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Jack Ryan

Value of Life?

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Why would a God that values life so much he forbids having an abortion, even if there is a valid reason, rather have you die than submit to a live-saving blood transfusion, even if there is a valid reason?

 

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The best we can do is maybe consider the principles of God law as to what would be considered right or wrong for Christians today.  The above links are very informative in regard the subjects you brought up. Below are additional commentaries and scripture(s):

 

*** it-1 p. 28 Abortion ***
Deliberately to induce abortion or miscarriage by artificial means, by the use of drugs, or by medical operation, the sole purpose of which is to avoid the birth of an unwanted child, is an act of high crime in the sight of God. Life as a precious gift from God is sacred. Hence God’s law to Moses protected the life of an unborn baby against more than criminal abortion, for if in a fracas between men a pregnant woman suffered an accident fatal to her or the child, “then you must give soul for soul.” (Ex 21:22-25) Of course, before applying that penalty, the circumstances and degree of deliberateness were taken into consideration by the judges. (Compare Nu 35:22-24, 31.) But emphasizing the seriousness of any deliberate attempt to cause injury, Dr. J. Glenn comments: “The viable embryo in the uterus IS a human individual, and therefore destroying it, is a violation of the sixth commandment.”—The Bible and Modern Medicine, 1963, p. 176.

 

(Exodus 21:22-25) “If men should struggle with each other and they hurt a pregnant woman and she gives birth prematurely but no fatality results, the offender must pay the damages imposed on him by the husband of the woman; and he must pay it through the judges. 23 But if a fatality does occur, then you must give life for life, 24 eye for eye, tooth for tooth, hand for hand, foot for foot, 25 burn for burn, wound for wound, blow for blow.

 

https://www.jw.org/en/bible-teachings/questions/abortion-bible-view/

The Bible’s answer

Life is sacred to God, and he views even an embryo as a distinct, living being. About God, King David was inspired to write: “Your eyes saw even the embryo of me.” (Psalm 139:16) God stated that a person would be called to account for injuring an unborn child. So, in his eyes, killing an unborn child is murder.—Exodus 20:13; 21:22, 23.

What, though, if an emergency situation at the time of childbirth forces a couple to choose between letting the mother live and the baby die or vice versa? In that case, the couple would have to decide which life to try to save.

 

- END Quote -

 

You did however, ask a very thought provoking question.  We had discussed the issue of blood transfusions quite thoroughly in the previous forum.  Listed below is the commentary from one of the links above:

 

https://www.jw.org/en/bible-teachings/questions/bible-about-blood-transfusion/

What Does the Bible Say About Blood Transfusions

The Bible commands that we not ingest blood. So we should not accept whole blood or its primary components in any form, whether offered as food or as a transfusion. Note the following scriptures:

  • Genesis 9:4. God allowed Noah and his family to add animal flesh to their diet after the Flood but commanded them not to eat the blood. God told Noah: “Only flesh with its soul—its blood—you must not eat.” This command applies to all mankind from that time on because all are descendants of Noah.

  • Leviticus 17:14. You must not eat the blood of any sort of flesh, because the soul of every sort of flesh is its blood. Anyone eating it will be cut off.” God viewed the soul, or life, as being in the blood and belonging to him. Although this law was given only to the nation of Israel, it shows how seriously God viewed the law against eating blood.

  • Acts 15:20. Abstain . . . from blood.” God gave Christians the same command that he had given to Noah. History shows that early Christians refused to consume whole blood or even to use it for medical reasons.

Why does God command us to abstain from blood?

There are sound medical reasons to avoid blood transfusions. More important, though, God commands that we abstain from blood because what it represents is sacred to him.—Leviticus 17:11; Colossians 1:20.

 

-END Of Quoted Text-

 

There are several aspects to consider:

1.  The Bible does not directly mention blood transfusions since the practice did not exist at that time although people may have drank blood of others or during religious rituals;

 

2.  The Bible does not state do not eat or drink whole blood components;

 

3.  The Bible does state, you must not eat blood of any flesh; you must abstain from blood;

 

The facts are:

1.  We do eat blood from animals or cooked meat with blood (whether whole blood or fractions of blood), after it has been drained or bled as far as possible.  Many people, including JW's, eat their meat rare which may include whole blood components.

