Blood transfusion forced on mother to give baby a family life

[muriel_volestrangler]

A young mother, whom the High Court ordered should be given a blood transfusion against her will in a bid to save her life, was recovering at a Dublin maternity hospital last night.

The 23-year-old Congolese woman suffered massive blood loss following the birth of her first child at the Coombe Women's Hospital early yesterday. However, speaking in French and through an interpreter, she told hospital staff she did not want a blood transfusion as she was a Jehovah's Witness.

The hospital's master, Dr Chris Fitzpatrick, rushed to the High Court for direction and, at an emergency lunchtime sitting, Mr Justice Henry Abbott was told the woman, known only as Ms K, had lost 75-80 per cent of her blood and was likely to die within hours unless a transfusion was authorised by the court.
...
He said the interest of her newborn child, a boy, who he was told was "in good shape", was paramount and the baby could be left with no one in the State, as far as was known, to look after its welfare, if its mother passed away.

http://www.ireland.com/newspaper/front/2006/0922/1158590881290.html

More comment on the Guardian's Comment is Free website:

High court Justice Henry Abbott gave an emergency ruling permitting the hospital to carry out the procedure, using force if necessary. Abbott claimed that constitutionally, the right of the newborn child to have a family life overruled the mother's right to refuse treatment. As there were no known relatives or others to take responsibility for the child, it was held that it has a right to a family. This, constitutionally, seems correct. Article 41 of the constitution of Ireland is fetishistic about the family: "The state recognises the family as the natural primary and fundamental unit group of society, and as a moral institution possessing inalienable and imprescriptible rights, antecedent and superior to all positive law."

So the judge did his job, legally. But morally was the decision correct? I must admit that when I first heard this story, I was in agreement with Dick Spicer of the Humanist Association of Ireland, who said of the ruling: "It overrides individual religious rights. It overrides the right to refuse treatment and the ramifications of this could be enormous in the future."

But that was partly because I hadn't heard the story properly. I wasn't aware of the baby. The thought of a newborn child faced with the prospect of considerable time in the state system after his mother effectively killed herself because of her silly beliefs rather dampened my ardour for this women's freedom of conscience. Reality has an ugly habit of scuppering principle. I'm torn. What do you think?

http://commentisfree.guardian.co.uk/padraig_reidy/2006/09/blood_and_belief.html

Like the Guardian writer, I'm conflicted. I definitely agree with the British (and, I suspect Irish, though I don't know what the USA does) practice of overruling the decisions of Jehovah's Witness parents when it come to transfusions for their chidlren; but for the parents themselves, it does seem a little different. Does a mother have the right to effectively kill herself? In many ways, I'd say her 'right' to do so would actually be at a maximum when the child is born - it has no knowledge of its mother, and adoption would be relatively easy and untraumatic for it.

[Lerkfish]

1. as much as I disagree with the JW stance on blood transfusions,

seeing as how its based on a completely misinterpreted admonition to not eat blood of animals sacrificed on pagan altars,
I still think someone has the right to refuse treatment, religious reasons or otherwise.

[ShortnFiery]

2. I'm not conflicted, I would have made the call as a doctor and

faced the consequences. That baby boy deserves an ALIVE and loving mother even if she's delusional about her religious beliefs - or - God would be the slightest bit offended if she had LIFESAVING Medical Care.

[ComerPerro]

4. I agree

[WindRavenX]

11. Hippocratic Oath, huh?

I absolutely would've done what the doctor did. You can't possibly argue letting a newborn's mother die is a good thing for the health of the child.

[RB TexLa]

3. This should be a basic human right

No one should be forced to receive treatment they do not want, no matter the consequences.

[EST]

5. Very difficult to see through clearly.

My opinion is that the mother, or any human being, has the absolute right to self-determination. Although not particularly at issue in this case, the woman could still commit suicide at a slightly later date.

I do draw the line at an adult's refusal to allow medical treatment, however, to someone besides themselves and, should that treatment be denied under circumstances that preclude intervention and result in damage or death to the patient, appropriate legal remedies, including penalties, should be applied.

[Book Lover]

6. I am usually on the individual rights side

in every instance of forced medical treatment, but this really tests me. What are you preserving when you refuse such treatment? To paraphrase Orwell, the religious and humanist attitudes truly are irreconcilable.

