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"Bloodless" Neurosurgery Among Jehovah's Witnesses: A Comparison with Matched Concurrent Controls

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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

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I had neurosurgery.  My Surgeon ask me how certain I was about not taking blood.  I replied that when Noah got off the ark, and the  rainbow covenant was made, we were allowed to eat meat, but must pour the blood out on the ground.  Jewish covenant, not allowed to eat blood. Christian covenant, Acts 15:28,29 "abstain from blood".  Never has any servant of God EVER been allowed to eat blood, or take it into their body.  When people are facing death, that's usually a time when they try to make peace with God.  As I am being operated upon, and things go south, my life is hanging by a thread, why would I want my last act on God's green earth to be thumbing my nose at my creator?

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      Among the victims of the Witnesses' shunning and stonewalling tactics interviewed by Inquirer reporter David Gambacorta were:
      The parents of a 4-year-old New Cumberland girl who was molested at the Jehovah Witness Kingdom Hall in Red Lion A Spring Grove woman who was molested when she was a teen by a Witness who was a family friend A York woman who was molested in her teens by a couple she knew through the Jehovah's Witnesses. Three defendants identified in the Inquirer investigative piece were prosecuted and sentenced in York County. A fourth is awaiting prosecution.
      https://www.ydr.com/story/news/2018/05/10/daily-news-investigates-coverup-child-abuse-jehovahs-witnesses/599366002/
    • Guest Nicole
      By Guest Nicole
      Anyone who regularly takes the el or subway has seen them.
      They stand quietly smiling with carts of religious publications, out on the sidewalk when it's nice out, and in the "unpaid" area of the station near the Ventra machines or turnstiles when the weather is inclement. The women are dressed modestly but sharply, and the men look natty as well, often wearing sport jackets and fedoras.
      They are volunteers from the Jehovah's Witnesses, a Christian denomination that claims 8.4 million members in 240 countries.
      Though I'm not interested in converting, I sometimes stop and say hello and pick up a copy of The Watchtower or Awake! out of courtesy, since I find their cheerful vibe oddly comforting. They're certainly more agreeable than the Old Navy Street Preacher, who hangs out at Randolph and State railing against fornicators and cigarette smokers.
      But not everyone appreciates the Jehovah's Witnesses' presence at transit stations. Kevin Havener, an Edgewater resident who often commutes via the Red Line, contacted me to share a message he sent to the transit authority, to which he says he never got a response. He claimed that the Witnesses' practice of offering literature inside el stations violated a guideline in the agency's Rules of Conduct warning against the distribution of written materials on CTA property.
      "I find this inexplicable permission deeply, personally offensive," Havener's message read. "Would the CTA allow other religious proselytizing [by groups] such as [Orthodox Jews], or Buddhists, or Hare Krishnas? OF COURSE NOT."
      Havener eventually revealed to me that he has a horse in this race. About a decade ago he and other members of the Buddhist Peace Fellowship, an activist group, wanted to hand out leaflets inside the Fullerton el stop in Lincoln Park. When they asked the CTA customer assistant for permission, they were told they needed to be out on the public sidewalk far away enough not to block any station doors. "That made perfect sense, and that's what we did," he said.
      Read more: https://www.chicagoreader.com/chicago/is-it-legal-for-jehovahs-witnesses-to-proselytize-inside-cta-stations/Content?oid=47477482

    • By James Thomas Rook Jr.
      If a Brother or Sister in good standing in the Congregation goes into the hospital, and agrees to a whole blood transfusion, and dies anyway, can they be disfellowshipped post mortem, and what about the funeral arrangements?  ( I have heard of this being done, but never explained....)
      Can they have a funeral at the Kingdom Hall?
      Let's say a Brother or Sister in good standing in the Congregation  goes berserk, and commits some crime, and either dies by misadventure, or gets shot by police ....
      Can they have a funeral at the Kingdom Hall?
      Considering such questions is like a submarine on the surface, at night, in the fog .... firing torpedoes randomly into the darkness, to see what lights up.
      .... sometimes survival depends on having the right answer about "What is out there?".
    • Guest Nicole
      By Guest Nicole
      (CNN)After a difficult, monthlong journey from Central America to the US-Mexico border, dozens of asylum-seeking migrants are vowing to remain outside an immigration processing center until "every last one" is admitted into the country, an organizer with the caravan said late Sunday.
      Earlier, the migrants marched from Friendship Park in Tijuana, Mexico to the San Ysidro port of entry. They stood on the Mexican side; on the other side lay San Diego, California. It was the final leg for some in the caravan of hundreds of migrants, which had reached Tijuana on Tuesday.
