In 1993, at a major medical center in the Midwest, parents were handcuffed and removed from their son's bedside and their child was taken into custody by the attending physician. What was the crime that these parents committed, resulting in the father's incarceration and the child being made a ward of the state for the following year? The case was a refusal by Jehovah's Witnesses parents to allow blood transfusion to their six-year-old child. The child was in a sickle cell crisis, with a stroke in progress, hemiplegia, and a hemoglobin so low that death was imminent. This essay examines the case as it progressed, the norms and values involved, the positions of the attending doctors and nurses, and the legal actions that took place, and makes recommendations for nursing and ethics committee considerations for the future.
Persons who practice the Jehovah's Witnesses faith accept medical and surgical treatment. However, they are deeply religions people who believe that blood transfusion is forbidden for them. This prohibition is construed from the following biblical passages: "Only flesh with its soul -its blood --you must not eat" (Genesis 9:3-4); ~Abstain from ...fornication and from what is strangled and from blood" (Acts 15:19-21). "You must not eat the blood of any sort of flesh, because the soul of every sort of flesh is its blood. I will set my face against that person who eats blood .... Anyone eating it will be cut off' (Leviticus 17:10, 13-14). Jehovah's Witnesses interpret these passages as forbidding the transfusion of whole blood, packed red blood cells, plasma, white blood cells, and platelets. Jehovah's Witnesses are allowed to decide for themselves, as a matter of conscience, whether or not to accept albumin, immune globulins, cryoprecipitate, and organ transplants (1). Non-blood plasma expanders such as saline solution, Ringer's lactate, and hetastarch are acceptable (2).