …
[RB] When you say “the Bible,” are you referring to the Old Testament?
[ER] No, we’re referring to the complete Bible. There are principles in that book, or laws that God gives us, then we must follow them, that’s the way it is, even when, at times, it may work to our disadvantage. And one of those, of course, is that, quite clearly, God gave instructions starting off with Noah, and through the Jewish Mosaic Law, right through to the first Christian congregation, that they should “abstain from blood.”
[RB] Obviously the Bible doesn’t mention blood transfusions because they hadn’t been heard of. It’s not actually in there, is it?
[ER] No, there’s no reference to blood transfusions; but then there’s no reference to smoking cigarettes or tobacco, either.
[RB] [Exasperated sigh]
So, you take the word of the Bible literally?
[ER] Not literally, because many parts of the Bible are, as you know, couched in symbolic and graphic terms, but we take the principles of the Bible absolutely seriously and we are determined to put them into practice in our lives. In all my experience as a member of the North London HLC it’s a very, very rare occurrence for someone to lose their lives, whether or not it was as the result of not taking blood or some other reason, it’s always a very sad thing, but I have to say in my experience of almost sixteen years now of visiting hospitals and dealing with these cases, it’s a very, very rare occurrence …
[RB] It may well be rare, but in this particular case it is reported that this particular lady, Emma Gough, could have been saved. Her life could have been saved if she’d had a blood transfusion after complications set in. Is it not terribly sad ... and does it not strike you as odd, in fact, that somebody who’s just given birth could have been saved and that those two children will now grow up without a mother and that this decision was based entirely on faith?
[ER] Not as strange at all, Richard, because that’s what faith is. You don’t have a faith while everything is fine and going easily; you have a faith through thick and thin. You stick to your faith even when it’s to your disadvantage, physically speaking.
[RB] Can you tell me, if she had accepted a blood transfusion, what would have happened then, apart from her life being saved? In the view of Jehovah’s Witnesses, what would that have meant?
[ER] Well … what would it have meant? I’m not quite sure I understand your question.
[RB] It would have been a sin of some sort, would it, if she had taken the blood transfusion, which is against your wishes … ?
[ER] No, the use of the word ‘sin’ is a little bit of a red herring in some ways because all of us are sinners and all of us commit sins every day of our lives. So you have to look at it from the point of view of young Emma. She had made a decision based on a very careful examination of God’s Word the Bible …
[RB] But what, she had been taught by the elders of the Jehovah’s Witness church, they had told her, they had made it very clear to her that’s one of the beliefs, one of the practises, one of the rules of the …
[ER] No, that’s not how it works, Richard, we come to these conclusions based on a careful, and sometimes extended, study of God’s Word the Bible … and each one then has to make their own decisions based on what they’ve learned.
[RB] So, growing up as a Jehovah’s Witness, no one tells you, no one explains to you, that you shouldn’t have a blood transfusion, that that is in effect a sin because the Bible says you shouldn’t do it? All Jehovah’s Witnesses independently read the Bible and decide that they shouldn’t have blood transfusions?
[ER] Yes, all of Jehovah’s Witnesses … in fact, you can’t become one of Jehovah’s Witnesses until you’ve done that, until you’ve made a careful, and prayerful …
[RB] No one tells you, no elder within the church, ever tells anybody they shouldn’t have a blood transfusion?
[ER] No, no one can tell you what you should, or shouldn’t, do, Richard. Each one must make their own decision.
[RB] Okay, I just struggle with it. I find it hard to believe, if I’m honest. But I want to ask other people to phone … this is never explained to you? If you bridge what is explicitly requested of you in the Bible, that is not to, I think the Bible talks about, effectively, the consumption of blood, doesn’t it, and that’s why you translate that into relating to transfusions. But if someone breaches what’s written in the Bible, then, effectively, that is a sin, isn’t it? That’s what you’re talking about?
[ER] Yes, we all fall short in so many ways on a daily basis and those who put their confidence and trust in the Bible, if they fail to fulfil that, for whatever reason, clearly we’re obviously sinners, all of us are.
[RB] And if someone who needs a blood transfusion decides to have one, who is a Jehovah’s Witness, and their life is saved, what happens to them then?
[ER] From the point of view of the congregation?
[RB] From the point of view of the congregation.
[ER] Well, nothing happens really, because that individual has had the freedom of choice at any point in his or her life to decide or not to decide what to do …
[RB] Do you still accept them as a Jehovah’s Witness if they have accepted a blood transfusion?
