250,000 Jehovah's Witnesses have died refusing blood

by nicolaou 739 Replies latest watchtower medical

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  Marvin Shilmer

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  “Well, I am not going to argue with you any more, you just keep repeating the same things, and dismissing any other concerns. I don't have confidence in your numbers, but you won't or can't imagine you are not 100% correct, so there is no point in discussing it further.”

  LisaRose,

  I am unaware of any concerns raised that I have dismissed. In each case I’ve examined the concern and responded with content tailored to that concern. The idea that I “just keep repeating the same things” is a product of what’s presented to me as concerns. That is, similar concerns are expressed over and over again in this discussion using different language. I respond accordingly.

  I’ve taken much time to address questions and concerns in this discussion. I think if readers spent a comparative pittance of time researching this subject as I have this one they’d hold a very different conclusion. I’d also advise readers who’re unfamiliar with the various means and methods to consult someone who is familiar with it in order to get some help on the subject.

  It’s not my aim to convince anyone here of anything. My aim is to research and share what I find. If I’m wrong I want to know. I’m not interested in asserting bogus information or conclusions. I got my fill of that from Watchtower and want nothing to do with the practice.

  Furthermore, I agree with sentiments of many here who find fault with spectacular assertions that cannot be supported. Spectacular claims must have support. Otherwise they have a counterproductive affect. In this case my extrapolation of deaths due to Watchtower’s blood doctrine does have support, and that support is only made stronger given the conservative approach. Those who disagree are free to say so, and have done so. What’s important is what we can support.

  Any questions?

  Marvin Shilmer
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  daringhart13

  If ONE person has died...........and they have........that officially makes the Watchtower ......murderers.
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  Scott77

  Marvin,

  You have done an excellent and superb job of clarifying matters to my satisfaction. Thank you . Ia m also surprised, Simon is very good at asking relevant quesitons. Similarly, other posters have done likewise and in a large way, it demostrates our deeper interest in this subject of blood. Watchtower's misleading of us have been and continue to be a pain to many of us who have lost loved ones. Its indeed a human,cult-inspired tragedy. By the way, Marvin, what was the power level used in the study?

  Scott77
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  steve2

  steve2,

  Thanks for sharing your view and experience.

  Marvin Shilmer

  Marvin, thanks for reminding me about what I had said on a previous thread that was on the topic of blood-transfusion refusal as a result of accidents when there has been massive blood volume loss and transfusions are practically the only safe rapid means of saving lives.

  I acknowledge my positive comments at the time about your article which bandied around the 50,000 figure. I can only say that, at that time, I myself had anecdotally reported the few cases I knew of in which blood-refusal had led to death. I understand from colleagues working in the Emergency Department that such occurrences are not frequent - but they garner a lot of publicity that creates the impression in the public's mind that the number of deaths is higher (disproportionate to their occurrence).

  Also, at that time, I had not carefully considered your statistical method(s) which my comments earlier on this very thread have well-covered.

  I had mentioned that I worked at a metropolitan hospital only to show I hear firsthand when JWs die from blood refusals (again, the numbers are very low).
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  Marvin Shilmer

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  “I had mentioned that I worked at a metropolitan hospital only to show I hear firsthand when JWs die from blood refusals (again, the numbers are very low).”

  Steve2,

  If, as you say, you have carefully considered what I’ve presented then you’d realize hearing reports from colleagues at a hospital of JWs who died over blood refusal would be a relatively rare event.

  New Zealand has more than 80 hospitals. The adjusted rate of 3.3 deaths per year my article speaks of in the New Zealand healthcare service area means that any given hospital could go many years, perhaps decades, without a single instance of this preventable mortality. Hence what you share as your personal experience is what I’d expect, which makes me wonder why you think your experience is somehow at odds with that I’ve presented.

  Furthermore, many of these deaths are not identified at the time for what they represent. Only after reviewing mortality over a period does frequency become apparent. The data set studied by Beliaev and his peers provide such a review. Again, without this retrospective the incidents would appear relatively rare. But these deaths add up over time. The only question is, how many have died due to Watchtower’s blood doctrine.

  I maintain the numbers supplied by Beliaev et al are sufficient to extrapolate a minimum value based on certain assumptions. Assumptions such as 1) JWs around the world tend to accept/reject blood similar to JWs in New Zealand, 2) the frequency of JWs worldwide suffering severe anemia is similar to JWs in New Zealand (adjusted for Maori ethnicity), 3) New Zealand’s healthcare is not less than the rest of the world on average, and a few others spoken of throughout this discussion.

  Scott77,

  I think the value you’re looking for is P < 0.05.

  Marvin Shilmer
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  adamah

  Marvin said-

  No. My extrapolation assumes JWs in the rest of the world refuse or accept blood transfusion as frequently or infrequently as do JWs in New Zealand.

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  Thanks. OK, so I'm just pointing out another assumption your conservative figure requires. Perhaps that would be a good disclaimer, for you to list ALL the unproven assumptions that one needs to accept for your number to be anywhere close to valid?

  ---

  Marvin said-

  Hence the authors scoured patient records from 4 trauma centers and extracted all incidents where patients suffered severe anemia and then separated these into 2 categories. 1 group that accepted red cell transfusion and 1 group that refused red cell transfusion. Will call this Group A and Group B respectively.

  Then they examined Group B (the group that refused transfusion) and used it as a model to segregate patients in Group A based on things like general characteristics (i.e., gender, ethnicity, comorbidities, hospital admission type and treatment type). Once this segregation was made the authors randomly selected from the segregated patients of Group A to achieve a matched comparison to Group B so that both groups were very close in all comparisons accept one, and that one comparison was whether the patient accepted or rejected blood. From that point forward it was only a matter of math, including making adjustment for things like Maori ethnicity given severe anemia was the subject.

