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Why Choose Bloodless Medicine?

 

Patients generally choose bloodless medicine for either medical or religious reasons.

 

Medical Reasons

n     Physicians recommend it

“The safest unit of blood is the one that is never given!”

Keating LJ. Quality assurance and safety of the blood supply. Cleveland Clinic Journal of Medicine 1989;56(3):282-4.

n     Eliminates adverse effects

“The need to reduce the amount of allogeneic blood transfusions in order to reduce the associated risks has been firmly established. RBCs are associated with clinically important immune suppression, and stored RBCs have been shown to cause adverse microcirculatory effects that result in increased organ failure.”

—Alvarez G, Hébert PC, Szick S. Debate: Transfusing to normal haemoglobin levels will not improve outcome. Critical Care 2001;5(2):56-63.

n     Lowers infection rates and minimizes immunosuppression

“There is now growing evidence bearing on the potential clinical significance of the immune system effects of blood transfusion. Several studies have suggested that exposure to RBC transfusion increases the risks of recurrence of cancer and the development of postoperative infection. Patients who receive allogenic blood transfusions experience increased morbidity, hospital stays, and cost.”

—Corwin HL. Blood Transfusion—First, Do No Harm! Chest 1999;116(5):1149-50.

n     Does not require special equipment

“A lot of new technology isn’t needed…. We don’t need new drugs or a lot of expensive new things. The important thing is to get the message out and get everyone doing what we already know how to do to avoid prophylactic transfusion of red cells or platelets and plasma. The addictive effects of all the techniques now on hand can provide good results.”

—Thurer RL. As the blood supply gets safer, experts still call for ways to reduce the need for transfusions. The Journal of the American Medical Association 1992;268(6):698-700.

n     Public demand

When asked which options they would prefer if informed they required a blood transfusion due to a surgical operation, only seven percent of the respondents would want to receive blood from the Red Cross. Eighty-nine percent preferred an alternative.

Gallup Canadian Public Survey, February 1996.

n     Shorter hospital stays

“Our study demonstrates an independent association of perioperative allogeneic transfusion with longer hospital stays (P < .001) and higher hospital charges (P < .001) after adjustment for the effects of 20 variables that confound these relationships and reflect the severity of a patient’s illness, the difficulty of the operation, and the risk of postoperative urinary tract infection, would infection, or pneumonia.”

—Vamvakas EC, Carven JH. Allogeneic blood transfusion, hospital charges, and length of hospitalization. Archives of Pathology and Laboratory Medicine 1998;122(2):145-51

n     Cost-effective

“Avoiding allogeneic transfusions reduced total treatment costs in abdominal and orthopedic surgery by approximately $5,000 per patient.”

—Spahn DR, Casutt M. Eliminating blood transfusions. Anesthesiology 2000;93(1):242-55.

“In conclusion, bloodless medicine and surgery is a new discipline which is cost effective, acceptable to patients, and provides new avenues to improve on quality of patient care. It is a complete philosophy dedicated to treating patients according to state-of-the-art medical and surgical principles with advance technology, but with the added challenge of avoidance of blood products.”

—Savarese D, Waitkus H, Stewart FM, Callery M. Bloodless medicine and surgery. Journal of Intensive Care Medicine 1999;14(1):20-33

Jehovah's Witnesses View of Blood

Excerpt from JAMA, Nov 27, 1981—Vol 246, No. 21

“Jehovah's Witnesses-The Surgical/Ethical Challenge”

 

“Jehovah’s Witnesses accept medical and surgical treatment. In fact, scores of them are physicians, even surgeons. But Witnesses are deeply religious people who believe that blood transfusion is forbidden for them by Biblical passages….”

 

“While [the Bible] verses are not stated in medical terms, Witnesses view them as ruling out transfusion of whole blood, packed RBCs, and plasma, as well as WBC and platelet administration. However, Witnesses’ religious understanding does not absolutely prohibit the use of components such as albumin, immune globulins, and hemophiliac preparations; each Witness must decide individually if he can accept these.”

 

“Witnesses believe that blood removed from the body should be disposed of, so they do not accept autotransfusion of predeposited blood. Techniques for intraoperative collection or hemodilution that involve blood storage are objectionable to them. However, many Witnesses permit the use of dialysis and heart-lung equipment (non-blood-prime) as well as intraoperative salvage where the extracorporeal circulation is uninterrupted; the physician should consult with the individual patient as to what his conscience dictates.”

 

For more in-depth information on their stand on medical care and blood, visit the Jehovah's Witnesses' website.



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