[iamtechus]

7. The child would be raised as a catholic!

I wonder if they warned the mother than the child would be raised in a catholic orphanage?

[Scribe]

8. Suppose she said Santa Claus doesn't want her transfused?

I think her religious belief is pure nonsense. That is my personal belief but what if she based her position on a belief that we all could agree is fantasy. Would you still give her the right to die based on her belief?

[RB TexLa]

14. it is her body, doesn't matter what caused her chose her position

Her body is hers and if she doesn't want a treatment performed it should not be performed against her wishes, that is how you treat a dog, not a human being.

[Scribe]

29. What about insanity? Is her right to choose involate?

What if she bases her belief on the words of invisible leprechauns in the corner of the room? Is there no time when other humans have a right to intervene in a personal decision about medical treatments?

I don't know. That's why I'm asking.

[ComerPerro]

31. It almost reminds me of parents who refuse to

take their children to the hospital and in for treatment, not because they lack the money, but because their "religion" forbids it.

Sorry, but I don't buy it.

You gotta take care of your kids...

[RB TexLa]

33. She was refusing treatment for herself, not her child

does she have the rights of a dog or of a human being?

[Binka]

34. Hey OK RG Let The Mother Die

Happy now? Ever see an infant who lost a mother? The inability to thrive comes to my mind. Really what is on your mind?

[ComerPerro]

36. can't you step back from the rhetoric for just a moment?

not everything is a pro-choice / anti-choice issue

[Warpy]

9. The US does the same thing

much of the time, especially when children are concerned. Adult JW patients can be overruled by the court, although in my experience those near death often accept the transfusion if there is no alternative except death. Usually a non JW relative is the person who initiates the plea to the court. I've never seen a doctor do it, although I've read of a few cases.

I have a great deal of sympathy for the doctor who made a difficult decision in an emergency situation when two patients were at risk: the dying mother and her infant, born without a support system in place. The mother may curse him. The child will bless him.

[Der Blaue Engel]

10. Excuse me, but what if she wants to give up the baby for adoption?

Will that be disallowed, too, in favor of "the family"? This is preposterous. The entire argument that her wishes must be overriden because the baby needs a mother is preposterous! Have they no adoptions in Ireland?? You can't force someone to raise a child, can you? This is as bad as incubating a baby in a braindead corpse.

[Bridget Burke]

12. Well--she can do that now.

Or she can commit suicide.

Somehow, I don't think she'll do either.

[WindRavenX]

13. apples and oranges

Doctors, by the Hippocratic oath that they take, must do everything within their powers as a doctor to save a life. The woman would have died without a transfusions. This, and not the question of raising a kid, was what made the doctor--any doctor would have done this-- perform the transfusion. A doctor must save the life if he can.

[Der Blaue Engel]

15. No it's not

High court Justice Henry Abbott gave an emergency ruling permitting the hospital to carry out the procedure, using force if necessary. Abbott claimed that constitutionally, the right of the newborn child to have a family life overruled the mother's right to refuse treatment. As there were no known relatives or others to take responsibility for the child, it was held that it has a right to a family.

Regardless of the doctor's motivation, the ruling by the court is based on the idea that she could not make a decision for herself because she was required to be this child's family. I find that appalling.

[WindRavenX]

16. The court made a bad ruling

It should not be based on whether or not someone has a "right" to a family-- but whether the doctor had the duty to save a saveable life.
Stupid court ruling.

[Der Blaue Engel]

17. Yes, and stupid court rulings set stupid precedents

And the question is, would this doctor have done the same with a woman with no infant? That's what would be really telling.

[WindRavenX]

20. Hopefully he would

Because again, the doctors I know focus on the individual-- you HAVE to make EVERY effort to save him/her if you can, regardless of if they are married, single, gay, straight, etc.

[kiahzero]

18. My right to refuse care trumps the doctor's duty

Your position would completely invalidate DNR orders.

[WindRavenX]

21. As I understand it, if you do not sign DNR or other related exemptions...

...like in this case, then you have to do it. If the woman did sign a waiver, then that must be respected. But I think the woman in this case did not sign anything--which is why the court had to intervene.

My DNR and other stuff is in writing and signed for these reasons.

[kiahzero]

25. That's only because you're unconcious at the time care would be given

Basically, absent any evidence to the contrary, assume that the patient would want care (which makes sense). However, there was evidence to the contrary: the woman was lying there telling them she didn't want care.