[ER] If they had accepted a blood transfusion which they had prior to that determined was wrong in God’s sight then clearly they were breaching their own faith, so we would … It’s a bit like when Jesus was on the earth, the Pharisees asked him why do you spend your time with the poor and the sick and Jesus gave a very simple answer. He said, well, healthy people don’t need a doctor. So if someone has had a strong faith and suddenly that faith collapses and they go against that faith, clearly we would give them as much, if not more assistance and loving care than we would to one another, in many cases …
[RB] But they would no longer be recognised as being a Jehovah’s Witness if they had accepted a blood transfusion?
[ER] If they accept a blood transfusion then they are, by that decision, saying, well, I no longer want to be one of Jehovah’s Witnesses.
[RB] So they would not be recognised as one. So at that point where the patient ticks that form as they go into hospital, saying I don’t want to have a blood transfusion in the event of complications, that threat hangs over them, that they will effectively be rejected by the congregation, by the church?
[ER] No, it’s not a threat, it’s a decision they have to make, each one makes their decision, each Witness …
[RB] But it’s a very clear choice, isn’t it? It’s either take the blood transfusion and be thrown out of the church, or don’t take the blood transfusion and die? There’s only two options. There’s no other option …
[ER] Well, there are other options and if you have the time you can explore what these options are. For example, in the case of patients who are offered a blood transfusion, there are alternatives to that which would enable their consciences to be unsullied. And I like what your doctor said earlier in the program, he said the patient’s autonomy must always be respected.
[RB] Did Emma Gough do the right thing?
[ER] From the point of view of God’s Word the Bible, yes, she did.
[RB] So God would be satisfied that these two children … she was faced with that decision, and you think God would be satisfied that she had done the right thing, in effect? It wasn’t her choice to die, but she had ticked the box which said that in the event of complications I’ll [not] take the blood transfusion. And God would think that was the right thing, even though now it means that these two children, these twins, will grow up without a mother? That’s your view?
[ER] No, you’re putting words in my mouth which I don’t think you want to do. But can I ask you a question, Richard? Do you believe in a resurrection from the dead?
[RB] I’m not making this about me. We do a lot of debates about religion and I have to remain impartial.
[ER] Do you think Emma Gough believed in a resurrection from the dead?
[RB] [Sighs]
It’s not for me to speculate.
[ER] Well, Jehovah’s Witnesses have this strong faith and I think if you look at the life of Jesus Christ, Jesus Christ didn’t have to die either, he sacrificed his life. In fact, there you have the only proper use of blood because the life blood of Jesus Christ is now available for all those who wish to exercise faith in him …
[RB] But you do see my point, Ernie, those two children are going to grow up without a mother because of this rule, this obligation? I perceive it, in effect, as a threat, because if she had taken a blood transfusion she would no longer have been in the church.
[ER] No, Jehovah’s Witnesses don’t see that as a threat because our faith is strong and that is a decision we have taken in a cool moment of meditation and prayer, as I’m sure this young lady did also. So, the consequences of our decisions, we must always be prepared to accept. There’s no guarantee that if other circumstances had prevailed that Emma had died, as I said to you earlier, it’s a very rare occurrence anyway, but, when it comes to it, no one who has faith in God and who exercises that faith during their lives, would want to go against it for some short-term benefit. They would want to stick to their belief in God and their faith in his promises even though it might result, possibly, in their death.
[Phone call with Graham]
[RB] I’m going to put a caller on. This is Ernie Reid, he’s a Jehovah’s Witness, a member of the North London Jehovah’s Witness Hospital Liaison Committee. The question tonight really is this, should a doctor be able to override a patient’s wishes? Graham is in Wanstead, in Greater London. Hello Graham.
[Graham] Good evening.
[RB] Good evening to you. If you’ve been listening to our discussion, tell us what you make of it.
[Graham] Quite frankly, Richard, I’m absolutely appalled at what I’ve been hearing. I’m quite stunned by it. My point really is that I feel the husband had the opportunity to save his wife and he clearly didn’t save his wife, regardless of his wife’s wishes. I cannot believe that given the choice of death and given the choice of holding her children in her arms the day after, that anybody would not have chosen the latter rather than the former. I really do believe that the husband should be held legally accountable for this and I just cannot imagine what the doctors and nurses were going through when they had to sit aside and watch a young woman, in the prime of life, having given birth, die when they could have saved her. I think this is such a terrible, terrible thing. And to hear your guest go on and on about this … he used the term “short-term benefit.” That meant “short-term benefit” she had life. “Short-term benefit” he meant she had life and not death. It’s incredible to me.