2.  It has been reported that some vaccines, antidotes are made from whole blood components of animals and/or humans as well as blood alternatives/substitutes accepted by JW's for treatment.  (Albeit, it would be such a small fraction of blood by the time it is purified and manufactured for human consumption.);

3.  There has been a case made that an unborn child while in the womb receives a transfusion of blood from the mother;

4.  The Israelites drained or bled animals for sacrifice and/or communal sacrifice, in which we can also assume they cooked and/or ate some amount of whole/fraction of blood;

5. Men in battle sinned by eating the blood of animals which had not been bled and yet the sin did not appear to be considered a deliberate crime, or one were the death penalty was imposed; 

 

(1 Sam 14:31 On that day they kept striking down the Phi·lisʹtines from Michʹmash to Aiʹja·lon, and the people became very tired. 32 So the people began rushing greedily at the spoil, and they took sheep and cattle and calves and slaughtered them on the ground, and they ate the meat along with the blood. 33 So it was reported to Saul: “Look! The people are sinning against Jehovah by eating meat with the blood.” At this he said: “You have acted faithlessly. Roll a large stone to me immediately.” 34 Saul then said: “Spread out among the people and say to them, ‘Each of you must bring his bull and his sheep and slaughter them here and then eat them. Do not sin against Jehovah by eating meat with the blood.’” So each of them brought his bull with him that night and slaughtered it there. 35 And Saul built an altar to Jehovah. This was the first altar he built to Jehovah.)

 

Summary:

I've recognized that often words/scriptures can have a deeper meaning that what we read on the surface and sometimes a completely different understanding according to the original context or ancient language(s).  At any rate, it appears an exception is made in the case of abortion if the mother's life is in danger, and;

 

1.  After much consideration, including the context and passages of Tertullian, along with others, I am of the opinion that abstaining from blood meant the bleeding of the animal although perhaps a great deal of blood would still remain.  Also abstaining from blood could mean murder in which God commanded Noah anyone shedding man's blood, by man his own blood be shed or God asks for the murderer's blood in return;   

2.  I was also left with the opinion that blood transfusion is a matter of conscience for the individual/families along with prayer, although considering that blood can be very contagious, it is best to seek alternative treatments. 

This is just my two cents, maybe others can share their opinions, although I'm sure they may have run out of steam regarding this issue.

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Jehovah considers human life to begin at conception ... to deliberately kill that, except in personal self defense to protect your own life (which you are NOT required to do ...  it's your decision.), that killing is premeditated murder.

There is, contrary to many opinions... NO BIBLICAL SUPPORT FOR PROHIBITING SUICIDE.

There are MANY Biblical examples of those ho deliberately killed themselves, or knowingly walked into death traps (suicide missions) for principles that they considered more important than their continued existence, without any censure from God.

Sampson

King David

Jesus Christ

You cannot murder yourself ... but you can die by your own hand, or your choice in life's many difficult decisions.

It's a semantics issue.

 

 

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      He takes everything into account. He looks at the whole picture. He sees our whole life, our whole background. The things we battle with, our imperfections. And He still loves us. And He does what He can to help us. 
      That’s a wonderful thing! That should really move us to really want to serve Jehovah and love doing His will. 
      There’s a scripture in 1 John that says: “Jehovah is greater than our heart.” Well, what that means is that our heart sometimes focuses in just on small individual imperfections and problems we have. But Jehovah sees much more than our little heart. He sees the whole picture. He’s greater than our heart. And we’re grateful for that because, He does, indeed, love every one of us. 
      And so, when you get discouraged and blue…think about that woman. And think about the wonderful hope we have and the beautiful things that are in store for us and our great privilege of serving Jehovah God right to the end. And then we can rejoice and be happy in our service. – Bible Speaks 

