Search the Community

LUXEMBOURG (CN) — A Latvian child who needed open-heart surgery prevailed Thursday in a religious discrimination case against the country’s Ministry of Health, which refused to sign on off on letting him undergo the procedure in another country where he wouldn’t require a blood transfusion. Names are withheld from the ruling released this morning by the European Court of Justice. It says only that the child was a Jehovah’s Witness who needed surgery because of a congenital heart defect, and that in Latvia the procedure is not possible without a blood transfusion. The boy’s parent requested a form called an S2 that would authorize treatment in Poland — presumably where the surgery can be performed without a transfusion — but Latvia’s National Health Service refused to comply. The family began fighting in court, losing every step of the way before the case reached Europe’s high court in Luxembourg, but ultimately the boy underwent heart surgery in Poland on April 22, 2017 — over a year after he was first denied an S2 form. https://www.courthousenews.com/europes-top-court-rules-for-jehovahs-witness-child-in-medical-bias-case/

The father of a severely jaundiced 14-day-old premature baby who denied the baby life-saving blood transfusion on medical and religious grounds, on Saturday explained his side of the story. Mr Emmanuel Onokpise claimed he and his wife were never informed their child was in any danger of death to the baby due to the weight. The Lagos State Government evacuated the baby via a court order following information from a concerned member of the public informed its Office of the Public Defender that Mr and Mrs Emmanuel Onokpise had, contrary to medical advice, discharged their severely ill baby from hospital after refusing her blood transfusion on religious and medical grounds. Baby Onokpise, who was born on December 18, 2019, is now in an orphanage home. According to the government, the baby’s parents, who were on Medical Insurance with a Health Maintenance Organisation (HMO), “vehemently opposed the blood transfusion” for the baby and took her home, where her condition deteriorated and death was imminent. Onokpise, who responded to enquiries from The Nation via a statement, said he and his wife loved their child and believed in medical intervention to cure ailments. He added that being Jehovah’s witnesses, they also had an obligation to obey Jehovah’s commandment to abstain from blood consumption. Read more: https://thenationonlineng.net/why-we-rejected-blood-transfusion-for-our-baby/

The Congolese woman, Bibiche Tshibola Makola, who is a Jehovah’s Witness by faith, was hesitant to have her own blood taken in advance, frozen and re-transfused into her. BENGALURU: A 39-year-old woman, who was diagnosed with a cardiac ailment, approached a city hospital, stating that she was ready to undergo any treatment, provided there was no blood transfusion involved in it. The Congolese woman, Bibiche Tshibola Makola, who is a Jehovah’s Witness by faith, was hesitant to have her own blood taken in advance, frozen and re-transfused into her. For Jehovah’s witnesses, transfusion of blood is against their religious belief. After a lot of analysis, surgeons at Fortis Hospital on Bannerghatta Road managed to perform a bloodless open-heart surgery and valve repair. According to doctors, the woman suffered from restrictive cardiomyopathy, where a chamber of the heart is unable to stretch and results in bleeding. The patient came to India for treatment, as many countries and centres refused to carry out the surgery. Dr Vivek Jawali, Chief Cardiothoracic and Vascular Surgeon at Fortis Hospitals said, “Makolo had severe restrictive cardiomyopathy, in which there is restrictive filling of the ventricles. With due respect to her religious beliefs, we recommended her to undergo a bloodless surgery.” The doctors then sat together and had a peri-operative plan. “We put the patient on a series of medications, including blood conservatives that helped increase her haemoglobin level to 14.8 g/dL. The surgery was conducted using all the blood conservation techniques practised at our unit for all patients , It was successful and no blood transfusion was required during the entire procedure.” Dr Murali Chakravarthy, Department of Anaesthesia, explained that bloodless surgery is a risky situation and can lead to hemorrhagic shock in the patient. Bibiche’s husband Roger Muamba said, “We were very worried about her treatment. We were very happy with the doctors.” Jehovah’s Witnesses against blood transfusion They believe, according to the Bible, that one must not ingest blood, even through transfusion. Under Quebec’s civil code, an adult who is conscious and of sound mind, has the right to either accept or refuse medical treatment. http://www.newindianexpress.com/states/karnataka/2019/mar/06/docs-operate-congolese-woman-respect-religious-sentiments-1947312.html

