Jehovah's Witness liaisons help surgeons adapt

The faith opposes traditional blood trans- fusions, and the representatives suggest alternative treatments.

Tulsa World/May 15, 2007
By Kim Archer

If it weren't for the Jehovah's Witness hospital liaison committee, Ted Christensen believes that he wouldn't be able to walk today.

"It pulled me through," the Tulsa-area contractor said. "Without doing the surgery and working with the liaison committee, I'd be in a wheelchair."

Christensen, 37, needed the surgery last year after an accident involving an all-terrain vehicle he was riding at Camp Gruber near Braggs. The vehicle rolled over, breaking his left pelvis and crushing his right pelvis.

Christensen was taken by LifeFlight to Tulsa, where he was transferred to St. Francis Hospital and scheduled for two emergency surgeries.

But Christensen is a Jehovah's Witness, whose doctrine opposes blood transfusions, including whole blood, red cells, white cells, plasma or platelets.

He refused to sign the consent form for the surgery.

"My surgeon was concerned," he recalled. "He said: 'We can't perform the surgery without blood. You're going to die.' "

The surgeon, Dr. Todd Swenning of Tulsa, said he was uneasy about a transfusion-free surgery because fixing Christensen's pelvis would require a large incision.

"If he lost a lot of blood, we would have nothing to give him and he could die," he said.

Christensen called the Tulsa-area Hospital Liaison Committee for Jehovah's Witnesses.

Richard Collins of the committee came to St. Francis to talk with Swenning about acceptable alternatives for Christensen, including blood salvaging -- a technique in which a surgeon collects the patient's lost blood, filters and washes it, and transfers it back into the patient.

Swenning performed the surgery using this technique.

Christensen "did as well as I could have hoped," he said.

Swenning said the liaison helped him understand Christensen's beliefs more fully and have more compassion for him.

"I think it's my obligation to respect his beliefs," he said.

Collins said the purpose of the committee is to ensure that Jehovah's Witnesses receive quality medical care without violating their beliefs about blood.

"Our beliefs are based on Scripture in Leviticus and Acts that call for us to abstain from blood," he said.

Some Jehovah's Witnesses will accept no blood of any kind, including blood fractions such as clotting factors, hemoglobin, interferons and platelet-derived healing factors, Collins said.

But because the Bible does not specifically address other procedures or blood fractions, the decision to accept their use is left to the individual, he said.

"We're not making decisions for them. We only want to ensure that their beliefs are respected," he said.

Every Jehovah's Witness carries a medical directive card that specifies that blood should not be given if the person is injured. It lists alternative treatments that the person might accept.

Collins said liaisons have access to those records to ensure that the person's wishes are re spected, particularly if the person is unconscious.

"We're not working against anybody," he said. "We're working with them to help the patient get better."

The medical community has come a long way, from early suspicions about the liaison's intent to eagerness to learn how to meet the needs of patients without violating their moral beliefs, Collins said.

"The poor doctor is trained to do certain things, but if he has one of his hands tied behind his back, he doesn't know what to do," he said. "What we do is help untie his hand so the patient can get the best care possible."

What is bloodless surgery?

The term "bloodless surgery" should not be taken literally. The patient will bleed. He or she just won't receive a transfusion of allogeneic blood. That's blood taken from someone else. It is the type of blood provided by blood banks.

People choose bloodless surgery either for religious reasons or personal preference. Jehovah's Witnesses, for example, firmly believe that blood has sacred meaning and that it should not be removed from the body and stored, nor should someone else's blood be taken in during transfusion.

Other people simply do not like the idea of putting a foreign substance in the body. The hepatitis scare in the 1970s and the AIDS epidemic in the 1980s made many people think twice about receiving blood.

Allogeneic blood transfusions also are very expensive. It is estimated that every unit of red blood cells that is transfused increases the cost of a hospital stay by $1,000 to $1,300.

Blood transfusion alternatives:

Blood salvaging: Blood that is lost during surgery can be collected, filtered, washed and transferred back into the patient.

Hemodilution: Blood can be removed before surgery, and the volume is replaced with water and minerals. The blood stays in storage bags connected to the patient, and it is returned to the patient after surgery.