[Interview with Ernie Reid]
[RB] Ernie Reid, Graham there mentioning the husband; the medics did speak to her husband and asked him to, effectively, overrule her, to give her this blood transfusion, and he said No. So, in your eyes Ernie, he did the right thing?
[ER] Well, I think you have to … I mean, in my eyes, the husband is not in a position to overrule the conscientious decision of his wife. I think you would all agree on that, wouldn’t you?
[RB] Well, we’ve got two more guests coming on in a moment, Ernie, we’ll talk about that very point at some length. I’m going to put a few more calls on. But as far as you’re concerned, Ernie, you think God would think the husband had made the right decision?
[ER] Well, you’re asking me for my opinion on what God would think and that’s a big question …
[RB] It’s not, you … presume to know a lot of what God thinks!
[ER] We all know what God thinks if we read the Word of God, that’s where he explains his point of view. It’s quite plain for anyone who reads the Bible that God has spoken on this matter of blood through all the ages …
[RB] And you can be absolutely certain that that particular part of the Bible is the Word of God because the Bible was put together by a number of people, on some occasions many hundreds of years after the event; and you can be absolutely certain that that part of the Bible, that is the Word of God, they are the express wishes of God? And further, that they actually do relate to blood transfusions which hadn’t even been invented?
[ER] Yes, we accept the entire Bible as the Word of God.
[RB] Do you think adulterers should be stoned to death?
[ER] Why would I want anyone to be stoned to death?
[RB] It’s in the Bible.
[ER] Yes, of course it’s in the Bible, but it also says in the Bible that we should offer sacrifices on an altar at a temple, but we don’t do that any more.
[RB] So why do you believe that the blood part is the express wish, the Word of God? Why stick so doggedly to that and set aside things such as adulterers being stoned to death?
[ER] No, we don’t set aside anything that’s in the Bible, we can learn from all of those examples God’s point of view …
[RB] But you’re picking and choosing!
[ER] Not really, because I think I mentioned in the early part of this discussion the Bible repeats the viewpoint of God on the use or misuse of blood right through the Bible, from the very first beginning when he spoke to Noah, and then later it was embodied into the Mosaic Law which was in operation for many, many years and which today is still being followed by the Jewish nation, and then it was repeated to the early Christian congregation in the book of Acts, chapter 15, where one of the letters sent by the governing body of that first century Christian congregation quite specifically repeated the viewpoint that God had given to Noah and to Moses: “abstain from blood.” We hold to that still.
[RB] You’re still picking and choosing!
[ER] Well, I think we may agree to differ on that.
[RB] [Exasperated sigh]
Okay.
[Phone call with John]
Let’s talk to John in Thetford in Norfolk. Hello John.
[John] Hi.
[RB] Good evening to you. Should a doctor be able to override a patient’s wishes?
[John] Absolutely not. However, I do actually think that this young lady was wrong, as is your other guest wrong in their interpretation. In the Mosaic Law he mentioned, I just picked a small passage which is Deuteronomy 12, it says, “But be sure you do not eat the blood because the blood is life. You must not eat the blood but pour it out on the ground.” And this is the ironic thing: “And do not eat it so that it may go well with you and your children after you, because you will do what is right in the eyes of the Lord.” That is speaking specifically about the consumption of blood with meat as food.
[Interview with Ernie Reid]
[RB] Ernie Reid, I don’t want to get too much into a detailed theological discussion, but do you want to respond to that part?
[ER] Well yes, if it was wrong, if God was telling the nation of Israel that it was wrong to eat animal blood, then it certainly would be incorrect to drink or eat or ingest human blood; human blood, of course, being the pattern that God used to represent the sacrifice of Jesus Christ, as well as the animal blood. How you take it into your body, whether it’s through your mouth or some other means, is not the issue. The fact is that you would “abstain” from it. I don’t think a doctor would be very pleased if a drug addict was told that he had to abstain, or not eat, cocaine (or whatever the drug that was causing him the problem), if he overcame that by having it directly injected into his veins. The method of entry is not the question here: the principle is that blood, in God’s eyes, should not be used in this way.
[RB] [Sigh]
[Phone call with Yvette]
Okay. Alright Ernie. Let’s take just one more call before we let you go. This is Yvette in Newhaven in East Sussex. Good evening, Yvette.
[Yvette] Hello, Richard.