Jehovah has clearly and unambiguously prohibited the use of blood for sustaining human life. Many times, OT and NT. Can I question this point please ? Did Jesus ever forbid the use of blood to save a human life ? Can you show me a scripture where JESUS forbids the use of blood to save a human life ? Let us look at a few points here. I think it is true that the Jews / Nation of Israel practised something known as Pikuach Nefesh https://en.wikipedia.org/wiki/Pikuach_nefesh This meant life was precious and should be saved even if it meant going against the Law. Add to this that Jesus gave an example which in my opinion goes much deeper than the actual words of the scripture. Matthew 12 v 9 through 12. 9 After departing from that place, he went into their synagogue, 10 and look! there was a man with a withered* hand!k So they asked him, “Is it lawful to cure on the Sabbath?” so that they might accuse him.l11 He said to them: “If you have one sheep and that sheep falls into a pit on the Sabbath, is there a man among you who will not grab hold of it and lift it out?m12 How much more valuable is a man than a sheep! So it is lawful to do a fine thing on the Sabbath.” Surely here Jesus is saying that it is right to go against 'the Law' and /or the principles of it, to save a life. And please tell me, from where do those 'blood bits' come from that the GB say the congregants can use ? I honestly have no idea on that one. However if those 'blood bits' come from blood itself then isn't that actually using blood ? My wife hates cherries in cakes, so she picks them out, but she still eats the cake. If a person uses bits out of blood then in my opinion they are still using blood. Over to you guys.

Substitute of Biological Blood: These are substances which act like biological blood and are used in cases requiring a blood transfusion. Purpose: The main purpose served by blood is oxygen carriage to organs of the body. The artificial blood synthesized so far are serving functions varying from carrying oxygen to the function of volume expansion. Thus, volume restoration can be done with the help of these substances. These substitutes are mostly under clinical trials. History: Blood was considered supernatural having magical properties. Many of the rituals were performed related to blood. Many beliefs are still followed. Several TV programs focused on the theme of blood like the vampires drinking human blood for survival. Jehovah’s witnesses are obligated to not receive or donate any blood-related products according to their beliefs even in case of matter of life and death. The history of blood transfusion dates back to very old civilization but documented research on this topic started after William Harvey discovered in the 16th century that blood flows in the arteries and veins. The blood transfusion often proved fatal. So different transfusions were tried like liquids from cows, goats, human milk as well as beer. The first cross-matched blood transfusion was done in the 20th century in Mt. Sinai Hospital in New York. Later advancements led to the Blood Component Therapy in which blood was separated into different components, which has made whole blood transfusion obsolete. Progress in the field led to improvements in the safety of blood transfusion with respect to decreasing transmission of blood-borne diseases such as HIV, Hepatitis B, and C etc. Who needs it? Artificial blood is used in cases which require a blood transfusion. The situations include; Patients of hemorrhagic shock: a state of decreased perfusion of organs due to the increased amount of bleeding. In case of emergency situations like roadside accidents In situations when blood donation is not accessible or not available such as remote or far-flung areas To meet the high demand for blood transfusion Types of Synthetic blood: Perfluorocarbon-based Hemoglobin-based Stem cells https://techengage.com/artificial-blood-saving-lives/

New research in the USA shows that Jehovah's Witnesses who refuse blood transfusions recover from heart surgery faster and with fewer complications than those who have transfusions. Patients who are Jehovah's Witnesses had better survival rates, shorter hospital stays, fewer additional operations for bleeding and spent fewer days in the intensive care unit than those who received blood trans­fusions during surgery, a study in the Archives of Internal Medicine shows. Jehovah's Witnesses undergo extensive blood conservation before surgery, including red blood-cell boosting erythropoietin drugs, iron and B-complex vitamins to guard against anaemia. The practice offered a "unique natural experiment" for scientists to study the short and long-term effects of the blood management strategy and may point to ways to reduce need for transfusions, researchers said. The study included 322 Jehovah's Witness patients and 87,453 other patients who underwent heart surgery at the Cleveland Clinic from 1983 to 2011. All Jehovah's Witness patients refused blood transfusions. In the other group, 38,467 did not receive transfusions while 48,986 did. The authors wanted to look at the difference between patients who receive blood transfusions during surgery and Jehovah's Witness patients, who undergo strict blood conservation practices before, during and after surgery, Koch said. While many patients do not have blood transfusions during and after heart surgery, they also do not undergo the same blood conservation practices that doctors use for Jehovah's Witness patients. Jehovah's Witness patients had an 86 per cent chance of survival at five years and a 34 per cent chance of survival 20 years after surgery, compared with 74 per cent at five years and 23 per cent at 20 years for non-Jehovah's Witness patients who had transfusions. https://www.secularism.org.uk/news/2012/07/refusal-of-blood-transfusions-by-jehovahs-witnesses-not-always-detrimental-research-finds?fbclid=IwAR2FqyNQ6S_ILvtLzBldwslGcpfBbvJQpk8kbbROMEMmyVsgMQDGMoZvgmU

