On Thursday September 5 th , we learned that a 20 year old Jehovahs Witness (JW) named Collins Stephens had died in an intensive care unit in Little Rock, Arkansas. For us, this tragedy is heightened by the knowledge that something as simple as a transfusion of red cells might well have saved Collins life by allowing physicians to repair his damaged heart and aorta.
We know that Collin was in an accident and that he survived for over ten days in a drug induced coma. We know that physicians worked feverishly to keep him alive and build up his blood count. We know that the Hospital Liasion Committee (HLC) and Hospital Information Services (HIS) were involved, and we believe that Collins father is a Jehovahs Witness (JW) elder.
We only learned of this situation a few days ago and we reacted as quickly as we could. A brother who still serves as an elder phoned the hospital I.C.U family waiting room and spoke with a man we believe was Collins father. As soon as the man understood the purpose the call, he hung up.
We contacted the doctor by phone and later faxed a letter to him. On Wednesday night, a decision was made to try and contact Collins mother. A letter was prepared was ready to fax to her at the hospital early on Thursday morning. Collin died around 3:30 a.m.
We were not as effective as the angel who intervened and prevented Abraham from sacrificing Issac. The level of frustration for those of us at AJWRB that work with these issues is only overshadowed by the grief of the families involved (both JW and non-JW) who have suffered such a devastating loss.
After having been involved in several of these situations, a few things have become apparent:
- Our efforts are hampered by the need for anonymity.
- If we sacrifice our anonymity and are disfellowshiped, weve lost the credibility we need to be effective speaking with JW patients.
- The typical crisis develops very fast and is difficult to effectively respond to. Therefore, we are looking at ways to improve our response by making more resources available online that lend themselves towards these situations.
- Physicians directly involved in the case are in the very best position to respond but they generally do not have sufficient time to get up to speed on the issues.
- Serious cases often involve an unconscious patient making it impossible to have a private consultation with the patient.
- The basic strategy that has been followed by AJWRB is correct. The key to saving lives is better educating physicians about the Watchtower Societys (WTS) irrational policies on the use of blood, as well as the coercion and control methods used by the WTS to force compliance.
It is very important that physicians and other medical personnel be prepared to question the JW patients understanding of the issues and determine with a high degree of probability that the patients choice is autonomous and informed.
In cases where the patient is unconscious, the validity of the advance directive must be carefully ascertained. This is especially true when younger JWs are involved.
It is one thing to talk about what needs to happen and quite another to actually do it. We are under staffed and under funded we do what we can. If we were better at what we do, it is probable that fewer JWs would die. We have learned a great deal through this gut wrenching process. In the years to come, the WTS will find that medical personnel are better equipped to deal with irrational arguments proposed by JWs and appointed elders/HLC members. Additionally, it will become harder for the WTS to interfere in the doctor/patient relationship.
The introduction and eventual wide spread use of hemoglobin solutions like Polyheme and Hemopure are going to save the lives of many JWs. While we wait for these products to obtain FDA approval and then for the manufacturing process to gear up, JWs and their physicians continue to have very few effective options to cope with massive blood loss.
Editorial
These comments are specifically directed to the Governing Body of Jehovahs Witnesses, HIS and all HLC members. I am not aware of whether or not hemoglobin solution was available in this case. It doesnt appear that it was. On the other hand, packed or washed red cells were available.
All of you know very well that a red blood cell is nothing more than a tiny doughnut shaped bag of hemoglobin it doesnt even have a nucleus! The red cell is 97% hemoglobin and 3% bag (membrane).
It is my opinion (and I think I speak for the vast majority of brothers, sisters, physicians, medical personnel and concerned non-JW family members associated with AJWRB) that for you to advise JWs that they may accept hemoglobin but not red cells demonstrates a depraved indifference for human life.
What possible ethical justification exists for you to sanction the use of animal blood (Hemopure bovine hemoglobin) and yet at the same time deny a desperately ill JW youngster the human based hemoglobin found in the red cell?
Your teachings and support of this policy result in the needless deaths of many JWs and their children. You are likely aware that approximately 2/3 of the children raised as JWs grow up and leave the WTS, so what does their death accomplish? Please extricate yourselves from the doctor/patient relationship and give JWs a free choice in their medial care.
A clock is ticking. Every JW whom you fail to make a full disclosure to regarding these issues and who is then coerced into rejecting transfusions of red cells moves you one step closer to legal action and potentially massive judgements against the organizations assets and your personal assets. Additionally, there is the potential for criminal prosecution in some jurisdictions. The world is watching and one-day Gods minister (Romans 13) may show up knocking at your door. Please stop and carefully evaluate the medical advice you freely dispense to every child that is born into a JW family especially when its clear that those of you who write the policies no longer have faith in the doctrine. How long will it be before memos and notes "leak out" showing the careful plan you are executing to slowly dismantle this death dealing policy?
When called upon, how you will explain why all of these people had to die because of your prohibition of a tiny membrane that accounts for 3% of a red cell? Additionally, what of the hundreds, perhaps thousands of JWs that have discontinued their chemotherapy because they were not permitted to accept the smallest of all blood components (platelets at 0.17%). An explanation may be demanded of you from God and Caesar. Moreover, these judicial hearings will not be some star chamber where you hold all the cards.
Wouldnt the course of wisdom be to simply revert to the pre 1961 policy on blood? Something like the following announcement (based on the format followed in the Watchtower of Dec. 15, 1952 p.764 when the ban of vaccination ended and the Watchtower of March 15, 1980 p.31 when the ban of organ transplants ended) could be made in Questions From Readers:
Q: Should congregation action be taken if a baptized Christian accepts a transfusion or injection of a blood product?
The transfusion of blood components or fractions is one for the individual that has to face to decide. The organization cannot afford to be drawn into the affair legally or take the responsibility for the way the case turns out. Objection to transfusion on Scriptural grounds is unclear since these products do not serve as food when transfused but rather as a cellular transplant. We merely offer the above information on request, but can assume no responsibility for the decision and course the reader may take.
(Suggestions from Dr. Muramotos article in the Journal of Medical Ethics - Bioethics of the refusal of blood by Jehovah's Witnesses: Part 3. A proposal for a don't-ask-don't-tell policy could be incorporated or used as an alternative)
See: http://www.ajwrb.org/jme/jmee.htm
Subsequent Questions From Readers could address related issues as necessary. This quick and simple approach would allow the organization to dispense with a huge potential liability and focus its resources on resolving the litigation surrounding the child abuse issues. I believe a failure to deal with the blood issue now will likely result in additional expensive litigation and large damage awards in the future.
This is simply the right thing to do and while it will be difficult and painful for some in the organization. It accomplishes many positive things:
- It gives JWs and their children the right to make an autonomous choice without controls or sanctions.
- It removes the dark cloud that hangs over the WTS from the perspective of physicians and the medical ethics community.
- It effectively ends much of criticism that the WTS is a dangerous cult.
- It brings the organization closer to having a balanced, biblical policy.
- It makes it easier to persuade individuals to join the organization and removes a reason that has caused many to leave.
- It protects the assets of the organization.
- Most importantly it honors that which blood symbolizes life!
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The Associated Jehovah's Witnesses for Reform on Blood, is a diverse group of Witnesses from over 25 countries, including elders and other organization officials, Hospital Liaison Committee members, doctors and members of the general public. All have volunteered their time and energies in an effort to bring about an end to a tragic and misguided policy that has claimed thousands of lives, many of them children.Website: http://www.ajwrb.org Email: [email protected] support our educational work, send your contribution to:AJWRB - P.O. Box 190089 - Boise, ID 83719-0089 U.S.A.