Bloodless

Since I am on the Med Consult service, I have to give resident report this upcoming Wednesday (in two days...yikes! Better get workin'!)

I've decided to do a case report/presentation on a patient who was a 37 year-old female Jehova's Witness who needed to have a total knee replacement performed due to severe pain from osteoarthritis in her right knee. The care of such patients brings up some interesting medical & ethical issues since one of the core teachings of this religion is the refusal of transfused blood products. Previously, a lot of surgeons would refuse to perform procedures on such patients due to the lack of an ability to transfuse patients packed red blood cells should the procedure go awry. Now there is a movement towards offering surgery to Jehova's Witnesses--most physicians have come to realize that they cannot ethically withhold a treatment which could be beneficial for a patient, and furthermore there have been several advances in the field of "Bloodless Medicine", which is what I intend to explore in my presenation.

There are lots of options, including the injection of erythropoietin (a substance which can stimulate the body to produce more red blood cells), the use of intra-operative technologies such as cell savers (machines which "save" an individual's red blood cells as they are shed during surgery), and even specialized centers around the country which are devoted to the idea of bloodless medicine--we have one in the Hospital of University of Pennyslvania System...

Regarding the theories of Jehova's Witnesses...why do they refuse blood? I can't pretend to be an expert by any stretch of the imagination, but there is a pretty useful explanation that can be found via the Jehova's Witnesses official web site.

BTW...my own personal opinion is that there is no rational reason to refuse blood transfusions, particularly in life-threatening situations in which blood transfusion may make the difference between life & death...however we're all adults here and if somebody's religious beliefs are that strong, who am I to force a treatment on them?

Enough procrastinatin'...time to start preparing for this talk! PEACE OUT.