[RB] You are a Jehovah’s Witness yourself?
[Yvette] Yes, I am indeed.
[RB] This was an absolutely tragic case, I don’t know if you’ve read the reports today, but it’s heartbreaking. Do you think that Emma Gough made the right decision? Do you think that when the medics appealed to her husband, Anthony, to override her wishes, do you think he made the right decision?
[Yvette] I think he made absolutely the correct decision. You know, we’re very, very carefully … We have so many talks on the blood issue, it’s a major part of our belief, the sanctity of blood in the Bible, from start to finish. Even with Cain, right at the start, he took the blood of his brother and he was cursed and God said the ground will be cursed and do you know …
[RB] [Sigh]
Yvette, Yvette, okay, but …
[Yvette] No, I think he did the right thing because of that, because you can’t leave these things out, you can’t leave the first things out, Richard, because it’s a continuity, the Bible …
[RB] No, but Yvette, Yvette, you’re picking and choosing, as I explained to Ernie, there’s all sorts of stuff in the Bible that you wouldn’t follow and you’re choosing to follow this …
[Yvette] No, we do follow them …
[RB] You heard me mention some examples a couple of minutes ago that you don’t follow …
[Yvette] No I didn’t! No! What were they?
[RB] Adulterers should be stoned to death.
[Yvette] No, not stoned to death, but it’s a terrible thing, it ruins the family, you have to know the principles behind it.
[RB] Yvette, one of the Psalms supposedly written by David – I actually went to church yesterday – and one of the Psalms read out in church suggested that Christians should kill unbelievers. It’s in the Bible.
[Yvette] Yea, but that was in the early scriptures, and there was a special purpose …
[RB] Picking and choosing, though, Yvette, it’s picking and choosing!
[Yvette] No, Richard, look, with deep respect you’re ignorant of the Bible from start to finish – in the nicest way, and I mean that …
[RB] [Laughs]
It's all right …
[Yvette] I do mean it very nicely. What you’ve got to realise is that we study, study, study. Now these aren’t words to us. Look, you join a club, you obey the rules, and that’s what this lovely girlie did. She took it to her death, which is her limit, just like Jesus did, he went to his death. Jesus could have chosen not to die, he only had to recant, he only had to do a few things that were required of him, act like a military leader, which the Jews wanted, but he didn’t, and …
[RB] [Sighs]
Alright, Yvette. But the Bible’s open to interpretation, that’s all I’m saying, and …
[Yvette] It isn’t really, Richard, when you really look into it, it isn’t, Richard, It honestly isn’t. It isn’t. It’s not blind faith, you know, it really isn’t blind faith, when you look into the scriptures you cannot be but convinced. You just have to do the study yourself …
[RB] Okay, I accept your point that I am ignorant of the Bible to some extent. I haven’t read it all, I’ve studied bits …
[Yvette] I don’t mean that you’re ignorant, it’s just that if you’ve studied something – and nothing that we’re allowed to do, Richard, is without full knowledge and understanding. We’re questioned before we take out vows at our baptism …
[RB] I’m going to move on now, but when you say it’s not open to interpretation, to me that means the other examples I cited aren’t open to interpretation either. But we’ll get nowhere, and I’m pleased you phoned the show.
[Interview with Ernie Reid]
Ernie Reid, we’re going to move on, and thanks for your time. Is there anything else you want to say?
[ER] No, I’d just thank you for the opportunity to listen to the comments made and we really respect everyone’s viewpoint and all we ask is that out viewpoint would also be respected.
[RB] Okay, there’s Ernie Reid, a Jehovah’s Witness and a member of the North London Jehovah’s Witness Hospital Liaison Committee.
[Interview with Timothy James]
Let me just say hello to my other two guests, we’re talking about whether a doctor should be able to override a patient’s wishes. Timothy James is Senior Lecturer in Law and Medical Ethics at Birmingham City University and Rachel Underhill is a former Jehovah’s Witness who refused a blood transfusion during the birth of her twins. Very similar story, survived to tell the tale, and is now campaigning for a change in the law. A former Jehovah’s Witness. Hello to you both. We must take the news at this point. Timothy James, just first of all, I wanted a quick response from you to what you’ve heard so far on the show.
[TJ] It’s an example of the difficulty when somebody’s fundamental beliefs are a very small minority. I should explain I’m not only what you said, I’m also a Christian and I’m also a blood donor. So clearly I don’t agree with the Jehovah’s Witnesses on this, and I’ve also studied the Bible for all my life. The difficulty is when somebody is building their entire view of reality on a fundamental belief, such as God speaks through the Bible, and you and I can see harm being done and think ‘God can’t possibly mean that.’ Do we let them make that choice or not? That’s our problem.
