The Cheerful Oncologist

The Death of a Jehovah’s Witness

I read fellow ScienceBlogger Orac’s take on the sad case of Dennis Lindberg, the 14 year old boy with acute leukemia who died after refusing to accept blood transfusions due to his religious beliefs, and felt like putting my own two cents in this dialogue.

As a medical oncologist who occasionally cares for patients who are Jehovah’s Witnesses my opinion is this:

Why would cancer specialists agree to give induction chemotherapy for acute myelogenous leukemia to a patient whom they knew could not survive the treatment? Such a decision, to proceed with intensive chemotherapy in a patient who is likely to die due to his refusal to accept blood transfusions, seems to me to be a splendid example of medical myopia, if not pretentiousness.

Not knowing the details of the case, of course it is ridiculous of me to speculate, but I do have a couple of questions:

1. Did the doctors think Dennis Lindberg would survive his treatment without transfusions? Is that why they proceeded with his chemotherapy?

2. Did they inform the patient that if he accepts chemotherapy without receiving any transfusions his risk of dying is much higher than normal, if not unavoidable?

3. Did they give Dennis the option to take a safer treatment, even though non-curative, in an attempt to palliate his illness without exposing him to the mortality of severe myelosuppression? If he was willing to die rather than violate his faith, did they consider alternative care that would help him to live out the rest of his life as he wished?

Putting aside the controversy over Dennis Lindberg’s age, my philosophy is this – if I think that a treatment is too risky to subject a patient to, then I will politely refuse and explain why, and if asked, help the patient find another oncologist. Life is fraught with danger and sadness enough without the meddling of physicians who cannot accept the fact that some of us are not willing to sacrifice our beliefs, whether religious or otherwise, on the altar of medicine.

Comments

  1. #1 PalMD
    December 2, 2007

    As far as I know, you’re the first one to bring up this point. It’s a nice, fresh line on it.

  2. #2 Thomas Robey
    December 2, 2007

    Thanks for this entry. I was alarmed by how quickly this was turned into a religion issue when the point you raise is at least as significant. Also at stake is the legal definition of autonomy in medical decision-making. As a medical student in Seattle, I encountered many parts of this story that make me wary of how the blogosphere has treated the story. I offer a lengthy response at Hope for Pandora. Still more issues may not be divulged at this time due to patient confidentiality. Suffice it to say, the case is almost as complex as the controversial Ashley Treatment and is more than just some ‘crazy religious folk killing their own’ as some would have you believe.

  3. #3 Iain George
    December 3, 2007

    Thought provoking. Thanks.

    Have a question about your option 3 though – in your experience with JW’s was palliative care in this circumstance really an option for the patient?

    I ask because refusing a medical treatment that apparently works (even if the medical profession views blood transfusions as a likely and necessary part of that treatment) and doesn’t rely solely on blood may not be an option. To refuse all treatment including the blood is to wish for death which may not be acceptable to JW’s.

    To attempt to survive the treatment, although refusing blood, may be to choose life but to not violate a tenet of JW belief. It may look like the same thing, and it had the same outcome, but it may be more consistent with JW beliefs.

    Those are just musings and questions for those with more experience and knowledge than I. It doesn’t approach your core question, other than if the medical professionals had no option but to treat without blood, which doesn’t appear to be the case judging by your last paragraph.

  4. #4 Tom Rook
    December 3, 2007

    In the controversy about this 14 year old, I would like to give the viewpoint of Jehovah�s Witnesses, who love life as much as anyone, and do everything God will allow to preserve it, but who also know that obedience to the principles God has made known come first.

    To those who inclined to insist, or demand that by court order or social pressure or convention, Jehovah’s Witnesses should be prevented from “committing suicide”.

    Would you suggest that Jesus, who willingly and knowingly walked into a trap, knowing he would be executed, should have been prevented from “committing suicide”?

    There are two world views …. those who fear death so much they are willing to do anything not to die …and those who fear death, but realize that some principles are necessary to die for.

    Ever notice that the civilizations that have a casual viewpoint on blood, blood puddings, blood sausages, blood food additives, are also casual about shedding mankind’s blood on the battlefields, cities, and nations of Earth?

    Jehovah’s Witnesses have adopted God’s viewpoint on blood … and that It has resulted in men, women and children that value integrity more than expediency … and even their own lives.

    Ever had a relative killed by an “enemy” in war? Many people have. Regardless of whatever else may be the case, Jehovah’s Witnesses did not do that, support that, or give moral support to that. They are free of the bloodguilt of all men.

    Those that think blood is �just� a medical liquid have historically, slaughtered each other with unceasing regularity on the battlefields of Earth, and have brought horror and hell to the experience of normal mankind.

    Let’s assume for a moment that God’s viewpoint on all blood belonging to him is set aside.

    JWs are forcing massive advances in bloodless surgery, which you will benefit from, and by their being absolutely Neutral as to politics, a more peaceful civilization, everywhere.

    Everywhere. And everyone knows this.

    Suchlike things are often specious reasoning for those to whom life is more important than principle.

    JWs were shot, frozen, starved and slaughtered because they would not sew buttons on Nazi uniforms. Who else would do that, except people who viewed not contributing to bloodguilt, and obeying God, of more value than their personal lives?

    God ignores those who live a life for “Now” � and “Now” is all they get.

    Those God invites to live forever are those that love the things God loves.

    Jesus sacrificed his life for an abstract principle … sometimes we have to do the same.