    • Guest Nicole
      By Guest Nicole
      Mrs Mortimer was undergoing a hip operation when she refused the blood transfusion
      A Jehovah's Witness lost her life after she refused a blood transfusion during a major hip operation due to her religious beliefs.
      Barbara Mortimer, 69, went against doctors' advice and sadly died on May 24, 2017, shortly after a hip replacement.
      A final hearing was held at The Old Courthouse in Hatfield yesterday (Wednesday, October 18) before Coroner Geoffrey Sullivan.
      The court heard that in January of this year, Mrs Mortimer visited her GP Mark Penwell with "severe left hip pain."
      Doctor Penwell said: "She was struggling to walk with it, even using a stick.
      "The only useful intervention was a hip replacement."
      He admitted however, that he had concerns about Mrs Mortimer, of Portland Road, Bishop's Stortford, who would decline any blood products due to her being a Jehovah's Witness.
      Mrs Mortimer also suffered what was thought to be a heart attack in 2006 and acute coronary syndrome after having chest pain in 2010.
      For her hip, Mrs Mortimer was referred to consultant orthopaedic surgeon Rajeev Sharma.
      He said: "She came to see me in the clinic on Thursday, March 23.
      "She came in with a diagnosis of hip arthritis on one of the sides.
      "She had an X-ray that showed the joints were worn out."
      Risks associated with the procedure including displacing the hip, heart attack and most commonly infection, were discussed with Mrs Mortimer.
      Mrs Mortimer chose to ungergo surgery, but was taking aspirin at the time which thins the blood. There was also a risk that she would need a blood transfusion during the operation.
      Steps included administering tranexamic acid, swabs soaked in adrenalin and a spinal aesthetic as opposed to general, as these all help to prevent and restrict blood loss.
      Mr Sharma said: "We needed to be sure our surgery is in such a manner to prevent bleeding.
      "It was safe to proceed providing we take all the necessary precautions."
      The procedure went ahead with Mrs Mortimer's haemoglobin levels being within an acceptable range.
      But during the operation after the joint was dislocated, the living part of the bone began to bleed.
      The bleed then became "exponentially massive," according to Mr Sharma following the removal of hard cartilage.
      The adrenalin swabs, an alternative method to stopping the bleed due to Mrs Mortimer's belief's, were inserted to constrict the blood vessels as well as a plastic membrane.
      Mr Sharma said: "We continued with the procedure, it was the best way to stop the bleeding.
      "I could not think why such a lot of bleeding would take place.
      "Was it the aspirin? Would it have had a significant effect on her or was there an anomaly in the pelvic bone?"
      Following the surgery, Mr Sharma spoke with Mrs Mortimer's family.
      "The recommended blood products were declined," he said.
      "We were struggling to keep her alive if we can't give her any blood. Persistent refusal was risking her life."
      Mrs Mortimer faced the decision of accepting blood products or hope that the fluids given to her post-operation would stimulate cell production after such a huge blood loss.
      She died during the early hours of the morning at Rivers Hospital in Sawbridgeworth.
      Mr Sharma was challenged in court by Counsel Kate Smith, who asked whether further enquiries should have been made prior to the hip replacement due to her age, religious beliefs, medical history and the fact she was taking aspirin.
      Ms Smith presented a booklet in court regarding Jehovah's Witnesses and surgery.
      It said "should avoid any medication that could increase blood loss," referring to aspirin which thins the blood and makes the likelihood of needing a blood transfusion more likely.
      Mrs Mortimer signed a refusal form indicating her religious convictions that "no blood transfusions are to be administered in any circumstances".
      Mr Sharma said in "hindsight" there are things that would have been done differently but at that stage all the safety precautions had been made.
      The operation was also not considered to be life-threatening.
      He was also challenged whether Mrs Mortimer needed to be on aspirin. The decision to take this course was made working on the basis that she had suffered a heart attack – later found to be untrue.
      Coroner Geoffrey Sullivan, said: "I cannot see a short form conclusion.
      "The adequate way to my mind is a narrative verdict to encompass blood loss [from the] surgical procedure and declining of blood products.
      "She was admitted to Rivers Hospital, she had advanced decision not to accept blood products, and asked to consider accepting blood products, but declined to do so."
      http://www.essexlive.news/news/essex-news/jehovahs-witness-dies-after-refusing-654766
    • By Bible Speaks
      12 "You have given me life and loyal love; You have guarded my spirit with your care."  (Job 10:12)
      Job maintained his loyalty to Jehovah despite severe pressure
      Job 6:3; 7:16; 9:20-22; 10:1, 12
      Extreme grief caused Job to have the wrong perspective. He mistakenly concluded that God did not care if he remained faithful Because of discouragement, Job did not consider other possible reasons for his suffering Though grief-stricken, Job still spoke to his accusers about his love for Jehovah  https://wol.jw.org/en/wol/d/r1/lp-e/202016088?q=job+10%3A12&p=par

    • By Bible Speaks
      "By him we have life and move and exist."—Acts 17:28.NWT
      #JehovahGod #Creator #miracle #JesusChrist #LoveOneAnother?
       

      "Por él tenemos vida y nos movemos y existimos." (Hech. 17:28).NWT
      #JehovahGod #Creator #JesusChrist #GodsKingdom #LoveOneAnother?