  ---

  And it's exactly what the researchers were able to do in the controlled environment of pulling charts to obtain medical records to create a matched comparison group (Group A) that I suspect is what most of us are objecting to: you are ASSUMING that Group B (the group of JWs who refused BT in the study) is similar to a third group (let's call it Group C), the entire NZ population of JWs; that's a statisticially-questionable extrapolation to make, in itself, since you're unable to verify that it matches group B, as you were able to create by pulling charts, as was done with Group A).

  Then you want to extrapolate Globally, in essence defining a new group (which we'll call Group D, the Worldwide population of JWs), which is even MORE PROBLEMATIC, since you're willing to assume that it's a matched set to Group B, even though it's KNOWN that it isn't: all the factors you mentioned (eg ethinicity, comorbidities, hospital admission, treatment modalities, treatment protocols, etc) are KNOWN to be different for various hospitals Worldwide.

  THAT'S the objection, and you're operating on the assumption that the differences don't exist and/or don't matter, but your methodology is built on many such assumptions and is likely flawed, which is likely only to generate a questionable figure. Is the actual figure too low? Is it too high? Who knows!?!

  Adam
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  Marvin Shilmer

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  “And it's exactly what the researchers were able to do in the controlled environment to create a matched comparison group (Group B) that I suspect is what most are objecting to: you are ASSUMING that Group B (the group of JWs who refused BT in the study) is similar to a third group, called Group C (the entire NZ population of JWs, which is a questionable extrapolation).”

  Adamah,

  My method has no dependency on a “Group C” except to have a total against which to establish a ratio. That is to say, the only dependency of the “Group C” you speak of in my method is to establish the number of JWs in New Zealand over the period of the study (1998-2007). This aggregate value for years 1998-2007 is: 126,989.

  The number of preventable deaths is established solely on the basis of comparing Group A and Group B. The number established by Beliaev’s data is 19 over 10 years, or 1.9 per year for the 4 hospitals whose patient data was used. This aggregate value for years 1998-2007 is: 19.

  Hence we have a ratio of 19-per-126,989 JWs over 10 years, or annually 1-per-6683 JWs.

  If we adjust this ratio by assuming the 4 hospitals whose records were used were the only hospitals in those 2 regions with like mortalities, and that hospitals in the New Zealand’s other 2 regions had a similar mortality rate based on population then we have a ratio of 33-per-126,989 JWs over 10 years, or annually 1-per-3838 JWs.

  “Then you want to extrapolate Globally, creating a group D (the Worldwide population of JWs), which is even MORE PROBLEMATIC, since you're willing to assume that it's a matched set, even though it's KNOWN that it isn't: all the factors you mentioned (eg ethinicity, comorbidities, hospital admission, treatment modalities, treatment protocols, etc) are KNOWN to be different for various hospitals Worldwide.”

  I’ve not assumed any matched set against a world population. I’ve assumed that JW patients in New Zealand receive on average a better standard of care across the spectrum you cite compared with the average standard of care in the world. When it comes to comorbidities, hospital admission, treatment modalities, treatment protocols, etc. what we find among JWs in New Zealand is no different than the rest of the world overall, and I have not treated these as different. As for ethnicity, in the New Zealand region there is a factor to consider regarding Maori, but this is adjusted for within the Beliaev study and it’s the findings of the Beliaev study driving my extrapolation.

  Otherwise I’ve made assumptions atop assumptions that, if anything, minimize the number of deaths due to Watchtower’s blood doctrine using the Beliaev data set. For instance, I assume there is not a single hospital in the 2 regions of New Zealand with even 1 more death of a JW refusing blood. This includes even the advanced and district trauma service hospitals. Given the fact that EACH of the 4 hospitals in Beliaev’s study incurred some of these deaths, this assumption of mine is very generous and it minimizes my findings.

  “THAT'S the objection, and you assume it doesn't matter, but your methodology is built on unproven assumptions and is likely flawed, since it can only leads to a questionable figure. Is the actual figure too low? Is it too high? Who knows!”

  Assumptions matter for one reason, so readers can understand what’s being said. From what I’ve read of your complaints you neither understand assumptions I’ve made nor care to. That’s why I’ve not responded to more often than I have to what you’ve said.

  Marvin Shilmer
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  The Quiet One

  Pm for Marvin
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  Marvin Shilmer

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  An Observation

  During this discussion it amazes me what little attention is given to substantive issues that impinge estimates of deaths due to Watchtower’s blood doctrine, and particularly due to anemia.

  Anemia has many causes. But when it comes to JWs anemia has increased frequency versus the rest of the population for one simple reason: refusal of red cell transfusion.

  This creates a vicious cycle. Refusing red cell transfusion puts a patient at greater risk of severe anemia. Severe anemia puts a patient at greater risk of mortality. Refusing red cell transfusion puts a patient with severe anemia at an even greater risk of mortality.

  This added risk due to refusal of red cell transfusion represents a cascading event, and it presents a tremendous driver for increased mortality among JWs refusing red cell transfusion. This risk assessment was identified and quantified in the Beliaev study.

  Yet among readers here claiming varying expertise in the healthcare field I’ve yet to see even one recognize and discuss this cascading event and how it drives numbers upward.

  Marvin Shilmer
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  Finkelstein

  Its not singularly the issue of this one particular health problem that people are being dismissive about its the

  statistical use of it to comprise a sum of jws deaths resulting from refusing a BT as a assuming total.

  Based on the known fact that deaths from JWS result from many forms of problematic health issues .

  In emotive theory we would like to have a high number to show as evidence to this alarming public problem

  but as its be noted many times on this thread that it pays to have somewhat of an honest calculated number rather than

  a number that has little backing or strongly supportive evidence.