Dublin, Ireland Hospital Faces 1m Bill Over Transfusion Case (page 2)

besty

...but I thought the British trial system was "loser pays."

Naughty Nathan - read the subject line of the post again and tell me which country is under discusssion here.

skeeter1

PLEASE READ THIS POST!

THE IRELAND CASE IS A BIG LOSS FOR THE WATCHTOWER SOCIETY.

IT'S A BIG WIN FOR EX-JWS.

I read the very long Irish High Court's opinion (link above). Here's a short synopsis:

FACTS:

Ms. K is from Africa, has been a JW since 1995, and her father is a HLC elder back in Africa.

Ms. K entered Ireland from Africa on bad paperwork. She is pregnant, and goes to the Irish hospital on multiple occassions for prenatal visits, tours, etc. She never bothers to tell the hospital that she was a JW. On admittance, she lists that she is a Roman Catholic (my note: the vilest of all religions to a JW) and states that the father of the child is in Africa. In fact, the father is also illegally in Ireland specifically for his wife's birth; and visited her in the hospital before heavy labor began...a fact the hospital staff doesn't know at delivery or the terrible hours afterwards.

Her sister-in-law is in the hospital room during labor & delivery. Her sister-in-law is also a JW and is interpreting for her. But, her sister-in-law speaks broken French, and can't communicate medical terms well.

Ms. K gives birth to a baby boy. The unimaginable happens, and she bleeds out 75% of her own blood, after ripping apart inside. Her hemoglobin goes from a normal 11 to a very anemic 5.1. It was her first delivery.

The sister-in-law reports that Ms. K. is a JW and refuses blood. Ms. K. also brokenly states that she doesn't want blood. Ms. K. can't produce her "no blood card".

The hospital tries to respect the woman's wishes & contacts the local congregation. The HLC elder sends an information sheet to the hospital. The hospital follows the instructions, and gives Ms. K. a blood fraction to stop bleeding. For over an hour, the doctor hand-holds a tampon like device inside Ms. K to stop bleeding on her cervix. The doctor consults with a few other doctors, and all state the urgency the she gets blood. While Ms. K is stable, she could re-bleed again. If her re-bleed is internal, the doctors will not know it. (Plus, woman bleed for several weeks after giving birth....).

The doctors tell Ms. K. the urgency of her medical situation. But, she replies with a general disbeleif that this she will likely die. Finally, she states in a serious tone to give her Coke & Tomatoes. The hospital thinks the woman does not have a full deck, and that the baby is going to be orphan.

So, the doctor consults with the hospital attorney, and they rush to the courthouse. The trial judge hears the case, and orders a blood transfusion. The woman does not understand the situation, her child is going to be an orphan, and she doesn't appear to be a bona fide JW who has everything in order.

The doctor sedates Ms. K to give her a blood transfusion. (Ms. K tried to rip out the lines.). Ms. K and baby boy live. Ms. K. sues the hospital on various legal grounds. She wants $$$$$$$$$.

ISSUE:

There were many issues in this case. But, the main issue is whether Ms. K. gave "informed consent." The court ultimately ruled that Ms. K. could not give informed consent as Ms. K did not demonstrate that she understood the gravity of her decision. The evidence was the lack of blood card, parading as a Roman Catholic, and the Coke & Tomatoes remedy. In other words, Ms. K was just another lulu sister that every KH has....

Interestingly, Ms. K gets on the stand and said that JWs understood that Coke and Tomatoes and Eggs were good blood substitutes as they helped build blood, provided iron, and energy. The JWs looked like fools.

(Ireland Judge Opinion)
"Ms. K’s account of the discussion about tomatoes and Coke was that she initiated the suggestion. When the Master told her that the only solution was a blood transfusion she thought they could give her another solution that she had and proposed tomatoes, Coca Cola, eggs and milk. She clarified this by saying that she proposed the eggs, the Coca Cola and the tomatoes but that milk she knew she could find. She expressed the view that those products were very important in the human body, that tomatoes come from the earth, that they are very important because they contain vitamin A and iron, eggs also contain iron and Coca Cola contains energy. Her view was that those products would improve her blood because her parents had used them and a lot of Jehovah’s Witnesses use them. However, the Master told her that he did not think the products would help. "
"In the course of cross-examination it was put to Ms. K that the Coke and tomatoes suggestion showed that she had no real medical understanding of the nature of the situation which confronted her on the morning. Her response was that she proposed those products because the doctors told her there was no other alternative and she proposed what she knew. She thought that Coke and tomatoes were going to be as effective to improve her low blood count as a blood transfusion, but “not as fast as that”, and it could help her “little by little”. She stated that she understood the situation, that it was between life and death, so that she could not play around with the situation. Later, when it was put to her that from a medical point of view a blood transfusion was medically indicated and appropriate given that her haemoglobin had fallen below 6 g/dl, her response was as follows:“What I have understood with visits of all the doctors is that my health wasn’t as serious as that and there was some alternative to propose.” When she was asked whether she thought coke and tomatoes would have been an acceptable medical alternative, her response was that counsel was taking it too lightly because he did not understand how many lives that, meaning Coke and tomatoes, had saved."