    • By JW Insider
      I can't describe my feelings very well about something I just learned. I seriously don't know how to handle this issue.
      A couple days ago, I made a post in the area of this forum about the blood doctrine. While writing that post, it reminded me that I have been holding on to a couple of questions about the ins and outs of the doctrine, more specifically about why we now accept just about 100% of the products that are made from blood. It's true that we don't accept "whole blood" transfusions, but "whole blood" transfusions are so rarely offered any more that even the word "transfusion" has come to refer to to several blood therapies that JWs regularly accept.
      Anyway, it occurred to me that I should have no problem getting a couple of these specific questions answered because I know some of the people who were involved very deeply in the blood issue. About three years ago, at the end of 2013, I talked to Brother Rusk in NYC immediately after the Annual Meeting. I hadn't seen him for many years. He was also good friends with my wife and he gave our wedding talk back in the very early 1980's. When I met with Fred Rusk in his office at Brooklyn Bethel in 1979 and 1980 to talk about the wedding, my fiancee, and leaving Bethel, among other things, he very often took phone calls about the blood issue. He wouldn't send me out of his office, but would usually just say, can you wait a second, and then he would go on for up to an hour (during my work time) talking to doctors, hospital personnel, elders, circuit overseers, patients, or sometimes a brother down in the Service Department who was trying to word a letter correctly about our policy. Our policy was still fairly straightforward back then. Fractions were not a big "thing" yet, but there were still questions about what did and did not contain blood, or whether certain kinds of blood storage machines were acceptable or not (containing the patient's own blood). There were also issues regarding blood decisions that I had never thought of before, related to child custody, headship over family decisions, etc.
      Brother Rusk died fairly recently, but he wasn't the one involved so much with the new "fractions" policy anyway. The person who began taking over for Brother Rusk as the Society's subject-matter-expert on blood was Gene Smalley, also from the Writing Department.
      These two brothers have very different reputations. Brother Rusk was a very well-loved, peaceful man, who was nearly always soft-spoken, kind, patient and helpful. Even when taking care of a serious issue, you never saw anger. He was a cornucopia of the fruits of the spirit. Gene Smalley was almost the opposite in every way. Spiteful, hateful, bad-tempered, yelling, angry, backbiting, divisive, contentious, etc., etc. (He wasn't that way all the time of course, but often enough to gain a reputation, and more than once threatened with losing his job in Writing.) But his sweet wife Anita just died very recently (from cancer) and I thought this might be a good reason to contact him and, perhaps, if the conversation could be comfortably turned, it could be a chance to get a couple questions answered about fractions. He would know the precise answer. 
      Well, I haven't called him yet. Instead, yesterday, I started asking around from friends who may have seen how he is doing recently. This includes one person who worked with him until fairly recently in Writing, and one person who was a close acquaintance of both Gene and Anita.
      Here is the most disturbing thing I learned. I was told that I shouldn't ask Gene Smalley about the blood doctrine. Although still on the Writing Committee, evidently he has not believed in the Blood Doctrine since about 1992, according to one of the persons I just spoke with. Yet, he has still promoted it and given interviews about it.
      I have always thought of Brother Smalley as the "father of the fractions doctrine." So he would be the perfect person to ask. But the persons I asked are both well known at Bethel, and one of them has even been mentioned in the publications as early as the 1970's. My obvious question was, "Well, if he doesn't believe in it, then why does he still defend it?" Both of the persons I asked gave me the same answer, even though I asked them separately. (Although one could have been repeating the answer they heard from the other.) The answer, paraphrased:
      Even though he doesn't believe in it, he still defended it because of all the persons who have died.
       
    • By Bible Speaks
      How Can Blood Save Your Life?
      APPEARED IN
      How Can Blood Save Your Life?
      Each day people face ethical decisions about health: organ transplants, abortion, the "right to die." Hopefully, you will never face those problems.
      Yet, there is one issue that demands your attention: How can blood be used to save life?
      With good reason, many now ask, 'How safe are blood transfusions?' But this is more than a medical issue. It has made news involving Jehovah's Witnesses. Have you wondered why these ethical people, who believe in good medicine, refuse to accept blood?
      As you will see, the medical and moral aspects of using blood bear directly on how you can save your most valued possession: LIFE.
      TABLE OF CONTENTS
      •    How Can Blood Save Your Life?
      •    Blood—Vital For Life
      •    Blood Transfusions—How Safe?
      •    Quality Alternatives to Transfusion
      •    You Have the Right to Choose
      •    The Blood That Really Saves Lives
      •    JEHOVAH'S WITNESSES THE SURGICAL/ETHICAL CHALLENGE 
      •    BLOOD: WHOSE CHOICE AND WHOSE 
      CONSCIENCE?

      Download the Free Brochure at:http://www.jw.org/en/publications/books/blood/how-can-blood-save-your-life/

    • By Bible Speaks
      How Your Life Can Have  Greater Meaning
       
      AN ANCIENT proverb says: “Do not toil to gain riches. Cease from your own understanding. Have you caused your eyes to glance at it, when it is nothing? 
       
      For without fail it makes wings for itself like those of an eagle and flies away toward the heavens.” (Proverbs 23:4, 5)
       
      In other words, it is not wise to wear ourselves out trying to become rich, for wealth can fly away as on an eagle’s wings.
       
      As the Bible shows, material wealth can disappear quickly. It may vanish overnight because of a natural disaster, an economic slump, or other unforeseen occurrences.
       
      Moreover, even those who achieve material success are often disillusioned. Consider the case of John, whose work involved entertaining politicians, sports figures, and royalty. 
       