      Alex Mensing, an organizer with Pueblo Sin Fronteras, which assembled the caravan, said 50 migrants were admitted to the immigration processing center. He said the migrants' decision to not return to a nearby shelter overnight was made in solidarity with the asylum seekers who are inside the facility.
      But the migrants' fate is uncertain. Before the group arrived, US Customs and Border Patrol officials said the port had already reached full capacity, and migrants trying to get into the United States may need to wait in Mexico as officials process those already in the facility.
      https://edition.cnn.com/2018/04/29/americas/migrant-caravan-us-border-crossing/index.html
    • Guest Nicole
      By Guest Nicole
      The parents of a 14-year-old boy with bone cancer won a legal challenge against a Mesa hospital that attempted to override their religious objections to blood transfusions.
      The Arizona Court of Appeals on Tuesday ruled that a lower court's emergency hotline used by hospitals to authorize medical treatment on behalf of patients is not allowed under state law.
      The parents of a 14-year-old boy with bone cancer challenged Banner Cardon Children's use of a Maricopa County Superior Court emergency hotline to authorize blood transfusions on behalf of the child. The parents and boy are Jehovah's Witnesses and objected to blood transfusions on religious grounds. 
      While Banner Cardon's medical-treatment plan initially consisted of alternative therapies to fit the parents' religious views, hospital staff later determined that blood transfusions were medically necessary. 
      Hospital staff called the Maricopa County Superior Court hotline multiple times from October through December last year to seek authorization for the blood transfusions. The court granted three of five requests, according to court documents.
      The parents filed a petition with the Arizona Court of Appeals seeking to halt the transfusions.    
      The parents, identified as Glenn and Sonia H., argued that the Superior Court hotline "lacked jurisdiction" for such emergency medical requests and also argued that hospital staffers did not justify the medical need for blood transfusions. 
      The lower court said that such emergency requests were "standard practice" nationwide and the hotline rotated among Superior Court judges who answered requests after hours. 
      In an opinion written by Judge Kenton D. Jones, the appellate court concluded that the question of whether the lower court had jurisdiction to OK emergency medical treatment was one "of significant statewide importance."
      Jones noted that Arizona law allows a Juvenile Court that has jurisdiction over a child to order a parent or guardian to get medical treatment for a child. However, the appellate court did not find any such jurisdiction for a Superior Court emergency hotline.
      "Our review of Arizona statutes and rules of procedure reveals no provision ... authorizing the superior court to maintain an emergency hotline for the purpose of ordering medical treatment for a non-consenting minor," Jones wrote. 
      Therefore, the lower court's order authorizing medical treatment on behalf of the boy is void, the appellate court said. 
      The parents filed the appellate-court action in November but did not request a stay of the lower court's order. The boy received blood transfusions on Dec. 1 and Dec. 5 before his parents relocated his care to a medical facility in Portland, Oregon. 
      Banner Health officials said the health-care provider has not yet decided whether to appeal the appellate court's decision.
      Representatives of Watchtower Bible and Tract Society of New York, which filed a legal brief on behalf of the parents, did not immediately return a message seeking comment.
      A Jehovah's Witnesses website said the religion considers blood transfusions a "religious issue rather than a medical one," citing multiple biblical passages.
      Patients who develop certain types of cancer, such as leukemia, often require blood transfusions as a part of treatment.