A side issue in this case was whether Ms. K was coerced. The judge would not decide the issue because it was not an issue in the original court pleadings. But, the judge did say that Ms. K did not appear coerced in this situation. But, the judge said that the potential for coercion exists within the JW blood situation (annual renewal proccess of blood cards, disfellowshipping, etc.); and each case must be judged on a "case by case" basis.

BIG WIN FOR EX-JWS: (Ireland Judge Opinion)"It is possible that in a particular case a court might conclude that the decision of a Jehovah’s Witness to execute an advance directive or, in particular circumstances, to refuse a life-saving blood transfusion was motivated by peer pressure or fear of social or economic deprivation due to disfellowship or disassociation to the extent that the decision was not voluntary. .......Every case must be decided on its own facts"

The JWs tried to argue that a blood transfusion was not necessary. To aid their argument, the JWs called three, distinguished medical experts to take the stand. All three of these demi-God-like doctors stated that they would have ordered a blood transfusion for Ms. K if she wasn't a JW. The judge looked at their testimony for the standard medical care, and determined that a blood transfusion was medically necessary. Another (black eye) dealt by the judge to the Watchtower attorneys.

BIG WIN FOR EX-JWS: (Ireland Judge Opinion)"Conclusion on necessity for blood transfusionWhat emerges from the evidence is that her treating clinicians and the experts were unanimous that the appropriate medical treatment for Ms. K at all material times after the haemorrhage and before 2.35 p.m. on 21st September, 2006 when her haemoglobin was a 5.1 g/dl, leaving aside her refusal of treatment, was transfusion of blood and blood products. The basis on which each of the experts called on behalf of Ms. K contended that a blood transfusion was not necessary or essential, or could be postponed until Ms. K’s condition deteriorated, related to her refusal to accept treatment and was not based on clinical considerations, applying normal standards of appropriate practice. Not only does the approach of those experts beg the question the court has to answer but the basis on which it was advanced in support of Ms. K’s counterclaim is fundamentally flawed.Similarly, an assertion by Ms. K’s counsel in their written submission that, to justify the administration of life-saving treatment where there is a doubt about the validity of the patient’s refusal of such treatment, it must be objectively demonstrated that the threat to life at a minimum is such as to mean that death would be likely “beyond reasonable doubt, or as an absolute minimum on the balance of probabilities” if the refused treatment were not administered, is fundamentally flawed. Such a test would place an impossible burden on clinicians.The duty of the clinician caring for a patient in the circumstances which prevailed in relation to Ms. K on the morning of 21st September, 2006 is to advise the patient of, and afford him or her the opportunity to receive, appropriate medical treatment. If, as a competent adult, the patient refuses to accept the treatment and no issue arises as to the capacity of the patient to make that decision, the clinician’s duty to provide such treatment is discharged. However, if an issue arises as to the capacity of the patient to refuse treatment, the duty of the clinician to advise on and provide the appropriate treatment remains. As a matter of law and common sense, the duty of care which the clinician owes the patient in those circumstances is no different from what it would be if there was no refusal or if the patient was unconscious. What is required of the clinician is to take the steps to have the capacity issue be resolved, with the assistance of the court if necessary.

The JWs tried to argue many court cases supporting their side. The judge slammed the JWs on these legal arguments. The judge took the time to show why each of the case holdings had no application to the present case. The judge easily figured out the Watchtower's faulty logic. In one case, the JWs tried to take a case that dealt with commercial contracts and notice of suits....to this blood case. The judge made the Watchtower attorneys look like fools. BIG WIN FOR EX-JWS

The JWs also tried to argue that the hospital doctors and hospital lawyers were not open and honest with the judge who ordered the emergency blood. The Court slammed the Watchtower again. Basically, the Court said that the hospital lawyers and doctors were as frank and prepared as they could be given the emergency situation....which was caused by Ms. K. not being frank and honest with the hospital.

Throughout the case, Ms. K stuck to her guns that she was making a religious choice, and not a medical choice. She specifically evaded questions about blood fractions, and about whether or not the elders talked about the medical risks of blood. I have no doubt that this was good coaching on part of the Watchtower attorneys. After "Jehovah's Witnesses, Blood Transfusions, and the Tort of Misrepresentation"......they can not have their hypocritical beleifs exposed in court. Ms. K. also lied about blood transfusion being between "the follower & Jehovah." I suspect this was another coaching by Watchtower attorneys in the art of theocratic lying.BIG WIN FOR EX-JWS....BIG WIN FOR EX-JWS......BIG WIN FOR EX-JWS

