posted on July 25, 2002 11:28:57 AM new
A man goes into the hospital for surgery. He signs a release stating he doesn't want any blood products because he's a Jehovah's Witness. The doctor ended up having to give him a blood transfusion during the surgery. The patient found out and is now suing.
posted on July 25, 2002 12:17:11 PM new
If the hospital and surgeon accepted the pre-surgery condition statement, seems to me the guy has every right to file suit...might be another case of doc's not reading patient's files. My mother felt very strongly about extreme measures and had numerous DNR forms in her various medical files, yet during her final illness she was "saved" three different times by doctors who "didn't know" the forms were in her files. When I spoke to them about it they were all very indifferent, and acted like I was supposed to thank them... Boy was she mad each and every time, too......
posted on July 25, 2002 12:35:37 PM new
kraftdinner that way I look at it is that it is a gray area. Yes the patient has the right not to receive a blood transfusion. PERIOD.
However, on the other hand, the doctor may say he was doing what he thought was to save the patient's life.
I think in the end the patient will win, though.
profe51
I am assuming that you are referring to the Living Will? If so, the living will is only good as the paper it is written on. In the process of inacting the document, the patient and the doctor verbally understand each other, which leaves alot to interpret.
Example 1: If the patient is on their deathbed, that with medical help they would live. One of the family members stand up and want to have the doctors to fight for the patient's life, the Living Will goes right out the window.
Example 2: The patient has a regular doctor who they have an "agreement" with, but they may be on the road or end up with another doctor. The new doctor has to interprete the document and do what he thinks is the idea behind the document. Which may or may not want the patient intended. That is, if he is aware of the document. How many people carry thier Living Wills?
Example 3: After the agreement between the regular doctor and the patient, the doctor may interprete the agreement differently than what the patient intended.
posted on July 25, 2002 12:44:08 PM new
It shouldn't even have come to the operation. The surgeon should have said, sorry we can't help you. And insurance companies should not have to pay up for these people because they commit "suicide".
posted on July 25, 2002 12:45:13 PM new
I have no problem with adults informing and signing papers that they do not wish [this or that], and believe the doctors should honor those requests. If the doctor didn't agree with the requests of his/her patient, then they should have asked the patient to get their care from a different doctor. [If possible - not an emergency.]
When I have mixed feelings is when an adult [parent/guardian] makes the same decision for a child. Very mixed feels there. So many issues. Rights to practice religious beliefs, parental rights and yet..since it's a child...would the child choose life?
[side note to clarksville - I hope you saw my apology to you on the other thread.]
posted on July 25, 2002 01:13:37 PM new
Those are good points.
If a person is unconscious you treat him and the doctor should not be held responsible later.
If he's conscious and refusing treatment, then you have to shrug your shoulders and order the plot. What else are you going to do? If it is a child, the state should treat the child up until he's 18.
posted on July 25, 2002 01:23:51 PM new
Was this a scheduled surgery? If so, the hospital had to know about the patient's position prior to the actual surgery and would be able to refuse the procedure if blood products could not be used. If it was an emergency, the issue is not one of consciousness but rather coherency. A conscious but incoherent patient may say things that the attending physician must ignore.
posted on July 25, 2002 01:38:45 PM new
I'll try to find a link. Apparently, he signed a release stating no blood products but I believe the transfusion was needed to save his life.
I just thought it was odd. He could be dead now, but instead he's suing the doctor that allowed him to be alive so he can now sue him...
Do the Jehovah Witnesses have their own hospitals? Should they?
posted on July 25, 2002 01:56:39 PM new
Truth is you can do most any surgery without blood. I knew a Jehovah's Witness in Ohio that needed abdominal surgery for a tumor and when she got to the point with the surgeon she said she did not want any blood he just waved the question away and said "I don't use blood anymore anyway. I got tired of so many of my patients getting hepatitis from it."
The Red Cross promotes blood transfusion as a big business. They get a lot of it free and charge outrageous fees for it. At the same time they discourage the studies to develop artificial blood that would free people from the risks of mismatch and infection. I just saw yesterday in the Telegraph the English paper that their health service is in a big row because they just had to pay millions of pounds to people that got viruses from blood plasma but they still complain they can't AFFORD to treat it so it does not pass infections. They reserve the treated blood for children only because it costs 50 pounds a unit instead of 20.
posted on July 25, 2002 03:31:10 PM new
If the transfusion was life saving, there is no case.
A doctor is immune from assault and battery theory negligence if the patient is in danger and unconscious. Even if the patient is conscious, the doctor can claim that the condition or time frame rendered the patient incapible of making a rational decision and the doctor had to act immediately to save the life.
In many states there is also no cause of action for "wrongful life", that is, an action taken by a doctor that is life saving is not actionable. To allow otherwise would produce crazy results and turn damages theory on its ear.
posted on July 25, 2002 03:56:51 PM new
I'm seeing some misinformation in this thread that I need to comment on.
