A Jehovah's Witness Patient with Polytrauma: Deontology, Law, and Faith

Abstract

AbstractPolytrauma involving traumatic brain injury poses serious threats like hemorrhagic shock and consumption coagulopathy. Blood and blood components are a necessity for maintenance of homeostasis in these patients. Elizabeth Topley and R. Clarke, in their study, demonstrated a considerable drop in red cell volume following a major trauma, nearly 11% in the next 14 days. Use of extensive perioperative blood salvage techniques, recombinant erythropoietin, iron complex injections, and antifibrinolytic agents cannot replace the benefits of blood and blood component transfusion. The real challenge of blood transfusion arises in Jehovah's Witness (JW) patients where a licensed medical practitioner (LMP) is caught in the loop of protecting the sanctity of faith over saving a patient's life. This case report highlights the successful management of a 19-year-old JW patient without transfusion of blood or blood products despite an absolute indication for transfusion. We also discuss the legal and ethical perspectives necessary for a legal medical practitioner, when treating patients of JW faith.