Judge Rules Teen Jw Must Have A Blood Transfusion

[LazyGun]

What do you think to this case?

I am all for authorizing blood transfusions when the prognosis is such that the patient will almost certainly die if they do not receive a transfusion, and where there is a clear expectation that having received a blood transfusion the chances of survival are markedly released, and were this case about a young child, under 15-16 say I would probably not have any issues with the decision.

But a 17 year old only months away from being 18? Not sure we should be forcing patients to receive blood -having to sedate them to give them a transfusion - is warranted.

http://www.theage.com.au/national/teen-witness-must-have-a-transfusion-rules-judge-20130417-2i0lc.html

[woofgang]

em10 if I profess my opinion that everyone has the right to choose, then that includes jim who can make the choice that he will accept the medical interventions that are prescribed for him without question or demur...my opinion therefore has no effect on him. His opinion, that everybody should do what he wants to do does have an effect on me and on everyone else....my stance enables jim(and everyone) to maintain his right to his opinion, his does not.
How about you? would you like other people to be able to decide what is right for you and insist that you comply whether you want to or not?

[jim360]

I've been trying to back down a bit in the last few posts and tried to understand where if anywhere there was a line for you between opinion and fact mattering. I note you haven't yet answered that point.

I want to be right, yes. I don't want to be wrong, though - if you or anyone else can persuade me I am wrong then I hope very much that I would change my views. My argument is based largely on the fact that for a period of my life and those of some of my relatives I do not believe I was capable of judging what was best for me. Therefore my choice, if I had made it, would, or should, have carried far less weight.

It's not just a matter of wanting to be right. It's a matter of knowing that sometimes I am wrong, biased or clouded. A doctor is far less likely to be any of those than me. So I would be usually happy to accept his/ her judgment over mine (albeit with some background reading just to be on the safe side).

[LazyGun]

To be honest, I am a little surprised this thread has prompted as much debate as it has, but thanks all for the contributions - it really has been very interesting to read.

What it does illustrate is that the law is actually pretty carefully crafted in this area,with a test of competence for minors. It also makes a distnction between the validity of that test when it comes to accepting or refusing a procedure. There have been instances where the wishes of the minor have been respected when it comes to refusing a treatment, but that seems situational and dependant upon the outcomes with or without treatment.

And someone here - sorry, forgot who - said those individuals who were directed by the court to receive a blood transfusion were not disfellowshipped or shunned by their family/community, which is important.

Beliefs and freedom are very important and should be respected wherever possible, but I think that medically and ethically speaking, it is the right decision to treat him.

[woofgang]

and actually em10 the law is not that different. A child in similar circumstances here would have an application made by lawyers representing the hospital for the child to be made a ward of court and then the court would decide on what treatment the child should receive. The same test (Gillick competence) would apply. There was a somewhat similar recent case of a much younger child who had a brain tumour.

[emmie]

chapta, i agree to disagree with people, as in real life, and there was more than 50 percent in favour of Mrs T, if you were to go back over the whole load of threads. Not to mention the post by our leader Ed. I don't understand the hatred emanating from some, which quite frankly is totally pointless, no matter the subject matter. Hatred doesn't get anyone anywhere. Healthy debate and differing opinions are what this site has been about for the most part.

[emmie]

as this case is in Australia, does the same apply here.

[chaptazbru]

OK em if you say so.

[jim360]

I hope at the very least I can't be accused of anything other than healthy debate.

[woofgang]

which facts jim? the medical fact of the odds of survival with and without transfusion? No, to me not relevant. The facts regarding competence to decide, then yes very relevant. BUT where its clear that the person is in circumstances where they are not competent to decide BUT BY REASON OF MENTAL STATE not because of their scientific or medical knowledge, then yes they need an advocate to support them in the decision making process, that support ranging from assistance with understanding and decision making; to taking on the entire decision making process BUT that process should be undertaken giving paramount importance to what the person themselves would choose were they able to do so. I too have been personally involved in this hard and painful scenario twice. The choices that I made both times were not at all what I wanted or would choose but my lasting comfort is that I know that those choices were what the person (both loved deeply by me) would have chosen.

[emmie]

take some reading through..

http://www.ruh.nhs.uk/about/policies/documents/clinical_policies/blue_clinical/Blue_783_Clinical_Management_of_Jehovahs_Witnesses_and_Other_Patients_who_refuse_blood_components.pdf

[jim360]

As and when I am in the same situation you were in those two times, woofgang, I'll let you know what choice I make. Perhaps until then I'm stuck in a hypothetical world.

[woofgang]

yes that's pretty standard.

[woofgang]

have I answered your question regarding when opinion gives way to fact? I don't claim that i must be right because of my experience, but my opinions are not based on hypothesis and what if. I have been there both as a professional and an advocate. Nothing in my experience has made me change my stance. I hope I am never placed in those circumstances again.

[jim360]

A surprisingly large amount of my views on this are based on watching pigeons in the city centre. The variety of horrific leg injuries and what not they have gone through. And yet still they persist in trying to live, hobbling around on stumps. It must be so painful. Goodness knows why they don't try and die. Maybe it's because they don't know how to.

Anyway, I watched them long enough to decide that since they had it far worse than me, but still carried on trying to stay alive, that I may as well too. So for me me at least life is worth fighting for, which in turn means that I find it hard accept that anyone who chooses to refuse a treatment is in general being rational. There are specific cases where it's impossible to make such a sweeping statement, but anyway death does not strike me as a rational choice. That, coupled with being perhaps overly scientific about some things, is what leads to my position.

At the moment anyway. I've not yet had anything happen near having to make the choice you've made, which is certain to shake things up again. So again it's certainly

[jim360]

... hypothetical at the moment.

Thanks for an interesting debate.

[emmie]

some don't get the chance to make any kind of decision, it's taken out of their hands by sudden death.

[woofgang]

Jim, sometimes death is a rational choice. Did I answer your question about the line between fact and opinion?

[jim360]

I'm probably missing something obvious but I can't see that you did.

[woofgang]

Here
woofgang
"which facts jim? the medical fact of the odds of survival with and without transfusion? No, to me not relevant. The facts regarding competence to decide, then yes very relevant. BUT where its clear that the person is in circumstances where they are not competent to decide BUT BY REASON OF MENTAL STATE not because of their scientific or medical knowledge, then yes they need an advocate to support them in the decision making process, that support ranging from assistance with understanding and decision making; to taking on the entire decision making process BUT that process should be undertaken giving paramount importance to what the person themselves would choose were they able to do so. I too have been personally involved in this hard and painful scenario twice. The choices that I made both times were not at all what I wanted or would choose but my lasting comfort is that I know that those choices were what the person (both loved deeply by me) would have chosen.
14:57 Fri 19th Apr 2013Report"

[jim360]

Yes, I was missing something obvious. Thanks.