      “Do not be anxious over anything, but in everything by prayer and supplication along with thanksgiving let your petitions be made known to God; and the peace of God that excels all thought will guard your hearts and your mental powers by means of Christ Jesus.” (Philippians 4:6, 7) 
       
      Instead of trying to carry our problems alone, we need to pray fervently, throwing our daily burdens on God. (Psalm 55:22) 
       
      Faith that he responds to such supplication through his Son, Jesus Christ, will increase as we grow spiritually and discern how God helps us.—John 14:6, 14; 2 Thessalonians 1:3.
       
      After we have built up our confidence in Jehovah God, the “Hearer of prayer,” we are better able to cope with trials, such as prolonged sickness, old age, or bereavement. (Psalm 65:2) 
       
      For a truly meaningful life, however, we must also take the future into account.
      Rejoice in the Hope Ahead
       
      The Bible promises “new heavens and a new earth,” a righteous, caring heavenly government ruling over an obedient human family. (2 Peter 3:13)
      #jworg
       
    • By Bible Speaks
      Prepare now for life in
      the New World ? 
       18 "Tell them to work at good, to be rich in fine works, to be generous, ready to share, safely treasuring up for themselves a fine foundation for the future,so that they may get a firm hold on the real life." (1 Timothy 6:18,19)

    • Guest Nicole
      By Guest Nicole
      A two year-old boy with failing health can receive blood treatment despite the reluctance of his parents,  the High Court has ruled.
      In An NHS Foundation Trust v T, the youngster, referred to as ‘Child T’, had an abnormally low blood platelet (cell) count which doctors believed was related to problems with his bone marrow. As a result he had fallen ill and regularly required hospital treatment.
      A haematologist (doctor specialising in blood disorders) concluded that T would require medical treatment for the foreseeable future “in order to prevent a very serious deterioration in his health”.
      But the likely use of “blood products” in this treatment had caused a dilemma for T’s parents because they were practicing Jehovah’s Witnesses, a high profile Christian sect based in the United States which objects to blood transfusions and similar procedures on religious grounds.
      High Court Judge Mr Justice Peter Jackson described the parents as:
      “…fully committed to their son and to achieving the best outcome for him.”
      The clash between their religious beliefs and their desire to do their best for their son meant they could neither consent to the treatment nor oppose it, a position they explained in letters to the court. They asked for alternative forms of treatment to be considered.
      The NHS Trust looking after the boy applied for a legal declaration that treatment with blood products would be lawful despite the parents’ reluctance to consent.
      Mr Justice Peter Jackson concluded that:
      “I am in no doubt at all, having read the medical evidence and having considered the views of T’s parents, that it is overwhelmingly in T’s best interests for him to be able to receive this treatment in order for his health to be supported.”
      If the hospital were unable to administer the necessary treatment, there could be “very serious and possibly even fatal consequences as time went on”, he explained.
      In the circumstances it was necessary, the Judge said, for the court to make this decision rather than the parents. The resulting legal order would, however, specify that blood products would only be used “if there is no clinically appropriate alternative.”
      Read the full judgement here.
      Image by Howard Lake via Flickr under a Creative Commons licence
      A two year-old boy with failing health can receive blood treatment despite the reluctance of his parents,  the High Court has ruled.
      In An NHS Foundation Trust v T, the youngster, referred to as ‘Child T’, had an abnormally low blood platelet (cell) count which doctors believed was related to problems with his bone marrow. As a result he had fallen ill and regularly required hospital treatment.
      A haematologist (doctor specialising in blood disorders) concluded that T would require medical treatment for the foreseeable future “in order to prevent a very serious deterioration in his health”.
      But the likely use of “blood products” in this treatment had caused a dilemma for T’s parents because they were practicing Jehovah’s Witnesses, a high profile Christian sect based in the United States which objects to blood transfusions and similar procedures on religious grounds.
      High Court Judge Mr Justice Peter Jackson described the parents as:
      “…fully committed to their son and to achieving the best outcome for him.”
      The clash between their religious beliefs and their desire to do their best for their son meant they could neither consent to the treatment nor oppose it, a position they explained in letters to the court. They asked for alternative forms of treatment to be considered.
      The NHS Trust looking after the boy applied for a legal declaration that treatment with blood products would be lawful despite the parents’ reluctance to consent.
      Mr Justice Peter Jackson concluded that:
      “I am in no doubt at all, having read the medical evidence and having considered the views of T’s parents, that it is overwhelmingly in T’s best interests for him to be able to receive this treatment in order for his health to be supported.”
      If the hospital were unable to administer the necessary treatment, there could be “very serious and possibly even fatal consequences as time went on”, he explained.
      In the circumstances it was necessary, the Judge said, for the court to make this decision rather than the parents. The resulting legal order would, however, specify that blood products would only be used “if there is no clinically appropriate alternative.”
       
      http://www.marilynstowe.co.uk/2016/12/02/toddler-can-receive-blood-treatment-high-court-rules/
    • By Bible Speaks
      Never let the things you want make you forget the things you have.
      5 Let your way of life be free of the love of money, while you are content with the present things."

