When I worked in the pediatric intensive care unit, one of these instances arose. The child was on a breathing machine and not doing very well. The patient's hemoglobin level was low. You may know this as anemia. However, that's just one type of anemia. What's hemoglobin? It's the part of your red blood cell that carries oxygen. When you don't have enough hemoglobin to carry oxygen, your cells begin to starve and die. This leads to shock and death. It doesn't matter how much oxygen we deliver, if there's nothing to carry it to those individual cells, the patient can still die.
This problem is easy to solve. We give the child a blood transfusion. The parents, based on their religious beliefs, refused. This child's levels were so low, he was at risk for complications and he's already critically ill. It won't take much to tip him over the edge. What are the options?
We ended up getting a court order to transfuse blood. The ICU docs were willing to respect the parent's position up to a point, but they were not willing to let the child die.
Imagine being the nurse at the bedside in the morning, trying as best as you can to only take a small amount of blood. Then getting the results back and wondering if you'll have to be the one to transfuse this patient.
The child survived and ended up not getting a blood transfusion and actually did really well. The nursing staff met with the family and a member of their church to discuss the issues that surrounded their child's care. A nurse asked the mother, "What would it have been like for you if we did give your child blood?" The mother responds, "It would have been like you raped my baby."
Those are strong, powerful words. I remember them to this day. Enough conflict? I think so and I definitely felt it at the time.
Powerful words--"It would have felt like you raped my baby." However, as a mommy, if my decision made my baby die, I would have felt like a murderer.
ReplyDeleteI guess I have to look at this mother's objections like I look at abortion. Convictions don't compromise.
Good post.
At least in politics when we have extreme differences of opinion/beliefs no one dies. I always find it interesting that a breathing machine is OK, but the blood transfusion is not. I mean if you don't want intervention, why would you even have a ventilator? Thankful that I have no medical drama in my life right now. I'm enjoying your blog.
ReplyDeleteThank you, Carol. Stacy... very interesting point. We face this in the ED at times. Parents come in and then refuse all treatment. We're wondering, how exactly can we help you?
ReplyDeleteStacy: I'd guess that in this case it was a specific objection to blood transfusion, rather than an objection to medical intervention. There are religions and denominations that refuse to allow blood transfusions - Jehovah's witnesses, for instance - because their interpretation of their scriptures prohibits it. I believe it's to do with a ban on consuming blood, at least in the Jehovah's Witness case.
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