      https://www.azcentral.com/story/money/business/health/2018/04/04/heres-why-parents-filed-legal-case-prevent-their-child-cancer-getting-blood-transfusion/483577002/
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    • True, however, testing the spirit does not include drawing one's own conclusions outside scripture. I have not found an insistence where the Watchtower has gone beyond what is written. Do they try to simplify certain things, yes they do. That doesn’t mean they are stepping away from the context. Another thing is with the comparison made. The GB are following the true spirit of God like the apostles. Therefore, they have NOT taken the position of the Jerusalem counsel. If you have, then you sit in Moses seat. Matthew 23:2 If the passion is to correct, as God corrected his people, Then I would suspect there is a resemblance to be equal to Christ as the Pope seems to indicate. The GB do not hold themselves in that high regard as to think, they can question God's motives for humanity. I would recommend studying the issue further. There are areas that haven’t been included with many presentations here. Since you claim the Watchtower is misrepresenting an issue that has become an obstacle to your personal faith, then I would make light of JTR and TTH comments about contacting the Watchtower directly. Feeding an assumption only emboldens the God of this world, no one else. Correct. There is only one way to view scripture. Anyone deviating from that is causing personal harm to the spirit of others. It doesn’t matter if those individuals hate the Watchtower, it’s by their own spoken words and actions of clear and concise misinterpretation of scripture, and misapplication of the Watchtower literature where they fail to see the difference. Removing themselves from the context of scripture to argue with the strength of hate and discourse is the sole definition of scripture when Christ clearly stated not to and to stay away from. Those are the dangers when we engage in an open forum. We like to think it is to discuss issues. However, the ever present danger will always be, the influence of the devil. It is one thing to defend the truth, but quite another thing to defend the truth when one’s heart is conflicted. Merely following that conduct disqualifies anyone from stating they are Christian. That is the kind of Christian Jesus spoke of as a danger. The confusion would lie with how the public perceives the Watchtower under the direction of the bible Student association. The word “association” should give anyone, pause to rethink, Russell and Rutherford belonged to the International Bible Student Association. A reason, Rutherford dismissed the edger pyramid scheme straight up. Russell, used it as a comparison, nothing more. Another thing that witnesses should consider, those works were made by not allowing Christendom’s view of scripture. Therefore, Russell essentially started from scratch. There are far more reasons why those dates were accepted. Mainly, by events of that time. Bible Students still believe, the Jewish nation has a pivotal role in the last days. According to Christ everyone became relative in the last days including the Jews. They are not the sole reason for the last days as Christendom exerts. Remember, even the most conservative view which is Bishop Ussher, his calculation referenced 586BC as the 3rd instance of judgment by Nebuchadnezzar. The third, not the first nor the second as historians and scholars claim, but the third. This is why history itself is flawed, since they continue to insist, there were only 2 campaigns against Judea and Jerusalem. Mainly 597-587BC. I will not beat on the bush with this one. I am confident we both know what limitations are imposed and previous actions taken.  
    • An interesting take with a lot to say for it. When Jude mentions these "rocks beneath the surface" for example, it always reminds me of the first time I read "Paul and Thecla" while at Bethel, but at the NYPL, via a book about Christian widows of the 2nd century. Paul and Thecla is an early Christian short story or novella with Thecla, not Paul, as the hero. It's one of a few stories of this type, probably written by and for women in the early Christian congregations. The antagonists of some of these stories are the 2nd century "circuit overseers" who would go from congregation to congregation saying all the right things from the "platform" but then they would also quietly worm their way into the houses of well-meaning sisters and widows, and try to take advantage of them sexually. I was quite surprised when the Watchtower last year mentioned Paul and Thecla for the second time in nearly 100 years, and was again surprisingly supportive of the work as containing possible reflections of true traditions believed in the 2nd century: *** w18 March p. 13 par. 3 Questions From Readers *** The Acts of Paul and Thecla was highly regarded in early centuries, as confirmed by the fact that 80 Greek manuscripts of it exist, as well as versions in other languages. Thus, our artistic presentations are in line with some ancient indications of what the apostle looked like. I personally have never experienced a "bad" circuit overseer. All of them have been exemplary and I have always looked forward to their visits, especially when hearing a new one for the first time. But I think all of us old-timers have had experience with congregational drifters, and we often look at them with the same kinds of suspicions. Sometimes it's a young brother who is very vague about his last congregation and who quickly latches on to an association with another eligible sister. Sometimes it's a more elderly brother, perhaps even a special pioneer, looking for an alternate congregation, hoping the trouble he caused in the last congregation won't get reported in too much detail. (Speaking from a real example, this elderly brother also latched onto a "relationship," and place to stay, with a family of sisters: a sister with an unbelieving and ailing husband, and a couple of daughters. It was a recipe for disaster.) The younger brother caused some heart-ache by getting engaged to a sister, and the engagement was later broken off.  It's hard for me not to imagine such cases when I read Jude. So, at first, it was hard for me to see them as drifters into forums like this one to cause other kinds of trouble, but I can definitely see a similarity now.  
    • I’m not really sure what “worshipful” means.  When celebrities come into town, they are mobbed by fans. Are those fans worshipful? I might say yes, but the fans themselves will just say they they are flocking to them out of respect for their accomplishments. If brothers pose for selfies with the GB members (much to the latter’s annoyance, I am consistently told, someone said with the possible exception of Lett) are they “worshipful?” It’s in the eye of the beholder, I think. Though I have a great many faults, admiring personalities is not one of them. I would love to have a GB member stay at my house so I could ignore him. “There’s your room—make yourself at home. If you’d like to visit, that works fine, but you have many things to do and if you ignore us completely that also works fine with us,”  Probably there are few words they could hear that would please them more. And no, @James Thomas Rook Jr., I wouldn’t present them with a list of my QUESTIONS that, as MEN of HONOR, they are obligated to answer,
    • Just for interest, here is an interview with prince Andrew. It's acutely embarrassing the excuses  he makes and the denials.... Read comments, they are entertaining  
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