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/

After being transported to Batroun Hospital suffering traumatic injuries, doctors were baffled after the girl's parents rejected a blood transfusion critical to save their daughter's life. BEIRUT: Farah D., the young girl who was involved in a recent car crash, received a blood transfusion Thursday after the Prosecutor of North Lebanon authorized Batroun Hospital Director Ayoub Moukhtar to perform the procedure despite her family's refusal because it goes against their beliefs as Jehovah Witnesses. After being transported to Batroun Hospital on Wednesday suffering traumatic injuries, doctors were baffled after the girl's parents rejected a blood transfusion critical to save their daughter's life. This bizarre development forced Moukhtar to contact his district's Prosecutor, who directed him to go ahead with the grueling operation which involved a set of blood transfusions. The prosecutor argued the hospital was legally bound to save the girl's life. "I contacted the prosecutor, who stressed the need to save the girl's life regardless of the parent's religious beliefs, and the hospital duty is to keep the girl alive," he said. According to Moukhtar, Farah is now recovering from her injuries. https://en.annahar.com/article/720753-minnesota-couple-delivers-christmas-day-baby-on-side-of-road

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

A judge has authorized a Montreal hospital to perform blood transfusions to treat a 14-year-old teen with cancer, despite her refusal because she is a Jehovah's Witness. By allowing transfusions, the court ruled that it is lawful to protect children, sometimes "against themselves," when their decisions can be fatal. Under Quebec law, minors over the age of 14 can refuse certain health services. However, if the child’s parents or a hospital--in this case, the McGill University Health Centre--wants to administer those services, they can seek a judge’s permission. Superior Court Judge Lukasz Granosik said in his decision that the teen is "a brilliant, articulate girl" who is very successful at school and has a "maturity beyond her biological age," but that she was not yet mature enough to decide for herself, and was under pressure from her parents who are also Jehovah's Witnesses. Granosik also noted the girl spoke of death with "resignation," despite having a 97 percent chance of recovery if she underwent treatment. In June 2017, she found out she had Hodgkin's lymphoma, a form of cancer, and had to begin chemotherapy. This treatment, however, often requires blood transfusions. Without it, the patient could die or suffer irreversible neurological damage, her doctor said. Jehovah’s Witnesses do not accept blood transfusions. Judge Granosik’s decision was rendered on Sept. 1. - With a report from The Canadian Press http://montreal.ctvnews.ca/judge-rules-teen-jehovah-s-witness-will-get-blood-transfusions-1.3599245