    • By Bible Speaks
      11 "However, you, O man of God, flee from these things. But pursue righteousness, godly devotion, faith, love, endurance, and mildness.
      12 Fight the fine fight of the faith; get a firm hold on the everlasting life for which you were called and you offered the fine public declaration in front of many witnesses." 
      (1 Timothy 6:11,12)

    • Guest Nicole
      By Guest Nicole
      Much has changed as doctors have come to understand the risks of blood transfusions and the ways to avoid them — helped in part by studies of Jehovah's Witnesses. 

      Michael Anderson, a Jehovah’s Witness minister who underwent a bloodless emergency bypass procedure after a heart attack earlier this month, was visited in his hospital room by Syl Jones, a fellow Jehovah’s Witness and an administrative resident/fellow at Hennepin County Medical Center.
      Dr. Daniel DiBardino didn’t have much time for niceties on Sept. 8 as he consulted patient Michael Anderson about the emergency cardiac bypass he needed. Anderson is a Jehovah’s Witness — opposed to donor blood transfusions — and DiBardino needed to know if he could breach that religious conviction during the procedure.
      “What if he’s bleeding to death, which occasionally can happen in cardiac surgery?” he recalled asking Anderson and his wife. “A lot of things can go wrong.”
      “Absolutely not,” was the reply.
      A decade ago, that answer might have touched off a doctor-patient argument or the kind of ethics crisis featured in medical TV shows.
      But as doctors have come to understand the risks of blood transfusions and the ways to avoid them — helped in part by studies of Jehovah’s Witnesses — much has changed.
      Hospitals such as Hennepin County Medical Center (HCMC), where DiBardino practices, have become more accommodating — and more adept at conserving patients’ own blood during surgeries.