[RB] Let’s take the latest BBC News …
[News and sport edited out]
Our main topic tonight is this, should a doctor be able to override a patient’s wishes? The reason I’m asking this is a tragic story in the papers today. A Jehovah’s Witness died after giving birth to twins when she reportedly refused to have a blood transfusion. She was called Emma Gough, just twenty-two years old and she believed that taking blood would be a sin.
[Texts]
Here’s some of your texts on this:
“The news of the young Jehovah’s Witnesses mother’s death is very sad. Unfortunately, we can’t impose our will on anyone,” says Nick in Northern Ireland.
P. Thomas says “Refusing a blood transfusion is tantamount to suicide. Society should not permit suicide.”
Jerry says “If you’re not going to accept treatment, why go into hospital? What would have happened if the babies had needed a blood transfusion, would they have been left to die?” The answer to that actually is No, it’s different for children, we’ll come on to that.
And Mark in Bath: “I understand that Jehovah’s Witnesses have their faith but to put yourself ahead of your children seems to me to be contrary to Christian practise.”
[Interview with Rachel Underhill]
My guests this evening are Ernie Reid, a Jehovah’s Witness, he’s left now; but with me are Timothy James, a Senior Lecturer in Law and Medical Ethics at Birmingham City University, and Rachel Underhill, a former Jehovah’s Witness who, basically, Rachel, a not dissimilar story. You refused a blood transfusion during birth, you had twins as well, and it turned out okay for you, but you are now campaigning for a change in the law. Now just tell me a bit more about your story. When you went into hospital, am I right in thinking, that at that point you essentially sign a form that says that, in the event of complications, I don’t want a blood transfusion?
[RU] It was actually just before I went down for the caesarean that I had to sign the form. So you don’t actually sign anything before you go into the hospital and obviously they, the HLC, the Hospital Liaison Committee, would be called if there’s actually a problem with your operation or your labour or anything.
[RB] The HLC is a Jehovah’s Witness organisation?
[RU] It is, yea.
[RB] And their job is to advise doctors, is it?
[RU] It’s basically just to mediate between the Jehovah’s Witness people and the doctors or the consultant, and so what they do is they do everything, what they do is take the decision away from you and talk to the doctors or the consultants or nurses on your behalf. So the consultants are totally aware that this person is one of Jehovah’s Witnesses and to make sure that they’ve got the correct forms that are signed to say they’re not going to have blood. They know that they do things in the right way.
[RB] Were you born to Jehovah’s Witness parents?
[RU] Yes. That’s right. I was actually brought us as a Jehovah’s Witness from birth.
[RB] When I spoke to Ernie Reid at the beginning, I was asking him if you were taught, growing up as a Jehovah’s Witness, that it’s wrong to have a blood transfusion, and he was saying that isn’t the case, that Jehovah’s Witnesses independently read the Bible and reach that conclusion. Was that your experience?
[RU] Not at all. I can actually remember for as long as I can remember, not to have a blood transfusion …
[RB] By whom?
[RU] By the elders, by my parents, by the other congregation people around me …
[RB] So it’s a very clear rule … ?
[RU] Absolutely. There’s even books that’s actually designed for children, there’s this school one that goes into school, to say that you’re not to have a blood transfusion.
[RB] So what did you make of what Ernie Reid said?
[RU] I didn’t believe any of what he said at all. And I found the bit where he said about the blood issue’s been there right from Noah’s day, was very hard to believe, because in actual fact the Jehovah’s Witness religion only brought in the ‘no blood’ ban from 1945, when in actual fact from the 1890s medical institutes have actually been doing the blood transfusions for people who’ve got haemophilia. So why’s it suddenly come in in 1945? If it was from Noah’s days? Which is totally wrong!
[RB] Well, they cite that passage in the Bible. Why did you change your mind?
[RU] I changed my mind because I saw a lot of things going on within the religion which I really wasn’t happy with, I certainly didn’t want my children anywhere near. There’s lots of hypocritical people within the religion, I didn’t want my children anywhere near them and I certainly didn’t want my children to have the childhood that I had, the isolated childhood that I had, and also to be brought up to be in the situation that’s exactly the same as what I had, when you were dictated to by the elders as to what you do and what you don’t do.