    And that, in abbreviated form, is why Jehovah�s Witnesses �abstain from blood�.

    Tom Rook

  5. #5 Dr. Homer Lim
    December 3, 2007

    Its really great to see that there are doctors who are still in touch with the world besides Medicine.

  6. #6 Danny Haszard
    December 3, 2007

    Jehovah’s Witnesses elders will investigate and disfellowship any Jehovah Witness who takes a blood transfusion,to say the issue is a ‘personal conscience matter’ is subterfuge to keep the Watchtower out of lawsuits.

    Many Jehovah’s Witnesses men,women and children die every year worldwide due to blood transfusion ban.Rank & file Jehovah’s Witness are indoctrinated to be scared to death of blood.

    FYI
    1) JW’s DO USE many parts aka ‘fractions’ aka components of blood,so if it’s ‘sacred’ to God why the hypocritical contradiction flip-flop?

    2) They USE blood collections that are donated by Red cross and others but don’t donate back,more hypocrisy.

    3) The Watchtower promotes and praises bloodless elective surgeries,this is a great advancement indeed.BUT it’s no good to me if I am bleeding to death from a car crash and lose half my blood volume and need EMERGENCY blood transfusion.

    Know this,the reason that JW refuse blood is because of their spin on the 3000 year old Biblical old testament,modern medicine will eventually make blood donations and transfusions a thing of the past.When this technology happens it won’t vindicate the Jehovah’s Witnesses and all the deaths that have occured so far.
    The Watchtower’s rules against blood transfusions will eventually be abolished (very gradually to reduce wrongful death lawsuit liability) even now most of the blood ‘components’ are allowed.
    In 20 years there will be artificial blood and the Red Cross will go on with other noble deeds.

    None of these changes will absolve the Watchtower leaders or vindicate their twisted doctrines
    Are there dangers from blood?There are over 500 aspirin deaths in USA yearly.

    Danny Haszard born 1957 3rd generation Jehovah’s Witness

  7. #7 Danny Haszard
    December 3, 2007

    Who are Jehovah’s Witnesses?
    Up close and personal Jehovah’s Witnesses can be wolves in sheep’s clothing.
    Think about this-When the devil comes knocking on your door he may not have the ‘dark goth look’.They could be smartly dressed and wielding the Christian Bible.
    The central core dogma of the Watchtower is Jesus second coming (invisibly) in 1914 and is a lie.Jehovah’s Witnesses are a spin-off of the man made Millerite movement of 1840.
    A destructive cult of false teachings, that frequently result in spiritual and psychological abuse, as well as needless deaths (bogus blood transfusion ban).
    Yes,you can ‘check out anytime you want but you can never leave’,because they can and will hold your family hostage.

    The Watchtower is a truly Orwellian world.

  8. #8 Rita Schwab
    December 5, 2007

    Thanks for your thoughtful post. I imagine it’s a rarity in medicine when there are absolutely no options and only one possible care choice. I for one appreciate physicians who seek to heal and comfort, not just prolong life no matter what the cost.

  9. #9 kozmetik
    December 23, 2007

    Ever notice that the civilizations that have a casual viewpoint on blood, blood puddings, blood sausages, blood food additives, are also casual about shedding mankind’s blood on the battlefields, cities, and nations of Earth?
    Jehovah’s Witnesses have adopted God’s viewpoint on blood and that It has resulted in men, women and children that value integrity more than expediency … and even their own lives.Ever had a relative killed by an “enemy” in war? Many people have. Regardless of whatever else may be the case, Jehovah’s Witnesses did not do that, support that, or give moral support to that. They are free of the bloodguilt of all men.

  10. #10 Danny Haszard
    December 23, 2007

    Jehovah’s Witnesses differences
    Debunking the Jehovah’s Witnesses beliefs:
    A) They are at your door to recruit you for enslavement to their watchtower corporation,they will say that “we are just here to share a message from the Bible” this is deception right off.

    B) The ‘message’ is their false Gospel that Jesus is ruling in heaven already since 1914.The problem with this is it’s not just a cute fairy tale,Jesus warned of the false prophets who would claim “..look he is here in the wilderness,or see here he is at the temple”

    C) Their anti-blood transfusion ban has killed hundreds if not thousands D) once they recruit you they will “love bomb” you in cult fashion to also recruit your family & friends or cut them off. There are many more dangers,Jehovah’s Witnesses got a bad rap for good and valid reasons.

    99% of the world has rejected the teachings of the Watchtower Jehovah�s Witnesses as a �joke� but the darker truth is they are a destructive and oppressive organization.

    Danny Haszard Jehovah’s Witness X 33 years

  11. #11 sohbet
    March 26, 2008

    Thought provoking. Thanks.

    Have a question about your option 3 though – in your experience with JW’s was palliative care in this circumstance really an option for the patient?

    I ask because refusing a medical treatment that apparently works (even if the medical profession views blood transfusions as a likely and necessary part of that treatment) and doesn’t rely solely on blood may not be an option. To refuse all treatment including the blood is to wish for death which may not be acceptable to JW’s.

    To attempt to survive the treatment, although refusing blood, may be to choose life but to not violate a tenet of JW belief. It may look like the same thing, and it had the same outcome, but it may be more consistent with JW beliefs.

    Those are just musings and questions for those with more experience and knowledge than I. It doesn’t approach your core question, other than if the medical professionals had no option but to treat without blood, which doesn’t appear to be the case judging by your last paragraph.