Truth is you can do most any surgery without blood
Nope. One of the main complications of surgery is blood loss. It is on every surgical consent form I have ever seen. Just think of abdominal, thoracic, transplant, or cardiac surgery without blood.
Reamond, I have no idea how many neonatologists and pediatricians are sued each year for poor outcomes of resuscitated newborns, but it is high. They are life saving interventions, because those kids would be stone dead without resuscitation. You have the right to an informed opinion -Harlan Ellison
"Established in 1994, The
NJ Institute has provided
medical care to more than
3,000 patients from the
U.S. and abroad. A
medical staff of over 150
physicians from every discipline has been
specially trained and practice bloodless
medicine and surgical techniques.
Additionally, 25 medical and surgical
specialties including Anesthesiology,
Cardiology, Gastroenterology, Hematology,
Infectious Disease, Neurology, Pediatrics, and
Vascular Surgery, utilize The NJ Institute's "no
blood transfusion" philosophy.
Highly complex procedures such as brain
surgery, liver tumor removal, prostate,
vascular, gynecological, and gastrointestinal
surgery have all been successfully performed
without blood transfusions at The NJ Institute."
Doctors get as emotional about this as they do the Atkins diet. If it's not mainstream they don't want to hear it. Many doctors went to their graves cursing Pastuer and calling him a fraud because germ theory was too much of a change for them to swallow. You still can't get some of the damn guys to wash their hands....
posted on July 25, 2002 05:09:42 PM new
Since everyone here seems to like the political side to threads here is a story about Clinton and company allowing sales of contaiminated blood products from prisoners to Canadians...
posted on July 25, 2002 05:35:55 PM new
[i]"Reamond, I have no idea how many neonatologists and pediatricians are sued each year for poor
outcomes of resuscitated newborns, but it is high."[/i]
posted on July 25, 2002 06:58:47 PM new
Gravid, I did a search. Only one of those facilities specified the procedures they were performing in their bloodless surgery facility. That and the NJ Institute's list there are not procedures that you would expect large blood loss, except possibly the liver. There were 2 interesting cases in the University Hospital of NJ site, but one of those cases usually would not have received a transfusion unless complications occurred. The liver tumour removal is interesting, because the liver is such a vascular organ, but I couldn't find any more info about it.
It is major medical centers that are providing these bloodless surgery centers. I also looked at the technology that they are using. They are using erythropoietin to increase rbcs, and that has to be done in advance. Some of the blood collection is done using pedi tubes, which are smaller. That would be a great idea to do for the whole adult patient population, IMO. Collecting patient's blood in advance has been done for a while, and also needs to be done in advance. Autotransfusers have been used for a while. They counted litho and laproscopic surgery, which have been around for a while, with excellent results. They also count pulse oximeters, which have been around for 17 years. The gamma knife sounds interesting too, but expense will keep it in the major centers for a while.
Some of these procedures are already mainstream, such as the laproscopic surgeries, and litho for stones. The less invasive, the better. Some I've seen a bit of because I have seen most surgeries on neonates, where it is imperative to minimize blood loss. Some can be easily adapted to adult use.
MacGill in Canada (excellent facility) is doing some interesting work on the artificial blood products. I think that will be the way that the surgeries where large blood loss is expected and traumas will go. But as of now, from the links I looked at, the procedures that these bloodless surgical centers are doing is limited.
Reamond, what absolutely sucks even more is usually the hospitals settle. Nothing done wrong, just easier. This is one of the reasons why malpractice premiums are so high, especially for OB/GYNs, Pedis, Neos, and some other specialities. And many OBs are stopping their practice for this reason. The public pays in the end by decreased access to these services. Malpractice premiums are skyrocketing for nurses also. My insurance co that I had my insurance through for 17 years stopped insuring nurses in Tx a few years ago because of the claims and settlements. Texas had made it easier to sue nurses. (Should I mention who was governor?) You have the right to an informed opinion -Harlan Ellison
posted on July 25, 2002 07:17:41 PM new
snowy- I don't think the real question is whether surgeries can be performed without blood but whether doctors/hospitals would agree to do major procedures knowing they could not administer it if necessary. FYI- The Gamma Knife procedure is a non-invasive laser technique used for cancer treatment. BTW- Here in Florida many docs are posting signs in their offices that they do not have malpractice insurance.
posted on July 25, 2002 07:19:21 PM new
My dad related an interesting story to me about an attorney who lived out west in an area that has limited population and there are not that many specialists availible. She had won law suits against basically every doctor that practiced gynocology in her state and when she got pregnant there was not a doctor in her state that would accept her as a patient. The doctors felt that some of her actions were of the sort that blamed the doctor for things that were not preventable. The - If it's not a perfect baby somebody must be at fault kind of case. She ended up having to go to the next state and spend the last couple months of her pregnancy out of state near her doctor. She could not understand - felt they were taking it "personally".
posted on July 25, 2002 07:43:57 PM new
There is a difference between a bad outcome from a birth and a "wrongful life" claim.
