by nicolaou 739 Replies latest watchtower medical
@ruby456 - the study only included people aged 15 and over.
I cannot reconcile the general population having an anemia death rate of 0.2/100,000 and the Beliav study in NZ showing a 10.74x increase in mortality for JW's, with Marvins extrapolated 0.26/1000.
Marvin separately acknowledges the 10x risk factor based on the same study here http://marvinshilmer.blogspot.co.uk/2012/02/anemia-10-times-more-witnesses-die.html
Surely the Marvin extrapolation should be 0.26/10,000?
I still think it's the same study, besty, only analyzed from two different perspectives. What I DON'T see reflected in this study is an A/B comparison between two sample groups (JW's and non-JW's) and their observable results, stratified, when one receives a blood transfusion and the other refuses.
Eden
there are two papers...
you need subscriber access to WileyOnline to see the full articles - Marvin has used some facts from the paper - Clinical benefits and cost-effectiveness of allogeneic red-blood-cell transfusion in severe symptomatic anaemia - in his extrapolation, but without the full article we have to rely on Marvins use of those figures...
Clinical benefits and cost-effectiveness of allogeneic red-blood-cell transfusion in severe symptomatic anaemia
Article first published online: 13 DEC 2011DOI: 10.1111/j.1423-0410.2011.01573.x
Article first published online: 17 SEP 2012DOI: 10.1111/j.1445-2197.2012.06228.x
thanks edenone - does this mean that inclusion age was upto 15 years?
here is another study I have been reading that imo also suggests that we cannot extrapolate from one country to another without allowing for local particularities
http://journal.nzma.org.nz/journal/117-1195/909/content.pdf
Iron deficiency is a preventable heath problem that affects a large number of New Zealand infants.1,2 Little progress has been made in the last 42 years since the first paper (identifying iron deficiency as a problem) was published.3 Iron deficiency is common amongst children living in underprivileged circumstances; children of Maori and Pacific ethnicity are highly represented in this group.1,2
Ok, I can't argue against it. I take your word for it. Still, as I pointed out before, where is the A/B comparison?
Here's a different study conducted in the US, with a much broader sample group:
http://www.petproject.pathology.vcu.edu/pdfs/08-Shander.pdf
Eden
For the sake of informed discussion about the risk/benefit of refusing blood, here's a list of studies involving JW's patients:
http://allie.dbcls.jp/pair/JW;Jehovah's+Witness.html
Eden
@edenone - you don't have to take my word for it :-) there are 2 different papers on a similar subject.
the point I need help from marvin with is how he reconciles the 10x mortality rate of anemic JW's shown by the Beliav paper (and used by marvin as the headline of a blog entry) with 0.26/1000 in his 50,000 blog article and 0.2/100,000 being the generally accepted anemia mortality rate in the general population.
Out of those 3 'facts' only 2 of them can be true.
@edenone
What I DON'T see reflected in this study is an A/B comparison between two sample groups (JW's and non-JW's) and their observable results, stratified, when one receives a blood transfusion and the other refuses.
You won't see that breakdown in the abstract - you would need a paid subscription to get the full paper which apparently does contain the A/B comparison you refer to and is relied upon by Marvin here http://marvinshilmer.blogspot.co.uk/2012/02/more-than-50000-dead.html and here http://marvinshilmer.blogspot.co.uk/2012/02/anemia-10-times-more-witnesses-die.html
I'm coming to this late, but want to share my own experiences with blood transfusion deaths of Jehovah's Witnesses. The time period was from 1951 to 1975 and in a relatively small geographical region of Los Angeles (Hollywood area only) and Riverside Counties of California.
I can't remember the names or exact years, but here are my personal connections to blood transfusion deaths and one near death:
When I was about 10 (1953) and in the Riverside (CA) Central KH, a young sister died from a hemorrhage. If I remember right she ignored what she thought was an excessive menstrual flow and became anemic. She was taken to Riverside Community Hospital, refused a blood transfusion and died within 48 hours. My family attended her funeral and the fact that she "faithfully" refused a transfusion was mentioned during the service.
