Jehovah's Witness in the news for refusing blood transfusion.

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    I had Hodgkins once too. courant.com/news/health/la-hew-hodgkins23-2008jun23,0,4955567.story Courant.com

    Hodgkin's disease treatment without a blood transfusion

    By Susan Brink

    Los Angeles Times Staff Writer

    June 23, 2008

    Hodgkin's disease

    For the masses in the middle -- people who may have to borrow and scrape to pay for care -- finding the best of the best can be just as Simportant.

    IRuth Medina, 25, had a good prognosis with standard medical treatment when she suffered a recurrence of Hodgkin's disease, a cancer of Mthe lymphatic system. But, raised a Jehovah's Witness in San Jose, she refused to submit to the life-saving procedure, a stem cell Otransplant, unless providers would guarantee that no blood would be transfused into her body -- even if her life hung in the balance. NAlmost no providers would sign on for such a deal. Without the transplant, she would die.

    SThen she found Dr. Michael Lill, head of the blood and bone marrow transplant center at Cedars-Sinai Medical Center in Los Angeles. "A Unumber of people think it's peculiar that I do this. Most of my colleagues are happy that I do it, and not them," Lill says. He developed Ca procedure called a bloodless transplant in which the patient's hemoglobin count is raised as high as possible before surgery, greatly Kreducing the chance that a transfusion will be needed. "We don't waste a drop of blood." He's done it 20 times or so, always for people Swho, rather than accept a blood transfusion, would forgo any care and surely die. And, in part because of their wishes to forgo transfusions, six of his patients have died.

    Lill is an atheist, but a strong believer in patient autonomy. "You have to be prepared to respect their wishes, even if you disagree," he says. "And even if it may result in the patient's death."

    Medina's own oncologist was unaware of Lill's technique. Church members, who had formed a health committee dedicated to finding care within the strictures of the religion -- and providing legal advice -- knew of Lill's procedure. She followed up, finding details through her own Internet searches.

    Lill is one of only two physicians in the country (the other is Dr. Patricia Ford at the Center for Bloodless Medicine and Surgery at Pennsylvania Hospital) who offer the procedure to people whose religious convictions lead them to prefer death to a blood transfusion. "These people wouldn't otherwise be helped," Lill says. "The world is full of people who hold completely different beliefs to yours. You can still respect them."

    Her oncologist knew of her beliefs. Medina showed him the results of her search, convinced him of her determination to have a bloodless transplant, or no transplant at all, and enlisted him in her effort to get the approval she needed from her HMO, Kaiser Permanente. "My transplant went very well," she says. "I'm blessed."

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