When Jim Steenhuizen wound up in the intensive care unit with massive internal bleeding, doctors ordered a blood transfusion to save him. But even though his condition was serious, the father of two refused. As a Jehovah’s Witness, his religion forbids taking blood transfusions from another person. So doctors tried a new blood replacement product, which was acceptable. And after a few weeks, the 48-year-old Anderson man was back at work delivering the mail on his rural route thanks to Sanguinate. “I had never heard of it. And I was very thankful for it,” he told The Greenville News. “I try not to think about what might have happened.” Dr. Sharif Khan, a hematologist with Bon Secours St. Francis Health System where Steenhuizen was treated, said it’s challenging when providers can’t offer supportive care because of religious restrictions. But Sanguinate could solve that problem. “About 85 percent to 90 percent of Jehovah’s Witness patients who are told about this product accept it,” he said. “He got several doses and was stabilized. And he made a complete recovery.” Promising alternative As a result of vehicle crashes, injuries and illness, about 13.2 million transfusions are performed every year in the U.S., according to the National Institutes of Health. And there are 1.04 million Jehovah’s Witnesses, according to nationmaster.com, which compiles data about a variety of issues. There are others who can’t take blood transfusions as well, including those who develop multiple antibodies for whom matching blood can’t be found, such as patients with sickle cell disease, Khan said. An alternative could be helpful in those circumstances, he said. But earlier efforts to develop such a product have proven unsuccessful, he said, and even dangerous. As a physician specializing in disorders of the blood, Khan followed the research and learned about Sanguinate. It looked more promising than the previous attempts. Sanguinate is produced through a process that links molecules from cow’s blood with molecules from carbon monoxide to create a bigger molecule that lasts longer than human blood and doesn’t have to be refrigerated, he said. It’s manufactured by New Jersey-based Prolong Pharmaceuticals. As a stabilizing agent, Sanguinate is not being considered as a replacement for chronic blood transfusions, he said. Rather, it’s used as a bridge to something else — surgery to stop the bleeding or buying enough time until the body can make more of its own blood, he said. Danger zone When Steenhuizen arrived at the hospital, he was bleeding severely in his intestines, Khan said. He’d lost more than 80 percent of his red cells — the cells that carry oxygen to the brain, kidneys and other vital organs. A search located some Sanguinate at a hospital in Charlotte, he said. And a staffer drove there to retrieve it. At the time, Steenhuizen was facing multiple organ failure, Khan said. But after receiving a few units of Sanguinate, his oxygen level improved substantially and he was out of the danger zone. “He was completely coherent, his oxygen level was up,” he said. “And made a complete recovery.” After that, St. Francis became one of 27 sites involved in a Phase 2 clinical trial of Sanguinate already underway across the country when blood is not an option, whether for religious or medical reasons, he said. It’s hoped that it can one day be used by the military in battlefield conditions and by EMTs who arrive on the scene to find a victim bleeding profusely, Khan said. “If somebody has been in a crash, the (EMTs) can’t stick an IV into their arm and start blood,” he said. “And the Department of Defense is interested in research into these products for obvious reasons. They are stored like medications on shelves, not refrigerated, and they can be carried in an ambulance or military vehicle.” They don’t need to typed either like blood does, he said. And while undetected diseases may be spread through human blood transfusions, the manufacturing process destroys all the organisms in the cow’s blood that might cause disease, he said. But Sanguinate is not without risks, though they’re considered manageable, he said. Patients must be monitored closely for potentially dangerous blood pressure spikes and kidney dysfunction. Staying alive Steenhuizen developed internal bleeding on Feb. 13 — as best anyone can figure from taking ibuprofen for his back pain. Ibuprofen is one of a number of non-steroidal anti-inflammatory drugs, or NSAIDs, that can cause bleeding in some people. A day later, he was in the ICU. At that point, he said, his hemoglobin was a fraction of what it should have been. But a life-saving transfusion was out of the question because of the religion he and his family observe. Sanguinate (Photo: Bon Secours St. Francis Health System) “Because of my stance as a Jehovah’s Witness, I refused to take blood,” he said. “The Bible states to abstain from blood, that blood is sacred and belongs to God. “If I was to die because I didn’t take blood, I would have died in good standing with Jehovah, my God,” he added. “And my family was OK with that.” Thankfully, it never came to that. As his concerned doctors were considering surgery to try and stop the bleeding, they decided to try Sanguinate along with other medications he was given. And slowly, his blood count began to rise. “The main thing was to boost the oxygen level to the organs to keep me alive,” he said. “Eventually ... my blood cells started going up.” Steenhuizen was released after two weeks in the hospital and was back at work on March 11. He no longer takes NSAIDS, says he’s pretty much back to normal, and is glad that Sanguinate is available for him and other Jehovah’s Witnesses. “I think it was a great product. And I think it could benefit others,” he said. “It saved my life.” http://www.greenvilleonline.com/story/news/health/2017/04/11/blood-replacement-bridge-life-upstate-man/100081856/

Peace Euodia pictured above, died of excess bleeding during child delivery, because her church, Jehovah Witness Church does not permit her to accept blood transfusion. http://www.lindaikejisblog.com/2017/02/photo-nigerian-woman-dies-after.html

