What Is Non-Blood Medical Management?

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Jehovah’s Witnesses are perhaps some of the best educated e-Patients.

EPATIENT Making up 7 percent of a human's total body weight, blood is a fascinating factory of complex structures on the anatomical level. Primarily, it carries oxygen to every part of the body. But it also feeds cells and removes wastes. Without it there is no life. [1]

Empowered and Enabled

By definition, an e-Patient is empowered, engaged, equipped and enabled. [2] By requesting bloodless medical care, it might appear that Jehovah's Witnesses are out of touch with reality. But they are unmistakably empowered and enabled.

Jehovah's Witnesses exercise the right of self-determination and informed consent.

Even Witnesses that are not online can search through back issues of the Awake! magazine, which reveal a treasure trove of descriptions on many medical ailments. Each year, the Witnesses are empowered by their review of current strategies to deal with elective surgery or a medical crisis involving blood. They know, for instance, that it is vital to maintain blood volume in the event of severe blood loss. They understand that it takes about 24 hours for transfused blood to reach full oxygen transport capacity. They know that during trauma, the bone marrow kicks into overdrive, producing additional blood at an accelerated rate. [3] Thus, volume expanders like Ringer's lactate, colloidal solution, dextrose, hetastartch, pentastarch or saline solution are viable alternatives to prevent arterial collapse. [4] During surgery, blood conservation techniques like cauterizing scalpels, fibrin glue patches, hemodilution and cell salvage minimize blood loss. [5]

@NatGeo : All of the blood in your body travels through your heart once a minute.

Enabled Jehovah's Witnesses exercise the right of self-determination and informed consent. [6] This is evident even in situations where blood is not even an issue. For example, if a patient with heart disease is allergic to nitroglycerin, another vasodilator is used. After considering recommendations of physicians, cancer patients decide whether to undergo chemotherapy, radiation or accept other treatments. Across the board, patients are given options. The use of blood, whether or not autologous, as a therapeutic treatment is no different.

More than half of blood transfusions may do more harm than good.

Equipped and Engaged

Individuals vary in their ability to articulate medical information and in times of trauma, a patient may be unable to converse. Hence, nearly all Witnesses are equipped with a completed Advanced Medical Directive that identifies chronic medical problems and expresses their position on blood transfusions. Though they unanimously refuse whole blood, red blood cells, white blood cells, platelets and plasma, the use of blood fractions such as albumin is an individual conscious matter indicated on their medical directive. A global network of Hospital Liaison Committee members assist with patient support and, when needed, engage medical professionals through the dissemination of appropriate information. [7]

When the uninformed consider Jehovah's Witnesses' position with regards to blood transfusions, they might question, "Are Jehovah's Witnesses religious fanatics?" or "Do they want to die?" Their goal is far from martyrdom when they get sick. In fact, they seek the best care for themselves and their children.

Hospitals Build Out Dedicated Departments

Accommodating the patient's wishes … is not predicated upon accepting their beliefs.

The stance of 8 million Jehovah's Witnesses against blood transfusions, though firmly rooted in scripture (Acts 15:28, 29), coincides with the highest standard of health care. More than half of blood transfusions may do more harm than good, with some patients facing a six-fold greater risk of dying following surgery because of transfusions. [8] Potential risks from blood-borne disease are eliminated and recovery time is shortened. Many hospitals are realizing cost savings from non-blood medical management. Georgetown University Hospital and Pennsylvania Hospital are two of many that have established Bloodless Medicine and Surgery centers. [9,10] Globally, there are more than 230 hospitals with transfusion-free programs—roughly half are in the United States.

Accommodating the patient's wishes in this regard is not predicated upon accepting their beliefs. An atheist at Cedars Sinai routinely treats Jehovah's Witness leukemia patients. [11] Even non-Witnesses are opting for safer non-blood medical procedures. It is not uncommon for physicians to seek blood-free alternatives when they, themselves, are faced with surgery. The U.S. Military began training medical personal in 2010 for bloodless surgery. [12] Non-blood medical management serves the needs of financially constrained medical facilities while elevating the standard of health care.