The right to one's body is absolute. No one, not a doctor, not a court... no one should have a right to compel you to undergo a procedure you have elected not to undergo while of sound mind.

[muriel_volestrangler]

22. Many medical schools do not have any sort of oath or declaration

And those that do have varying ones - see eg http://bmj.bmjjournals.com/cgi/content/full/309/6959/952

From an Irish site:

Although we may not make a public avowal of the Hippocratic oath, I am sure we make our private declarations, altering a detail here and there, perhaps.

http://www.rcsi.ie/library/History_of_Medicine/Antiquity/index.asp?id=1087&pid=1087&jid=33&jpid=1086

So you should never base an argument on assuming doctors have taken some sort of oath. In any case, it is normal practice to follow "do not resuscitate" instructions, so it's clearly incorrect that doctors think they "must do everything within their powers as a doctor to save a life".

[boolean]

19. A Jehovah's witness is a FUNDIE NUTJOB

Sorry, but I can't side with the woman here. She's brainwashed. Sometimes things have to be done for someone's own good.

[Avalux]

23. As a medical professional, I would have saved her life.

While I understand her desire to not receive a transfusion and die because of her religious beliefs, it would have been a senseless loss of life and a little boy would have lost his mother. I would have saved her, then let her scream at me afterwards.

[muriel_volestrangler]

24. Would you also do that without the involvement of a baby?

If her wishes were clear, wouldn't this be like a DNR order?

[Avalux]

Very tough question

A blood transfusion is considered a simple intervention and even having a DNR order on record, it is a difficult decision. Usually a DNR order is associated with life-prolonging procedures that would often not "cure" the patient with chronic illness. A little different in this case of course.

That said, a person with such strong religious convictions should have an instructive advanced directive, where the wishes of the patient can be spelled out for certain situations (as in pregnancy complications). It is generally accepted that if a Jehovah's Witness chooses the right to die, it is to be honored.

So most physicians would not go against the patient's wishes. Of course that's on paper, not real life and I again go back to this situation with the child and the lack of planning - I would have done the same thing.

[Mind_your_head]

26. Would someone who suffered a 75-80% blood loss be phyically

able to be "think clearly" about anything at all? :shrug:

I don't know enough about biology, medicine, etc. to know the answer, but it's a reasonable/honest question, me thinks.

I would *GUESS* that someone with such significant blood loss would not be able to think clearly at that point. I even wonder if they could even be conscious at that level of blood loss, but as I said I don't know enough about the subject.

Anyone with some expertise care to advise what kind of mental state a person in this condition would be in?

TIA

[muriel_volestrangler]

27. As a Jehovah's Witness, she would have made it clear beforehand

though the question that someone on the Guardian blog raised is a good one - Jehovah's Witnesses often have their own blood drawn so it can be used in case of emergency, so why hadn't that been done in this case? But I guess that might not be advisable with a pregnant woman starting to have complications. We'd have to know more of the specifics.

[Crunchy Frog]

28. Her right to refuse treatment should have been respected.

I see no reason why the child could not have been quickly put up for adoption. I don't think that a baby has any right to have any particular individual as its family, just as long as it actually has a family of some sort, which can be achieved through adoption.

If she had undergone a normal delivery and then decided to put him up for adoption, would that have been forbidden as well? Would they have required her to keep the baby on the basis of his having the "right" to a family?

And for the people here who think that she didn't have the right to make that decision on the basis of her being a fundie nut-job, well, you've just decided that a newborn child should be condemned to a life of being raised by a fundie nut-job who's to crazy even to make her own medical decisions. You really think it makes sense to force parenthood on people you regard as insane?

[Katzenjammer]

30. Yes, it should have been.

But I doubt the child would have been adopted very quickly. Look where she's from. I doubt the number of Irish couples queued up to adopt a Black child is more than...zero?

[Crunchy Frog]

32. They do have ethnic minorities in Ireland.

http://www.amnesty.ie/user/content/view/full/3125

I simply can't believe that it would be impossible to get a healthy newborn adopted in Ireland, even if not white.

[muriel_volestrangler]

35. Adoption of healthy newborns is fairly popular in most countries

whatever their ethnicity. There are, after all, quite a few white people adopt babies from Asian orphanages. Many people aren't that bothered that it's obvious a child has been adopted.