      “When I was in medical school, honestly, that was never a thing; people didn’t talk about blood conservation,” DiBardino said. “You just used blood because that’s what you did. And that has changed.”
      Today, for example, surgeons understand that one unit of blood often works as well as two and that excessive blood from donors can result in transfusion-related complications and even deaths. As a result, HCMC has reduced the use of donated red blood cells by 32 percent since 2009. Other Twin Cities hospitals have reduced their use of blood products as well.
      HCMC has taken the approach a step further through its Bloodless Surgery and Medicine Program, including a firewall in its computerized medical records system that prevents doctors from ordering donor blood products once patients have refused them.
      The computer system gives doctors alternatives, such as medications that stimulate more blood production in the body, which they can consider even when preparing for emergency surgeries, said Dr. Jed Gorlin, who directs transfusion medicine at HCMC and is the medical director for Memorial Blood Centers, a regional donor agency.
      “In the heat of battle, you won’t remember all of those,” Gorlin said, “so it’s a checklist to go through all of that stuff.”
      The Jehovah’s Witnesses’ objection to receiving donor blood comes in part from interpretations of the Bible, including a passage in Acts that calls on people to “abstain from pollutions of idols, and from fornication, and from things strangled, and from blood.”
      Practical interpretations vary somewhat, Gorlin said. Some members of the religion accept the experimental use of a substitute made from cow’s blood, while others refuse it. A few object to the use of a machine that recycles a patient’s own blood once it has exited the body. But almost all reject transfusions of red blood cells from donors.
      Anderson, 66, has walked hundreds of miles visiting homes in southwest Minneapolis to teach his religion. He carried a medical directive with him for just such emergencies.
      Then, driving from his home in Robbinsdale to his Kingdom Hall on Sept. 8, the minister knew something was wrong.
      “All the way there, I had pain and it wouldn’t go away, and it wouldn’t go away and it wouldn’t go away,” he recalled.
      Medics determined that he was having a heart attack and gave him aspirin and nitroglycerin pills, which had eased his pain by the time DiBardino sat with him to discuss his surgery: a triple bypass to reroute blood flow around blockages to the heart.
      “There was no question ... transfusion would not be an option,” Anderson said in an interview from his hospital bed last week.
      Hemoglobin levels
      HCMC’s policy is to accommodate such objections for adult patients, when they are conscious and able to communicate their wishes, but not necessarily for parents acting on behalf of pediatric patients.
      A 1944 child labor decision in Massachusetts still governs such cases, stating that “parents are free to become martyrs themselves. But it does not follow that they are free ... to make martyrs of their children.”
      Once viewed harshly by the medical establishment, Jehovah’s Witnesses have taught doctors much about the body’s ability to survive surgeries without transfusions, Gorlin said. He gave a lecture in South Dakota this month titled “Management of blood: What we can learn from Jehovah’s Witnesses.”
      A key measure is the patient’s hemoglobin, the protein in red blood cells that carries oxygen from the lungs. Doctors once thought a hemoglobin measure of 10 grams per deciliter was the key threshold at which patients needed a transfusion. Now, they have found that patients are just as likely to survive if their levels drop to seven.
      In one local case, a woman who hemorrhaged after childbirth survived despite her hemoglobin dropping to 2.3.
      “Nobody really knows for any given person how much blood loss they’ll tolerate,” DiBardino said. “You just have to kind of put your faith into it.”
      ‘Every red blood cell matters’
      Still, the odds of surviving the triple bypass that Anderson underwent are substantially lower without transfusions, DiBardino said.
      As a result, surgeons make it a priority to conserve blood, from the initial step — severing a leg vein to serve as a bypass line around a clogged artery — to connecting that bypass line to the heart.
      “It’s on your mind that every red blood cell matters for this guy,” DiBardino said. “You’re operating on the biggest structures filled with the most blood in the human body.”
      At the end of the four-hour operation, Anderson’s hemoglobin level stood at seven. But with rest, iron pills and other medications, it rose to 12.
      One week later, Anderson had fewer IV tubes and was standing and eating solid food. Two weeks later, he was back home.
      He believes his clean living helped him survive the surgery and said he is eager to ease back into walking and his door-to-door ministry.
      “It’s just a matter of pacing myself,” he said, “as I go.”
      http://www.startribune.com/minneapolis-hospital-embraces-bloodless-surgery/394648141/
    • Guest Nicole
      By Guest Nicole
      Highlights
      •Neurosurgical outcomes in patients who refuse blood products are similar to control patients when blood management protocols are followed
      •No significant differences in mortality or morbidity were identified
      •No significant differences in hospital length of stay or readmission rates were identified
      Abstract
      Background
      Jehovah's Witnesses (JW) are a Christian faith with > 1 million members in the United States who do not accept autologous blood transfusions. The optimal management of these patients undergoing neurosurgical procedures is not well defined. Here, we examined the feasibility and safety of JW undergoing neurosurgery in a blood management program.
      Study Design and Methods
      Sixty-eight JW patients including 23 males and 45 females (mean age 53 +/- 12 years) who underwent a variety of cranial (n=19) and spinal (n=49) neurosurgical procedures over a 5-year period were identified retrospectively and their hospital charts, anesthetic records and operative reports reviewed. A concurrent cohort of sex - age- and procedure-matched non-JW controls also was identified.
      Results
      Among JW patients a cell-saving system was used in 27 cases, with blood re-transfused in 13 cases. Lactated Ringers solution was used extensively intra-operatively; albumin was given to 15 patients. The median decrease in Hgb was 2.1 g/dL. One patient had a postoperative Hgb value < 7 g/dL. One patient returned to the operating room to revise a lumbar pedicle screw, and one patient had postoperative seizures. No cardiopulmonary complications, sepsis, pneumonia, or wound infection were observed. When compared to the matched control group, similar outcome results were observed. Blood loss and operative time also were similar in JW patients and controls.
      Conclusions
      Neurosurgical procedures in Jehovah's Witnesses are feasible, safe, and have similar outcomes to patients willing to accept transfusion when managed within a multidisciplinary blood management program.