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/

The death of a Frankston toddler who contracted a rare infection that left him with blood-stained diarrhoea and coffee-coloured vomit was most likely linked to his consumption of unpasteurised bath milk, a coroner has ruled. Coroner Audrey Jamieson has issued a stern warning to parents still considering giving their children unpasteurised milk, despite new restrictions put in place by Dairy Food Safety Victoria. "If members of our community choose to drink farm-gate unpasteurised milk, that is their choice," Ms Jamieson said. "However, they should do so in the knowledge that it may contain harmful bacteria." The three-year-old boy, who cannot be named, died on October 13, 2014, from a rare and severe complication of E. coli infection, called haemolytic uraemic syndrome, after drinking unpasteurised Mountain View Organic Dairy milk. Four other children fell seriously ill in the same month. Three of the affected children contracted haemolytic uraemic syndrome, while two others developed a parasitic bowel infection called cryptosporidium. All five children had consumed Mountain View milk being sold in health food shops as "bath milk". "I find on the balance of probabilities that [the] child's death was most likely linked to the consumption of unpasteurised milk," Coroner Audrey Jamieson said. Yet, she cleared Mountain View Organic Dairy of any wrongdoing, saying the container was properly labelled and included a warning. She said regulation of unpasteurised milk sales had been adequately managed in the wake of the boy's death. The police investigation revealed the boy's parents had changed his diet in June 2014, after a naturopath assessed the toddler as intolerant to dairy, gluten and eggs. The boy's father said they had gone to "a lot of trouble to get milk". The family had been buying Mountain View Organic Dairy bath milk for two or three months before the toddler's death. The father told police he and his wife understood the milk was labelled as "not to be drunk", but said he "would be surprised if anyone used it for cosmetic purposes", because the bath milk was packaged in a two-litre plastic container which looked like "every other milk container". The couple used the milk in tea and occasionally gave the boy a small amount with his formula. They also used the bath milk to make their own yoghurt. Since the boy's death authorities have imposed licence conditions on Victorian diary producers to ensure that "cosmetic dairy products" are not sold in regular two-litre milk containers and presented in such a way that they cannot reasonably be mistaken as being for human consumption. The parents took their son to the Medicentre Clinic at Frankston Hospital on September 30, 2014, after he had been unwell for 24 hours with abdominal pain, diarrhoea and fever. They were sent home with advice to keep up his fluid intake. They returned to the hospital on October 2 and October 4 and were sent home both times with a diagnosis of viral gastroenteritis. The father expressed concerns about his son's medical treatment to police, saying he and his wife refused to be sent home when they visited the hospital with their son again on October 5 after he developed blood in his stools. "We knew he was sick and we insisted that he was admitted," the father said. "I felt like they were still treating [it] like a severe case of gastro. All they wanted to do was get fluids into him and get him to start eating. "If he had had the surgery or been given the right antibiotics then I feel like this could've been fixed and we would still have our son." The boy was transferred to Monash Medical Centre on October 6. His treatment at the Monash Medical Centre was somewhat delayed when his parents, who are practicing Jehovah's Witnesses, initially objected to the toddler receiving a blood transfusion. The coroner said the medical management of the boy was reasonable and appropriate, noting that nausea, vomiting, diarrhoea and abdominal cramping were common symptoms of acute gastroenteritis. http://www.theage.com.au/victoria/frankston-toddlers-death-most-likely-linked-to-unpasteurised-bath-milk-coroner-finds-20161111-gsn5yj.html

Mirlande Cadet, 46, died of suspected hemorrhage day after giving birth by C-section. Mirlande Cadet left behind two daughters and her newborn son. (Isaac Cadet) A Quebec coroner is investigating the death of a 46-year-old Jehovah's Witness who died Oct. 3 from complications shortly after giving birth by caesarian section in a Montreal hospital. A spokeswoman for the coroner's office, Geneviève Guilbault, confirmed that the bureau was launching an investigation into Cadet's death in an email to CBC Montreal. "Based on information that's been circulating … and other information we received from the hospital, it's been decided that a coroner will investigate the death of Mrs. Cadet," Guilbault wrote. The inquest is the second coroner's investigation this month into the death of a Jehovah's Witness following childbirth in Quebec. Unclear circumstances Cadet experienced complications after she gave birth to a healthy son by C-section at St. Mary's Hospital on Oct. 2 and required a blood transfusion, according to her brother Isaac Cadet. It is unclear if Cadet got a blood transfusion, or if she did, when she received it and what the circumstances were that led to its approval. Blood transfusions are forbidden under Jehovah's Witness doctrine, which holds that the Old and New Testaments command them to abstain from blood. Isaac Cadet says his family welcomed the news of the coroner's investigation after getting little information from hospital. (CBC) All Jehovah's Witnesses are expected to sign and carry a card refusing a blood transfusion. Isaac Cadet questions whether his sister would have signed a card and refused a blood transfusion. He described her as a loving mother to her two other children and a devoted aunt who loved to get family together. "I have a lot of doubt that my sister signed that document," Cadet told CBC News. He welcomed news of the coroner's investigation, saying his family needs to know what happened to its "leader." "It's a relief because we've tried to find out what happened, tried to access documents, and we weren't allowed. We were told they're confidential," he said. Mirlande Cadet's husband declined to be interviewed when contacted by CBC Montreal. Church elders at hospital 'intimidating' A Quebec coroner is already investigating the death of Éloise Dupuis, 27, who is said to have refused an emergency blood transfusion for a hemorrhage after delivering a baby by C-section at Hôtel-Dieu de Lévis Hospital near Quebec City. She died Oct. 12. Coroner Luc Malouin is working to determine whether her refusal was free and informed as required by medical and legal standards. After her death, Dupuis's aunt, Manon Boyer, filed a complaint with police in Lévis alleging her niece was pressured into refusing consent by a Jehovah's Witness hospital liaison committee. The committees are composed of Jehovah's Witness elders who are dispatched to a hospital when a member is facing a blood transfusion decision. According to the faith group, their role is to advocate for bloodless medical procedures and ensure their members' wishes are respected. Their presence, however, has been criticized by a former Jehovah's Witness, who said it's "intimidating." http://www.cbc.ca/news/canada/montreal/quebec-coroner-investigates-death-of-another-jehovahs-witness-1.3822768