When I was about 15 (1958) a young newly married couple had just been married and were returning home in a private airplane. It crashed and both were badly injured. The husband died at the scene and the young woman was rushed to the hospital with severe injuries. According to my parents (my father was a servant at the time) the woman had lost a lot of blood but could have survived her injuries - but refused to have a blood transfusion and died within hours. That too was mentioned at their funeral.
A young couple who were very close to my family had just had a baby. The baby was in her mother's lap when their car was involved in a front to rear collision. The baby was crushed up against the dashboard (this was before seat belts and child seats). All three of the passengers were rushed to the hospital. The father and mother had minor injuries and the baby, while seriously injured, could have survived. The parents refused a transfusion for the baby and it died within hours of the accident.
When I was 17, a JW mother in her mid-30s attending the Magnolia Center (Riverside, CA) congregation was diagnosed with a serious blood disease. Her doctor told her that they would have to completely transfuse her blood and continue to fight anemia for several months with additional transfusions. When she refused the doctor told her that she should go home and settle her affairs as she had less than two weeks to live. She died ten days later. I attended her funeral too (I'd dated her niece) and the story of her faithful decision was mentioned by the brother giving the memorial talk.
When I was 18, I was asked by a JW friend of mine if I could drive over the his house and drive his mother to the hospital. I remember their car very well (it was similar to the Plymouth in Steven King's "Christine"). She could not drive herself because she had just had surgery on her female organs and could not use her feet to push the pedals. My friend went along for the ride. As I remember it, we drove home after leaving his mom at the doctor's office because she had to be transferred to the hospital by ambulance. I'm not sure what happened, but I heard later that she had to refuse a transfusion and ended up in the hospital for several weeks because she had to be so closely monitored. I heard that she did get extra fluids and "expanders" to help her survive. I lost contact with them because they lived in the Arlington (South Riverside, CA) congregation and we rarely made it over that far. I count her as a survivor, but I'm not sure if she had more problems after that or not.
The last incident that I was aware of took place in the West Hollywood (Fairfax) congregation around 1968. I was not going, but my wife was still a JW at the time. I do not know the details, but I know that a sister who was a part time actress was taken to Cedars-Sinai Hospital in very bad shape. I thnk it was female problems again or maybe a miscarriage - but she too (or her husband) refused blood and died within a day or two. I did not go to the funeral and could not get off work to take my wife - and she barely knew anyone there anyway. But I do remember that the incident caused us to discuss what we would do if she or our baby girls was in a situation where they needed a blood transfusion. Being out by then I made it very clear to her that I would insist on our girls having transfusions, but she could make her own choice. I think my wife was somewhat relieved by my hardline position since it would be me and not her that would be held reponsible and end up dying at Armageddon in 1975.
So that is 5 down and only one survivor in a very small geographic area during just a few years. Some of those persons may have died anyway, but the point of the above discussion has been that "not that many cases could have occured over the past 50 years." 250,000? Maybe not, but I know that there were a lot of stories going around during the years I was a JW or associated that the blood transfusion issue was fairly common. It was a always a discussion during assemblies. As a teenager I often spent many sleepless nights worrying that I might be injured and die before I had a chance to have sex because of the no blood rules. I was lucky then and later in my life when I had open heart surgery that did not require any blood transfusion even though I was OK with having it if needed.
And I just remembered - we had at least 2 young hemophiliacs in our area. I don't know whatever happened to them but their odds were not good.
JV
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“Marvin: I have not read it, but several things occurred to me in reading your blog about it. You seem to have made a lot of assumptions based on this fairly small study.”
LisaRose,
Let’s take a look.
“You seem to assume that all hospitals in New Zealand have severe anemia cases in equal ratios as the four hospitals used for the study.”
Wrong. My presentation does not assume all hospitals in New Zealand have severe anemia cases in equal ratios. In fact my presentation assumes that in the given region there were no additional deaths among JWs suffering severe anemia who refused blood product.
Oh, and by the way, if 1) we assume all trauma centers in New Zealand experienced equal mortality of severely anemic JWs refusing blood and 2) we assume no other hospitals in New Zealand experience any mortality of severely anemic JWs refusing blood then the statistical number of deaths over the period of 1961-2011 jumps to over 200,000.
This objection of yours has no merit. The assumption you suggest is not made in my presentation. Why? Because I wanted my numbers to remain conservative for improved veracity.