(Ireland Court Case) "In later exchanges in which she was cross-examined about what she had learned at meetings in Kingdom Hall or from other members of the Jehovah’s Witness faith about the medical benefits of blood transfusion and alternatives to it, Ms. K demonstrated an unwillingness to engage in an exposition of what she had been taught and understood about those matters. Her response was: “We respect the law of God, we respect the principle of God”. On the first occasion on which she made that response she read the passage from the Bible, from Acts, which is the cornerstone of Jehovah's Witness’s rejection of blood and blood products, the injunction “to keep abstaining from things sacrificed to idols, and from blood and from things strangled and from fornication”. When the question was pursued by reference to whether at Jehovah's Witness meetings there was discussion that with very low blood count a blood transfusion is not medically necessary, Ms. K repeatedly gave the same response – that they were told to respect the principle, the law of what is said in the Bible. She qualified the response on a number of occasions by adding that it was a personal choice whether to respect the principle or not. On one occasion she added that it was a personal decision “because it is a question of life and death”. Ms. K did testify that the Elders tell the community that they are often situations that are very dangerous and she added that they are told that the person has to make his own personal decision and the decision is between the person and Jehovah. When Ms. K was questioned further as to whether members of the community are told that there are medical products which are alternatives to blood transfusion where the blood count is extremely low, she reverted to her reliance on the principles of the Bible and did not answer the question. I draw no inference from the foregoing exchanges as to what Ms. K was taught by the Elders of her church about the efficacy or otherwise of medical or other alternatives to blood transfusions. It may be that Ms. K did not understand that counsel for the plaintiffs was not trying to elicit information about the principles of her faith but was trying to ascertain what she was taught and had learned about the efficacy of various remedies in a situation where a patient’s blood count is low. However, she manifested a persistent unwillingness to open her mind to questions concerning her understanding of the medical realities of her case. Her demeanour gave some insight as to why the Hospital personnel who were treating her on 21st September, 2006 would have harboured doubts about her understanding of the gravity of her condition."

Skeeter's Notes:

I bet Ms. K will be reprimanded for her misdeeds of lying. Why? The Watchtower lost in court.

I bet there will be an upcoming article in about 6 months stressing the importance of JW adults to be well versed in the blood argument and to have all of their legal documents in order.

I bet the Watchtower will make all blood decisions between the follower and Jehovah. Why? Legal coercion argument goes out the window. No coercion because no disfellowshipping or disassociation whip. Also, this fixes the fraction hypocrisy. Each follower must decide either: 1) no blood, 2) some blood products, or 3) any blood. It's all between JW & Jehovah.

Rabbit

Thanks Skeeter, this case is going to make the GB bleed -- internally from embarrassment.

Interestingly, Ms. K gets on the stand and said that JWs understood that Coke and Tomatoes and Eggs were good blood substitutes as they helped build blood, provided iron, and energy. The JWs looked like fools.

*sheesh*

10p

Can someone explain to me how the Society gets involved in these cases?

I don't understand amicus curiae etc.

What I don't understand is who iniates these legal proceedings anyway. Would this sister, an illegal immigrant, normally bring more attention to herself, after having the 'out' of being forced a transfusion (so she doesn't get DA'd), by sueing the hospital? Wouldn't you be thankful just to be alive, and let the matter drop?

How does the society's involvement work? Do they have attorneys who, in effect, defend the sister?

Would the society voluntarily defend a witness who was being sued for a business deal that went bad?

And where do all these huge costs come from? And was this sister gonna donate the money to the society if she won?

I read these posts about court cases about blood, and I can never figure out how the society is actually involved, because how can the society sue a hospital if it forces a transfusion on someone - only the person can sue - or am i wrong?

skeeter1

When there is a blood case, the HLC members are first notified.

If there is a legal battle, the HLC calls Legal. A legal team of JW lawyers is flown to the ailing JW, and is appointed to defend the JW. In the sextuplets, this is what happened. In Dennis Olberg, Jr. (Seattle boy), this is what happened. In Bethany Hughes, this is what happened. If Bethel does not have a lawyer who is admitted to practice law in the jurisdiction, then Bethel usually pays an attorney who is admitted. But, Bethel "advises" the paid attorney on every element of its argument.

I don't know if the lawyer for Ms. K was a JW or not. If he wasn't, he was working on JW money.

M.J.

BIG WIN FOR EX-JWS: (Ireland Judge Opinion) "It is possible that in a particular case a court might conclude that the decision of a Jehovah’s Witness to execute an advance directive or, in particular circumstances, to refuse a life-saving blood transfusion was motivated by peer pressure or fear of social or economic deprivation due to disfellowship or disassociation to the extent that the decision was not voluntary. .......Every case must be decided on its own facts"

This is huge, Skeeter! I'm no law expert but I wonder since this was a side issue in the case, how much could this expressed opinion by the judge affect future cases?

It's all between JW & Jehovah.

This is the only way the WTS can really "back out" of the blood thing. Put the decision on the JWs, while still maintaining it's wrong. This was their stance in the 1950s, before it was made a disfellowshipping offense. I wonder if the legal situation, as you infer, has potential to push the WTS to make this move?

Dublin, Ireland Hospital Faces 1m Bill Over Transfusion Case

besty

skeeter1

Rabbit

10p

skeeter1

M.J.

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