Jehovah’s Witnesses refuse transfusion based on strong religious beliefs. Despite this, blood bankers must be prepared to assist in their care.
How Does This Impact Blood Bankers?
When a patient shows up at a medical facility and says, “I am a Jehovah’s Witness and I do not want any transfusion whatsoever,” clinical providers may find themselves unsure of how to proceed. Since there are over 8.5 million Witnesses worldwide, it is almost inevitable that most facilities will face this issue at some point. Somewhat ironically, Transfusion Medicine professionals are often asked for their “expert” opinions on what to do with patients who actually refuse most of the blood products we provide!
Why Discuss This Here?
In these often-challenging situations, I believe it is essential that those of us who work in Transfusion Medicine be aware of the issues our clinical colleagues face with patients who refuse transfusion. Blood bankers can often help ensure that Witnesses receive compassionate, respectful, and excellent care, and there is much we can learn from them. There are also nuances to the transfusion prohibition (such as a general acceptance of “derivatives” which may include coagulation factors and even cryoprecipitate), and we would be wise to understand the general principles. I asked Jed Gorlin, Medical Director at Innovative Blood Resources, to share his expertise in these settings with you.
About My Guest:
Dr. Jed Gorlin received his BS from Stanford and his MD from Yale. He is board-certified in Pediatrics and Blood Banking/Transfusion Medicine. He is Medical Director and Vice President, Quality and Regulatory Affairs at Innovative Blood Resources. Jed’s duties include Memorial Blood Centers in Minnesota, Nebraska Community Blood Bank, the Community Blood Center of Greater Kansas City in Kansas City, MO. He has served in various leadership roles with AABB through his more than 20 years in Transfusion Medicine, including Chair of the Standards Committee for the 20th and 21st editions of AABB Standards, and as an AABB board member. He is a chapter contributor to 21 published books and anthologies, and author or co-author of over 120 published papers and abstracts.
DISCLAIMER: The opinions expressed on this episode are those of my guest and I alone. Statements made on this podcast are not official opinions of the organizations with which either of us is affiliated. Neither Dr. Gorlin nor I have any relevant financial disclosures.
- Case report discussed by Dr. Gorlin in this interview: Salmen M, Hendriksen S, Gorlin J et al. Oxygen Delivery during Severe Anemia When Blood Transfusion Is Refused on Religious Grounds. Ann Am Thorac Soc 2017;14:1216–1220.
- Resource from American Society of Anesthesiologists: Transfusion Consent Form with Product Options
- Official position statements from JW.org:
- Religious and Ethical Position on Medical Therapy and Related Matters (thanks to Patricia Cannon for the link).
- Clinical Strategies to Avoid Blood Transfusion
- Other downloadable resources