“Have you read the study and do you know why those hospitals were chosen?”
Yes. I have read the study, and I know why the 4 databases were used. I suggest you do the same if you want to engage the subject.
“You are then assuming that all populations in the earth have the same ratio of severe anemia cases, which I think needs to be proven. That is a pretty huge jump.”
I do not assume this. It’s a consequent to the life expectancy of New Zealanders. That is to say, given the life expectancy of New Zealanders we have basis to conclude the rest of the world suffers no more and no less severe anemia. This is no jump.
This objection of yours has no merit.
“You seem to be assuming that all Jehovah's Witness populations have access to hospitals, medical care and blood transfusions, equal to the four hospitals in the study. Populations in wealthier countries get far more blood transfusion, so I doubt JWs in poor African countries even have the opportunity to get one in the first case.”
I agree with this. But to be conservative my presentation does not leverage this fact because it would increase the statistical number of JWs dead due to Watchtower’s blood doctrine based on something I have no hard numbers for. My presentation assumes that all populations have the same life expectancy and healthcare services as found in New Zealand.
This objection of yours has no merit.
“You are assuming that all Jehovah's Witnesses in all parts of the earth refuse blood transfusions in the same ratio as the four hospitals in the study.”
No. I assume only that JWs in one part of the world are no more and no less likely to suffer severe anemia than JWs in New Zealand. Given the life expectancy of New Zealanders and the nation’s healthcare system, this assumption makes my figures very conservative. If anything, it’s safe to say that by comparison to New Zealand, on average JWs in the rest of the world are more likely to suffer severe anemia.
As for the ratio of JWs refusing blood product, it’s not a stretch to think individuals indoctrinated the same way will react similarly under the same conditions. Study upon study performed in diverse regions of the world consistently show a similar pattern of JWs refusing blood. The percentage is that between 10-12% of JWs will accept blood product forbidden under Watchtower doctrine that the rest of the JW community refuses. Quite of bit of this research is made available on my blog.
This objection of yours has no merit.
“Anecdotal evidence is that some JWs get the transfusion and don't tell the elders. Jehovah's Witnesses in other countries may have a different culture, in some ways, where they don't emphasize the blood issue as much. I noticed different attitudes even within my state (California) about the blood issue.”
See above, plus:
- Larry J. Findley, MD and Paul M. Redstone, MD, Blood Transfusion in Adult Jehovah’s Witnesses A Case Study of One Congregation, Arch Intern Med, March 1982; Vol. 142 pp. 606-607.
- Kaaron Benson, Special Article: Management of the Jehovah's Witness Oncology Patient, H. Lee Moffitt Cancer Center & Research Institute Cancer Control Journal, Vol. 2, No. 6, November/December 1995.
- Cynthia Gyamfi, MD and Richard L. Berkowitz, MD, Responses by Pregnant Jehovah’s Witnesses on Health Care Proxies, Obstet and Gynecol Vol. 104, No. 3, September 2004 pp 541-544.
Well vetted medical literature shows a consistent pattern of how many JWs abide by Watchtower’s blood doctrine. This is documented for those who care to research the subject, like me.
“Mainly I just think it is impossible to take one study, where only 19 JW patients died, and extrapolate that to 50K worldwide. That is just too small group to make it meaningful. A small anomaly in the way one or two patients were selected could throw off your numbers by thousands and thousands.”
19 deaths over 10 years with an annual population of 12,700 is huge in the world of medical science. This is precisely why Dr. Beliaev and his fellows were able to conclude as they did that “compared with JW patients, ARBC transfusion in anaemic patients was associated with a 10 times reduced mortality, lower rates of cardiac, neurologic and infective complications.” That conclusion is not said only of JWs admitted to 4 trauma centers in New Zealand. Rather, it’s said of all JWs everywhere.
“That is not to say that you don't have a great idea, I think we do need to get this out in the open, I just think there needs to be more proof before we start throwing numbers around. The study, on its own, is pretty powerful stuff.”
What needs to happen is that people like you with an interest in the subject should continue their education on the subject so you can share decent information to help people understand the scope of this issue. People like you should also ask questions before complaining of things you don’t understand and have not bothered to even read!
Marvin Shilmer