[RB] What did your parents say to you when you turned your back on the religion?
[RU] Well, obviously, within the lines of the actual religion they actually did shun me the first year of when I did come out of the religion, because that’s what they’re told to do, because I was actually disfellowshipped from the religion, which obviously is very sad and I know now that I would never do that to my children …
[RB] From what I’ve read, and I can only go on mostly what I’ve read today – I have read bits in the past – about Jehovah’s Witnesses but, as you say, you are shunned as a former member of the church. The Jehovah’s Witnesses aren’t even allowed to go to the funerals of former Jehovah’s Witnesses …
[RU] That’s it, yea. And even to this day, four years on after coming out of the religion, I still have people who used to know me when I was in the religion and people who I was actually brought up with, ‘cos all my friends were in it; they would still turn their noses up at me and walk away from me if they saw me in Asda, for example. I still get that, four years on.
[RB] Why is that? Because you committed a sin?
[RU] Yes, because I came out of the religion and got disfellowshipped …
[RB] Is their view that God will now take a negative view of you, that you have sinned in God’s eyes? And that you’re not to be associated with?
[RU] Yes, that’s it exactly. Exactly.
[Interview with Timothy James]
[RB] Okay. We’re talking about whether or not doctors should be able to override a patient’s wishes. Timothy James is a Senior Lecturer in Law and Medical Ethics. Timothy, you set out your stall a little bit earlier, but let me just ask you again whether or not you think a doctor should be able to override a patient’s wishes?
[TJ] On balance, I don’t think a doctor should be able to override the wishes of a competent adult patient, and that is the law as we have it and I think that’s probably about right.
[RB] The law as we have it is different for children. Can you explain that, Timothy?
[TJ] Because of the fact that, certainly up to the age of sixteen, and even up to the age of eighteen, parents have some rights to give or withhold consent on behalf of their children, if it is feared the parent isn’t doing that in a right way, the state, through a judge, steps in and takes that decision on their behalf, right up until the eighteenth birthday, in effect. Even intelligent, committed Jehovah’s Witness children will be compelled to have a blood transfusion if the doctors think it is medically indicated …
[RB] But then, of course, if a teenager themselves says ‘I’m afraid don’t want one,’ you can’t override the patient as a child … ?
[TJ] There was a case with a Jehovah’s Witness boy with, I think, a blood cancer, a leukaemia, who, at the age of seventeen-and-a-half was able, very articulately, just as your first guest did, to explain why he believed this was what God wanted. Nevertheless his wishes were overridden by the court, but as of his eighteenth birthday that ceased. So that’s the way things are done.
[RB] That must be a very tricky predicament, Timothy, because you have to forcibly give someone a treatment who says ‘I don’t want it.’ Do you have to hold them down, in effect?
[TJ] I don’t know, you’d have to ask a doctor who’s actually had to do this. Obviously it’s an unusual situation and it’s an extreme situation, but it can occur. That’s just to illustrate the law.
[Phone call with Lindsay]
[RB] Let’s take some calls on this. Lindsay is somewhere in Scotland. Hello Lindsay.
[Lindsay] Hi there.
[RB] Hi there. Good evening to you. Now you were brought up as a Jehovah’s Witness …
[Lindsay] I was, unfortunately, yea …
[RB] … and at what age did you change your mind?
[Lindsay] I knew from about thirteen that didn’t want to be involved with the religion but as I was living in my parents’ house I had to go to the meetings and the door-to-door work and all that until I was sixteen.
[RB] Why didn’t you like it, then?
[Lindsay] The inconsistencies, the hypocrisy, everything your guest was talking about. For example, the particular chapter in Leviticus they were talking about, about the blood, is under the section titled “Clean and unclean foods,” specifically being food, whereas the next chapter is purification after childbirth and they wouldn’t apply that, where as woman, because she was bleeding after childbirth, was unclean for sixty days and no one should go near her …
[RB] So it’s picking and choosing …
[Lindsay] Yes, constantly …
[RB] That’s the thing, when I was talking to Ernie Reid, that confuses me; who has the authority to pick which bits from the Bible should be law and which bits isn’t. To do that is to presume to know which bits God favours, and that confuses me. Lindsay, when you turned your back on the church, did your parents shun you?