Éloïse Dupuis was giddy with excitement the day before she gave birth to her first child, a son she and her husband named Liam. In a Facebook message to her aunt Manon Boyer, the 27-year-old said “she couldn’t wait to see him, to hold him and to rock him.” “She said the dream of her life was about to come true and she couldn’t wait to introduce him to me,” Boyer recalled, one week after her niece died in a hospital following complications from a difficult delivery. Dupuis was a Jehovah’s Witness and had signed a document, when she became an adult, saying she would not accept a blood transfusion. Jehovah’s Witnesses believe that passages in the Bible order them to abstain from taking blood, even when their life is in danger. The young woman died six days after giving birth in a hospital in Lévis, near Quebec City, after being transferred from a birthing centre when complications arose. The exact cause of death has not yet been determined. However, reports suggesting she didn’t accept a blood transfusion have created a stir in Quebec, with friends, some family members and politicians questioning whether she made the decision freely. Her parents, her husband and her in-laws were with her for six days before she died, Boyer said. “I don’t believe she would have refused blood after having her baby if she knew her life was in danger. I don’t think she had the capacity to make a free choice because she was ill from two surgeries. The family never notified us that she was ill.” Boyer said she is happy that coroner Luc Malouin is investigating her niece’s death, because he will probably question the nurses and doctors who treated Dupuis at the hospital. Boyer said she has already spoken to Malouin about the death. Boyer said she felt that something was amiss when Dupuis, and her niece’s mother, failed to answer Facebook messages she had sent inquiring about the birth on Oct. 6. “I sent a message congratulating her on being a grandmother, but she didn’t answer,” Boyer recalled. “The next day, I sent a message saying I know they’re busy, but could they let me know if Éloïse is fine. But that wasn’t answered either.” A few days later, Boyer noticed a message on Dupuis’s Facebook wall, congratulating her and her husband on their second wedding anniversary. However, the person who posted the message said that they knew “it wasn’t a happy time but that the couple would have other times to celebrate.” Boyer said she was confused by the message, so she replied to it asking for news about her niece. “Why isn’t it a good day to celebrate when you just had a baby?” she wondered. It was then that someone wrote that Dupuis was fighting for her life and had lost a lot of blood. Boyer said her daughter called the hospital to find out what was going on. A nurse said she would ask a member of Dupuis’s family to speak to her, but family members refused to come to the phone, she said. “The nurse said we could come to the hospital to visit, but she said that Éloïse’s heart was beating slowly and it was just a question of hours before she would die.” After hearing the news, Boyer contacted Cassandra Zélézen, a childhood friend of her niece. Zélézen and her two sisters, who are triplets, drove to the hospital from their home in Rawdon, in the Lanaudière region, to try to see their ailing friend. Zélézen told the Montreal Gazette that Dupuis’s father refused to allow them to see his daughter. Dupuis’s husband told the triplets that he had regrets about having the baby at the birthing centre and wondered about the decision not to have a blood transfusion. “Now, it’s too late,” Zélézen recalled the husband saying. Her friend died a short time later. While at the hospital, Zélézen said that Dupuis’s husband showed her a note that Dupuis had written, while intubated, after having her uterus removed. “It’s OK, we can adopt,” the note read. After Dupuis’s death, her friends messaged her aunt saying: “She’s dead, she’s dead.” On the day Dupuis died, three elders from a Jehovah’s Witness congregation were present at the hospital, according to Zélézen. John Redwood, a former Jehovah’s Witness from Maryland who wrote about Dupuis’s death on his website, said the organization has a Hospital Liaison Committee made up of trained elders who are dispatched to hospitals any time a Witness may require a blood transfusion. “Their purpose is to support the family in their decision (and) to avoid being coerced into taking blood,” said Redwood, 49, who left his congregation three years ago. “They may not have ever met the patient, but these are the enforcers of the policy.” He said there is a second committee, called the Hospital Visitation Committee, made up of members who visit and pray with sick patients but don’t “interfere with blood policy.” Simon Picard, a spokesperson for the Jehovah’s Witnesses in Canada, denied that elders are sent to hospitals to ensure that blood transfusions do not take place. “We have members who will be there to provide support, but the choice to not have a blood transfusion is an individual choice,” he said. “When you’re in a crisis situation, you like to have members to support you in a decision you have made.” Quebec Premier Philippe Couillard called Dupuis’s death “terrible,” but said it was important for society to respect the law and individual choice. “The jurisprudence has been very clear: if a person of sound mind refuses medical treatment, even if it costs them their life, we can’t go against their will.” In Quebec City, the Coalition Avenir Québec described the incident as “troubling,” and said it raises serious questions about the health care system. “I don’t have answers today, but I say to myself: ‘How can it be that we let someone die in Quebec for religious reasons?’ ” CAQ Leader François Legault said. Nathalie Roy, the CAQ critic for secularism, wondered whether Dupuis “had really given free and clear consent. Are there people who spoke for her, who decided for her? Did she know she was going to die leaving her child there?” Dupuis, whose immediate family could not be reached for comment, had moved to the Beauce region two years ago, following her marriage, but still remained in touch with Boyer and her family. “It’s unbelievable that you could die a few days after having a baby,” Boyer said. “The baby will be raised by them (Dupuis’s family) and we will never see him. We have lost a beautiful girl. She was full of love and was ready to help anyone, anywhere, any time.” http://montrealgazette.com/news/aunt-questions-whether-niece-refused-blood-transfusion-before-death