Finding a Cooperative Doctor

Patients that desire treatment without allogenic blood should engage in a candid and respectful conversation with their physician(s). Not all doctors are surgeons. A primary physician typically fulfills an advisory role during ER visits. Before elective surgery, patients need to have conversations with the surgeon(s) and the anesthesiologist.

It needs be clear that physicians are willing to become advocates for the patient on the matter of non-blood medical management, not merely one who passively martyrizes patients by withholding blood along with other viable treatment options.

A cook that prepares saltless meals is not synonymous with one who provides tasty sodium-free alternatives. Similarly, a physician that agrees not to use blood is not the same as one who provides quality health care with transfusion alternatives. Depending on locality, patients should look for doctors who are familiar with the necessary techniques and have the appropriate tools available at the designated hospital.

Finding Cooperative Doctors

Scheduling and sitting down with a list of potential primary care providers or surgeons to discuss their proficiency and supportive role during a time of crisis can be frustrating. Patients are looking for a clear statement of cooperation. So, baring health insurance restrictions, like other experienced e-patients, they may turn to a support network for recommendations.

Poster identifies blood components and assures quality health care with transfusion alternatives.

Some physicians have watched videos, attended seminars on bloodless care techniques or have binders filled with strategies to employ during a variety of circumstances. Others are in the forefront of bloodless medicine, routinely performing various procedures. Patients are actively seeking such physicians. Don't make it a game of hide-and-seek.

Facilities that are willing to address the needs of patients seeking non-blood medical management can post such proficiency on their website and prominently display an appropriate poster in the office. A level of commitment may be read into the quality of the posted sign. Something produced on a desktop printer and taped up might infer that support is temporary or on a trial basis. A professional sign conveys existence of established policy. Hospitals that publicly reiterate patients' wishes in this regard alleviate additional anxiety on otherwise ill or stressed patients and family.

Store.ClinicalPosters.com offers a highly visible poster in a variety of sizes to fit every workspace. Going further than displaying the nearly ubiquitous "no-blood" headline cranked out on desktop printers, with vibrant colors, this professional anatomy poster removes ambiguity by identifying blood components and offers comforting assurance that quality health care is provided with transfusion alternatives. Hang the poster in doctor's offices, restricted areas in lobbies or hospital patient rooms.

Tags: experts, hematologists

References
  1. What is the Most Precious Fluid of All? Awake! August 2008, jw.org
  2. How Empowered Physicians Can Embrace e-Patients. ClinicalPosters.com
  3. Anesthetic Challenges and Considerations Presented by the Jehovah's Witness Patient. Anna L. Harris, M.D. and Thomas P. Engel, M.D., anestit.unipa.it
  4. Are Synthetic ‘Blood Substitutes’ Currently Available in the United States? 2008, mybloodsite.com
  5. Electrocauterization. nih.gov
  6. Informed consent--on the right of self-determination. January 7, 1998, Hokkaido Igaku Zasshi, nih.gov
  7. Jehovah's Witnesses and blood transfusions. wikipedia.org
  8. Many blood transfusions may increase risks, doctors warn. guardian.co.uk
  9. Bloodless Medicine and Surgery Program. georgetownuniversityhospital.org
  10. Non-Blood Management Techniques. pennmedicine.org
  11. A meeting of hearts if not minds. February 2, 2012, latimes.com
  12. U.S. Military Training for Bloodless Surgery. March 22, 2010, ClinicalPosters.com
  13. Blood substitute. wikipedia.org
  14. Nonblood Treatement—What Experts Say. Awake! March 1999, jw.org
  15. Adverse effects of transfusion. The Royal Children's Hospital Melbourne, rch.org.au


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