[Lindsay] They didn’t, no they didn’t, but they let me know their feelings on the situation but I had never been baptised as a Jehovah’s Witness, so it was a little more easy for me, it was just down to personal decision whether I was shunned or not and several of the Witnesses I knew did but, to be honest, it didn’t bother me, they weren’t really the kind of people I wanted to be associated with. As I say, very hypocritical, I wasn’t allowed to spend time with my friends in school who I’m still friends with now, whereas the girls I knew who were going to the Kingdom Hall were shoplifting and doing all sorts.
[RB] All right, Lindsay, it was very good to speak to you tonight, thanks for your call.
[Texts]
Here’s a couple of texts on this, Lindy says, “But other Christians don’t refuse transfusions. Are they reading from the same Bible?”
Roger: “The Bible was written in an era when this technology wasn’t available. Wouldn’t a modern-day Bible support life?”
And Rick in Manchester, “Richard, I would love to know what the partner of Emma and the father of her twins thinks of the Jehovah’s faith at the moment.” Well, the question was put to him, whether or not he wanted to override his wife’s wishes and he said No.
[Phone call with Sam]
Sam lives in Cheltenham, Sam you’re a doctor. Good evening to you. Should a doctor be able to override a patient’s wishes?
[Sam] Well, I think as Dr James alluded to, there are clear-cut legal principles. Obviously the first is [?] there are ethical principles that have been in operation since Hippocrates, of which, formally, beneficence and [?] took pre-eminance, and then the view that there was paternalism in medicine has meant that autonomy is now at the forefront. Now, to your question as to whether a doctor should decide, I think it should be expanded to, should society allow this to happen? The caveat to this is, as Dr James would probably be able to tell you, is cases where pregnant ladies who have certain religious views refuse to have a caesarean sections on the advice of their doctors and are forced to have them under the mental health rules where you could be compelled to have treatment because they are deemed not to be competent because of mental illness. When the eventuality came that these cases went to court it was decided that this was an erroneous application of mental health law. In fact, there was one case where a Jehovah’s Witness lady, I think she was involved in some terrible burns, came to hospital and the decision was would they give her blood: apparently she carried a card saying ‘I’m a Jehovah’s Witness, I don’t want to have blood,’ but her father popped in and said, “Look, she’s changed her faith, and she’s changed her views.” And so there was an element of doubt and hence the judge at that time, when the case was taken to court, decided in the existence of any doubt you have to observe life.
[RB] That is interesting, thank you. Did she, when all this was over, support her father?
[Sam] I’m not sure exactly the outcome of that case, but the principle still stands. If there is evidence there is refusal of treatment and that has been made by a person who is deemed to be competent at the time, any transgression of that and you could be taken to court for battery, assault. So even though one’s immediate feeling is, you know, we should preserve life, if we take a step back then, what else can we compel a patient to do? A patient should have the right to say No, but the decision as to whether a certain belief should be allowed to be transgressed by doctors should be a societal matter …
[RB] Yea, Sam, thank you. I really appreciate you phoning. Sam is himself a doctor. We’ll hear more from Dr James in a moment.
[Interview with Rachel Underhill]
Rachel Underhill, to remind people in case they’ve just joined us, you’re a former Jehovah’s Witness, refused a blood transfusion during the birth of your twins, and we’re talking about whether or not a doctor should be able to override a patient’s wishes. Let’s just talk a little bit more about your experience of childbirth and what actually happened …
[RU] Basically, I went into premature labour with my twins. I went into premature labour at home at thirty weeks, that was ten weeks early and obviously I wasn’t expecting to go into premature labour at all, so that was a big shock and it was when I went to the hospital, it did take quite a while the doctors were deciding whether I was going to have a natural birth or a caesarean and it turned out I needed an emergency caesarean and so very late into the evening once they’d gone through my medical records and realised I was one of Jehovah’s Witnesses they called in the elders from the HLC and they obviously all turned up at the hospital in force with all their paperwork and files and documents and everything and basically just spoke to the consultants and doctors and nurses on my behalf and made sure they knew that I was definitely not going to be having any blood transfusion …
[RB] But they were your views, though, they were your wishes … ?
[RU] Yes, they were my views, but they were actually something that was influenced upon me and totally conditioned on me as I grew up as a child …
[RB] Yes, I appreciate that, but at that time that was your wish?
[RU] Yes, it was, yea.
[RB] So, the doctors did not give you a blood transfusion, and luckily, you’re here to tell the truth, and your children are fine.
[RU] Yes, absolutely.
[RB] But, of course, there was the chance that what happened in this tragic case that we’re talking about today could have happened to yourself. And you talk about feeling as though you were conditioned. Are you saying it wasn’t really your view, it wasn’t really your wish?