(QUEBEC) The Government does not intend to restrict access to hospital rooms to specific groups, religions of the disciples, said yesterday the Minister of Health, Gaétan Barrette. “You ask me to decide on a person can receive visits from his entourage. You are going away, “said Mr. Barrette briefing. Mr. Barrette has acknowledged that as a physician, he had already faced JW representations to patient. Earlier in the National Assembly, the caquiste MP Simon Jolin-Barrette had claimed that Quebec clearly gives hospitals the right to restrict access to patients. In addition, a judge should be asked to intervene to assess if a patient refuses treatment rightly whose life may depend, proposed caquiste Member for Borduas. The young Eloise Dupuis, died last week at the Hotel Dieu de Lévis, refused a blood transfusion because she was a follower of Jehovah’s Witnesses. However, shortly before his death, the young woman had been in the hospital, visiting senior members of the sect. This “Jehovah’s Witnesses Hospital Liaison Committee” had pressured the young woman to conform to the dogma and refusing to receive blood. The Sun reported yesterday that relatives of M me Dupuis had indicated that members of this group were found in the room of the young mother until the final hours of his life. “We know that a font of blood is present in Québec hospitals,” said Simon Jolin-Barrette, caquiste Member for Borduas. “[The policy of blood] put pressure on patients and their families, it denies access to people who are not members of Jehovah’s Witnesses in the patient’s room,” reported Mr. Jolin-Barrette. According to him, access to in-patients should fall away. Can not let the “blood police” control access to rooms. It exceeds certain limits” According Gaétan Barrette, it is an exaggeration to talk of “blood police”; the opposition would, in fact, create a “police visits.” But the patient is “autonomous in his choice must be done independently.” It is a “situation is dramatic.” “But to use inflammatory language, when we talk of” blood police, “I think here we exceed certain limits,” said Gaétan Barrette. A coroner examines the circumstances of his death. For the PQ member Agnes Maltais, not need a judge. “Decisions on the free and informed consent, he takes daily by doctors, and it faces, in general, this kind of situation. We do not agree with the position that says that they can attack the doctors. The doctors do their job. In this case especially, we know very well that there were lawyers, there was an ethics committee and there were doctors who intervened, “said she summarized. http://stopru.org/quebec-said-no-to-a-police-visits-in-hospitals/19694

More and more doctors have come to understand the risks of blood transfusions, in part over the scriptural stand of Jehovah's Witnesses. One of the most misunderstood and misjudged beliefs practiced by Jehovah’s Witnesseses is their refusal to eitherdonate blood or accept a transfusion of blood in a medical emergency. So firm is their conviction in this regard that they are willing to die in order to uphold ascriptural command to “abstain from blood.” But this long standing precept now has forced many in the medical community over the last number of decades to admit the stand of the Witnesses is – and has always been – a medically sound decision. Why don’t Jehovah’s Witnesses accept blood? To be clear, Jehovah’s Witnesses are a people of high morals and principles. Like anyone else, they seek out the best medical treatments available. They do not practice “faith healings.” But just as organ transplants, abortions, and right-to-die decisions are left to one's conscience, deliberated on in courts and debated for their ethical ambiguity,#Blood Transfusions are also questioned – not just for medical reasons, but based on Bible commands. Witnesses believe that the life force of a person – their spirit if you will – is found in one’s blood. From a physiological point of view, this is accurate. Blood is linked intrinsically to life; it carries life-giving oxygen to cells and removes carbon dioxide. But the Bible also makes a number of references to blood, first off as “belonging” to God, and second, not to consume it. Bible references to blood When Noah and his family left the ark, they were allowed to eat animals, but not their blood (Genesis 9:3-6). In the law code given to the Israelites, God forbade the eating of blood (Leviticus 17:10-14, Deuteronomy 12:23-25). In the First Century, the direction sent to the early congregations was the same – to “keep abstaining from blood” (Acts 15:29). That apostolic decree was binding, was not allayed in medical emergencies, and was listed among other well-known Christian tenets as not giving worship to idols and not engaging in immorality. Whether the blood enters via one's mouth or through a transfusion directly into the veins, it is the same. A medically sound decision Decades ago, a refusal to accept blood was seen as ill-informed – even barbaric. But no longer. Doctors now see the tremendous medical risks of blood transfusions. More than ever, major hospitals and trauma centers employ a variety of bloodless alternatives – thanks in part to studies done by Jehovah’s Witnesses. “When I was in medical school, honestly, that was never a thing. People didn’t talk about blood conservation,” commented Dr. Daniel DiBardino, a surgeon atHennepin County Medical Center (HCMC) in Minneapolis. “You just used blood because that’s what you did. And that has changed.” HCMC is one many hospitals to roll out a non-blood program. The hospital’sBloodless Surgery and Medicine Program even has a firewall restriction that physically prevents doctors from overriding a patient’s non-blood medical proxy. Back in 2004, the medical journal Continuing Education in Anesthesia said: "Many of the techniques developed for use in Jehovah’s Witness patients will become standard practice in years to come." And they have. A 2010 article in the journalHeart, Lung and Circulation said that "bloodless surgery should not be limited to Jehovah’s Witnesses, but should form an integral part of everyday surgical practice." Alternatives to transfusions Witnesses accept a wide range of bloodless alternatives, such as hemodilution – where blood is diverted but remains in a circuitous relationship to the patient and volume expanders are added – and cell salvage – which captures and returns blood lost during surgery. http://us.blastingnews.com/news/2016/10/bloodless-surgeries-are-no-longer-procedures-simply-requested-by-jehovah-s-witnesses-001161089.html

