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Major abdominal surgery in Jehovah’s Witnesses

Rollins, Katie E.; Contractor, U.; Inumerable, R.; Lobo, Dileep N.

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Authors

Katie E. Rollins

U. Contractor

R. Inumerable

DILEEP LOBO dileep.lobo@nottingham.ac.uk
Professor of Gastrointestinal Surgery



Abstract

Introduction

Patients who are Jehovah’s Witnesses pose difficult ethical and moral dilemmas for surgeons because of their refusal to receive blood and blood products. This article outlines the personal experiences of six Jehovah’s Witnesses who underwent major abdominal surgery at a single institution and also summarises the literature on the perioperative care of these patients.
Methods

The patients recorded their thoughts and the dilemmas they faced during their surgical journey. We also reviewed the recent literature on the ethical principles involved in treating such patients and strategies recommended to make surgery safer.
Results

All patients were supported in their decision making by the clinical team and the Hospital Liaison Committee for Jehovah’s Witnesses. The patients recognised the ethical and moral difficulties experienced by clinicians in this setting. However, they described taking strength from their belief in Jehovah. A multitude of techniques are available to minimise the risk associated with major surgery in Jehovah’s Witness patients, many of which have been adopted to minimise unnecessary use of blood products in general. Nevertheless, the risks of catastrophic haemorrhage and consequent mortality remain an unresolved issue for the treating team.
Conclusions

Respect for a patient’s autonomy in this setting is the overriding ethical principle, with detailed discussion forming an important part of the preparation of a Jehovah’s Witness for major abdominal surgery. Clinicians must be diligent in the documentation of the patient’s wishes to ensure all members of the team can abide by these.

Journal Article Type Article
Acceptance Date Jun 5, 2016
Online Publication Date Jul 14, 2016
Publication Date Nov 1, 2016
Deposit Date Apr 18, 2018
Publicly Available Date Apr 18, 2018
Journal Annals of the Royal College of Surgeons of England
Print ISSN 0035-8843
Electronic ISSN 1478-7083
Publisher Royal College of Surgeons of England
Peer Reviewed Peer Reviewed
Volume 98
Issue 8
DOI https://doi.org/10.1308/rcsann.2016.0210
Keywords Jehovah’s Witness; Abdominal surgery; Blood loss; Blood transfusion; Patient perspective
Public URL https://nottingham-repository.worktribe.com/output/974416
Publisher URL https://publishing.rcseng.ac.uk/doi/full/10.1308/rcsann.2016.0210

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