[RU] No, it wasn’t, no. I don’t think, that because I was in premature labour, I didn’t actually have the mental and emotional and physical strength to be able to turn round and say, ‘Give me what I need to have.’
[RB] But even so, prior to being in that predicament, and in that state, it was still your view?
[RU] Yes, it was, but then I never thought I’d ever be in that situation, because you never think it’s actually going to happen to you.
[RB] Did you think when you went to hospital, did it feel in any way like a threat the fact that if you had accepted a blood transfusion you would then have been, in effect, thrown out of …
[RU] Yes, it was a complete threat because as I’d grown up in the religion and in the talks that we always had, I’d always obviously been brought up in that way, to make sure that, I knew that I wasn’t ever going to have a blood transfusion and so I never thought I’d be in that situation when I was older.
[RB] But it did feel like a threat?
[RU] It was a total threat, because I know if I did accept a blood transfusion …
[RB] … you’d be expelled and shunned …
[RU] I’d be disfellowshipped, exactly, and shunned completely because I did actually see that happen when I was younger in the congregation that I was in and there was somebody who did have a blood transfusion and that did actually happen to them. They were actually disassociated from the congregation.
[RB] At the time, you did believe all this stuff? And did it never cross your mind that it is arguably odd that God would rather somebody died than take a blood transfusion, and that kids would rather grow up without a mother?
[RU] It never really crossed my mind, I didn’t really think about it too much because all I’d had been conditioned and influenced so much upon me, was that this is what you will do, you make sure that you do it in this way. So you just go along with being told and doing what you’re told to do, until you wake up to it, as I did.
[Interview with Timothy James]
[RB] Dr James, I was reading an article from the Press Association and it said the General Medical Council was drawing up new guidelines for doctors on when they can give medical treatment against the patient’s wishes and that these guidelines are expected to give doctors a greater say in cases when a patient is deemed unfit to make decisions about their treatment. What does that mean, “deemed unfit”?
[TJ] The question of when somebody has the capacity to make their own decisions is the hard one. We’ve got the Mental Capacity Act now, a recent Act, that’s supposed to clarify this, but not everybody thinks it does clarify it and it’s presumably in the light of that that the General Medical Council – which has the duty to give ethical guidance to doctors – is producing these guidelines. Of course, those can’t overrule the law, they can only supplement and apply the law, though, to be fair, the judges are very reluctant to overrule doctors’ ethical decisions.
[RB] I’m just trying to imagine – of course I can’t – what it mush have been like for the doctors in this particular case, to be there, knowing that they could save this mother, that she’d given birth, knowing that she would die unless she had this transfusion and not being able to give it to her.
[TJ] People refuse treatment for all sorts of reasons …
[RB] What’s it like from the doctor’s point of view?
[TJ] It must be agonising because it’s not only just like any human being must it be agonising, but particularly it is their life’s work to try to preserve people’s health and they’re being prevented from doing that, and presumably for reasons which they do not accept. And that, I think, is the fundamental problem, that this is the most fundamental life belief for people, and yet it’s one that seems entirely nonsensical, even to those of us who are also religious.
[RB] Okay, Timothy James, thanks for joining us tonight. Senior Lecturer in Law and Medical Ethics at Birmingham City University. Rachel Underhill, thanks for coming on and being so open with us, I appreciate your time. Rachel is a former Jehovah’s Witness who refused a blood transfusion herself.
[News and sport edited out]
[Texts]
So we had a big discussion in the first hour, it got very heated and a huge response to it as well, about whether or not doctors should be allowed to intervene and overrule and override a patient’s wishes. This is because a Jehovah’s Witness died after giving birth to twins. She refused a blood transfusion; if she’d had the transfusion she would have lived.
Tony in Kilburn: “The law should be changed to allow doctors to ignore any religious beliefs in order to save a person’s life. Religion is imposed on a child from the day it is born and distorts its view of life. Any child born into a Jehovah’s Witness family has lost its right to life.”
Several people are making similar points to that in the texts, saying in some ways you could argue it’s tantamount to child abuse: “I’m a Christian myself and I think this is a cruel belief and God will punish them.”
And Rob in Kent says: “This desperately sad case of a young mother who will never see her new-born twins has done nothing to help these religious fanatics in their cause. It is no less than murder to allow her to die as she did. Doctors should have just saved her and then been sued for saving her. Better that than these kids with no mum.”
More, please, if you want to share your views …
[Program moved on to next topic for discussion]