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

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/

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

Dana Edson was talking with a friend from her church in Kerrville, TX. Her friend’s son was in need of a kidney transplant. Edson offered to be tested to see if she was a match for Mark Ridgaway, whom she’d never met. Ridgaway had been given a kidney transplant from his mother 16 years ago, but he was in need of another transplant and had been on a wait list for over a year. It turned out that Edson was match, but instead of donating a kidney to Ridgaway, Dr. Osama Gaber – director of the J.C. Walter Jr. Transplant Center at Houston Methodist – asked her to enter a swap program. She agreed on one condition: “I wouldn’t want to give my kidney if Mark had to wait three years for his, and that’s when (Dr. Gaber) gave me the guarantee that Mark would get his the same day as I gave mine,” says Edson. When it was all said and done, Edson’s willingness to enter the program resulted in a six-way kidney swap. 71-year old Rudyne Walker was the last of the six to receive a kidney. She was in stage five renal failure when she received, Edson’s. “I got from Dana a kidney that is young and vigorous and excited about life. I haven’t had a kidney like that in 40-years. It moves me when I’m not ready to go,” said Walker. In order for a recipient to receive a kidney, they must have a donor willing to enter the swap program. Kellie Canaday worked with Walker at Exxon. Canaday had offered to donate a kidney for Walker but they weren’t a match. Maria Coronado ended up receiving Kellie’s kidney. Juan Coronado shed 30 pounds to help his wife. Maria had been dealing with dialysis for two years. Juan’s kidney went to Steve Miller, whom Coronado had never met. Miller had been battling with diabetes for 43 years and like Ridgaway, was in need of a second transplant. Olivia Miller wanted to help her husband, but she was not a match. So instead she helped Esmerelda Guerrero. Guerrero and her husband Cesar are Jehovah’s Witnesses from New Mexico. They had been turned down in their effort to receive a kidney transplant for Esmerelda because they refuse to have blood transfusions. Fortunately for them, Houston Methodist is one of a select few hospitals that perform bloodless transfusions. “We have a program for Jehovah’s Witness transplants. We do actual lung transplants with Jehovah’s Witnesses. So, we give them hormones to raise their blood count, we prepare them differently for the transplant,” says Dr. Gaber. While Cesar didn’t provide a kidney for his wife, he was still able to help. Felix Rodriguez received Cesar’s kidney. Sandra Izquierdo wanted to help her brother, Felix, but couldn’t because she wasn’t a match. Instead her kidney went to Mark Ridgaway. Six donors and six recipients, all thanks to the kindness of strangers, though they all consider themselves family now. Dr. Gaber says months of preparation went into performing the “six-way” organ swap. “You actually need 12 operating rooms and it is hard on the hospital because of the complexity, you don’t want to make mistakes. The kidney needs to go to the right place,” said Dr. Gaber. With more than 1,400 people on the Methodist kidney transplant wait list, the hospital hopes more people will participate in the program. http://www.houstonpublicmedia.org/articles/news/2016/08/01/162583/houston-methodist-performs-six-way-kidney-swap/