If a doctor kept an otherwise malformed child alive, there is no cause of action, except where the actions by the doctor actually contributed to the malformation.
I know that a case for a woman who had her tubes tied (tubal ligation) who sued after she became pregnant and gave birth to a normal child. The case was thrown out as there was no cause of action for "wrongful life". Had the child had genetic problems or other defects, there may have been a case, but based on another theory.
But where wrongful life would turn things on its ear is calculating the damages. If we must calculate damages for "living", then this would also be brought up in cases for wrongful death and injuries.
A court/jury would have to do a calculus in cases of wrongful deaths as to what the life was actually worth as compared to the "advantages" to being dead. In wrongful life theory, the subject is literally "better off dead". So there would have to be a presentation in each case weighing the benefits of living compared to being dead.
If someone who was a paraplegic and wrongly killed, the jury would now have to calculate damages on the difference between the benefits of being alive and of being dead. Or if the deceased was a drug addict and homeless etc..
posted on July 26, 2002 12:31:49 PM new
1. Religion makes people do some really irrational crap sometimes. Receive donated blood or die? Um, gee, dunno....
2. If it was a planned surgery, the doc should have had the man donate his own blood beforehand.
posted on July 27, 2002 07:07:12 AM new
snowyegret- for several years, some South Florida doctors have been trying to self-insure. Past efforts have fizzled but now it seems that it may work, as 70 area doctors have started a "risk retention pool" to replace traditional, cost prohibitive malpractice insurance. The hardest hit have indeed been Ob/Gyn's whose costs have risen by as much as 50% over the past few years.
posted on July 27, 2002 08:28:15 AM new
I guess the basic question to me about all this is am I in charge of my body or is the doctor or the state. If I reject ANY course of treatment - chemo - surgery - blood - steroids - gastric bypass and am willing to assume the conseqences of my actions I do not expect some doctor to play God and tell me what I have to do. It reminds me too much of my one uncle who was in the Navey and the doctors he had available could not diagnose or treat a particular nasty tropical parasite he had picked up in the Pacific. When he had read up on it and treated himself successfully the doctor was so mad he tried to have him court marshalled for treating himself. So should we civilians be that way also? Obligated to take whatever treatment some doc says is what we need regardless? No thank you. Even if I choose to die rather than be kept alive in pain and without enjoyment of life that is my decision. Not some little self important god with a diploma.
I can just see a little unrecorded moment in history - "Yes Mrs. Washington we are going to bleed him again. If you don't want to accept the standard treatment your doctors have been trained to administer you are welcome to withdraw from our practice and seek an Indian Shaman or whatever else the devil you may care for."
posted on July 27, 2002 10:34:49 AM new "Even if I choose to die rather than be kept alive in pain and without enjoyment of life that is my decision. Not some little self important god with a diploma."
And then there is the possibility that if you want to stay alive that the little self important god with a diploma may kill you.
posted on July 27, 2002 11:01:14 AM new
Well I know they won't do it on purpose - except a few deranged fellows now and then like any group of people, but they can do it by inattention real easy. Once my allergist wrote for the nurse to give me exactly 10x the amount of an injection she needed to and it did not sound suspect to her. I got to my car in the parking lot and could not breath. I just barely made it back inside the office before collapsing. If I had pulled out of the parking lot a little faster I would have been dead. Other than scaring me there was no lasting harm. They gave me a powerful stimulant and came real close to doing an emergency treachiotomy (spelling?) on me. He was surprised I did not sue him but we all make mistakes - mine in a machine shop mean a piece of metal is scrapped. His kill someone. The only way to end the mistakes would be not to treat someone. There was nothing more that he could do to "make me whole" I have been scared worse believe me. He was forthright and honest about his mistake. Did not try to cover it up. or destroy the file.
Right now they are having a crisis over this sort of thing in Nevads
posted on July 27, 2002 11:24:02 AM new
The Jehovah Witnesses must have a pile of money. Why don't they build their own hospital facilities so this type of thing doesn't happen? Can they? Maybe they have their own techniques on how to save lives without giving blood products. Maybe they keep coming to regular doctors so they can sue if anything happens. (??)
posted on July 28, 2002 08:37:11 PM new
IMO Religous freedom is an important aspect of our constitution. This person was an adult and hopefully had received enough information from their healthcare provider to make an informed decision...and it should have been honored.
In determining a settlement one must determine the degree of harm caused by the giving of blood, and I am not sure how it could be impartially determined what the value is in this case.
James Michner finally decided that he would no longer accept dialysis treatments. Should he have had to build a medical facility to have his wishes honored?
Many physicians fail to properly plan for elective surgery. In most cases autogolous tranfusions could be available and this is a much safer proposition than receiving blood from another individual. Some surgeries are expected to have 1000+ cc of blood loss...and this should be accounted for and planned for. In emergency situations, a patient should have the choice if they are able to make it.
So all this said...there is not enough known about this particular case for me to form a definitive conclusion.
Please call me Charlotte so I don't have ta change my ID.