      http://www.worldneurosurgery.org/article/S1878-8750(16)30854-3/abstract
    • By Bible Speaks
      Prepare Now for Life in the New World
      "Tell them to work at good, . . . so that they may get a firm hold on the real life.” (1 Timothy 6:18, 19.)
    • Guest Nicole
      By Guest Nicole
      Donated blood at a bank in Indianapolis. The F.D.A. has recommended that all donated blood in the United States be screened for the Zika virus. CreditMichael Conroy/Associated Press
      The Food and Drug Administration on Friday took steps to safeguard the nation’s blood supply from the Zika virus, calling for all blood banks to screen donations for the infection even in states where the virus is not circulating.
      The recommendations are an acknowledgment that sexual transmission may facilitate the spread of Zika even in areas where mosquitoes carrying the virus are not present. Officials also want to prepare for the possibility that clusters of local infection will continue to pop up in parts of the United States for years to come.
      “There could be multiple outbreaks of Zika happening outside the known current ones in South Florida, but because we are not actively looking they could be happening silently,” said Dr. Peter J. Hotez, the dean of the National School of Tropical Medicine at Baylor College of Medicine, who applauded the F.D.A.’s move.
      Without federal funds, it is generally not possible for local health departments to conduct active surveillance for Zika virus in the blood or urine of patients with fever or rash, he added.
      “In some ways the inaction from Congress has forced the F.D.A. to adopt this position,” Dr. Hotez added. “They have no other choice.”
      The agency urged blood centers to use one of two experimental tests intended to detect active infections, called nucleic acid tests, before releasing donated blood for use in transfusions. As an alternative, banks may decontaminate plasma and platelets with so-called pathogen reduction technology.
      But the recommendations are likely to pose a significant challenge for some blood banks and for the third-party labs that perform much of the blood screening nationwide, some experts said.
      Eleven states must put the new safeguards into place within four weeks. They include Alabama, Arizona, California, Georgia, Louisiana, New York and Texas, which have many residents who travel to Zika-affected countries or are near an area that already has locally acquired mosquito-borne cases.
      Other states have 12 weeks to carry out the recommendations.
      “This is a bombshell, because this is extremely rapid introduction of a new test nationwide that’s almost unprecedented,” said Dr. Jeffrey McCullough, emeritus professor of laboratory medicine and pathology at the University of Minnesota Medical School. “To try to implement this, in four weeks, is really, really difficult.”
      Yet the new safeguards also are necessary, Dr. McCullough said. Under current guidelines, it is too difficult to identify infected donors by “trying to sort out risky donors by history of where they’ve been or what they’ve exposed to.”
      Nationwide, nearly 14 million units of whole blood and red blood cells are collected each year from about seven million donors. Every day, as many as 36,000 units of red blood cells are given to patients, along with 7,000 platelet units and 10,000 units of plasma. Consistent screening of the blood supply is an enormous task.
      There are more than 11,500 confirmed cases of Zika virus in states and territories, according to the C.D.C. Nearly 2,500 of them are people in the continental United States who traveled abroad where Zika-infected mosquitoes are circulating. More than 30 cases were acquired in Florida.
      Puerto Rico has been screening all blood donations since March. TheCenters for Disease Control and Prevention in June found that asurprisingly high percentage of donors had signs of active infection with the Zika virus.
      The F.D.A. provisionally approved two screening tests for Zika in blood donations on an investigational basis in March and June respectively. The first is made by Roche Molecular Systems, and the second by a collaboration between Hologic Inc. and Grifols.
      Neither test is fully F.D.A approved yet, and the facilities using them are enrolled in a continuing study. As part of Roche’s investigation, four centralized testing labs that screen blood for multiple banks in the South have been “collecting and testing blood for weeks now,” said Tony Hardiman, who leads the blood screening operations at Roche.
      For the 11 states that need to be ready in a month, he said, “we are pretty much locked and loaded.”
      “Our focus now is what do we do for the rest of the country to bring them up in 12 weeks,” he added.
      Officials at Blood Systems, which operates blood banks in 24 states, said they will be able to test blood donations in California and some Southern states like Mississippi in a month. The company will then work on getting sites in the Rocky Mountain States operational, said Dr. Ralph R. Vassallo Jr., the chief medical and scientific officer.
      Creative Testing Solutions, a large blood donor testing lab, already is using both experimental Zika screening tests. In Tampa, the company has relied on Roche’s test since the Zika outbreaks began in Miami-Dade County.
      In its Dallas and Phoenix outposts, C.T.S. has installed two so-called Panther machines to be able to screen tubes of blood with the Hologic-Grifols test, in case Zika-infected mosquitoes arrive along the Gulf Coast.
      In light of Friday’s F.D.A. recommendations, officials said they will have to train more employees to use new tests and significantly scale up.
      “We test 35 percent of the blood supply, so in order to be able to do that in all states in 12 weeks, we are going to need additional pieces of equipment,” said Marc Pearce, a spokesman for C.T.S. — 12 more Panthers and one more machine that runs the Roche test.
      Asked on a conference call with reporters about funding the new safeguards, Dr. Peter Marks, the director of the F.D.A.’s Center for Biologics Evaluation and Research, said, “I can’t speak to the cost of implementation at this time.”
      Hospitals may wind up paying more for each unit of blood because of additional screening costs, some experts said.
      “When hospitals hear this, they will be concerned that they could see a cost increase of up to $8 more per unit,” Dr. Vassallo said, which is roughly how much it costs to screen each unit for the Zika contamination.
      This month, after the first cases of local transmission in Miami were discovered, some blood banks near Zika hot zones in Florida began screening blood donations. According to Dr. Marks, one donation contaminated with the virus had been found in recent weeks in the state.
      The bag of contaminated blood was discarded. “The system worked correctly,” Dr. Marks said.
      http://www.nytimes.com/2016/08/27/science/all-donated-blood-in-us-will-be-tested-for-zika.html?_r=0
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