Hi, this is very informative! Just have a quick case I’ve been trying to understand. A lady scheduled for caesarean expresses her wish to refuse blood transfusion because she is concerned about the health risks having heard about historic infection issues. So she also express refusal of blood transfusion to the baby at delivery if required. 1) flowing both legal and ethical considerations what would the clinical team require deciding about any potential blood transfusion
It’s concerning that the inference postulated is that refusing allogeneic blood transfusions automatically result in the death of a patient. That’s an oversimplification of a very complicated scenario. Every case no doubt is unique, as is the Drs experience in patient blood management, tools and resources of the treating facility, as well as other factors. Regarding the ethical component; is over riding the deeply held religious conviction, expressed verbally or in writing,(given capacity is demonstrated) “In the best interest of the patient”? Drs may feel blood transfusion is the quickest and simplest solution to help a patient; it’s not the only solution. It isn’t the forum to discuss strategies that make blood transfusion redundant, being aware of such erodes the ethical questions Drs face. Ie if I can’t transfuse, what can I do to improve the chance of a positive outcome for this patient? If the clock is ticking, time isn’t wasted arguing or threatening the patient with death if they refuse blood transfusion. The treating team does the best they can in the circumstances they’re in.
Are there any jehovah witness doctors or nurses who would refuse to give or even suggest a transfusion because of their beliefs.! Cos that's a really scary thought😮
I’m glad it helped! It’s outlined quite well in this book 😊 www.amazon.co.uk/Medical-Interviews-Questions-Analysed-Multiple-Mini-Interviews/dp/1905812051/ref=sr_1_1?dchild=1&keywords=medical+school+interviews&qid=1631473098&sr=8-1
Thank you so much for this video, I'm preparing for my interviews now and this has been really helpful. One question though, in the situation where the patient is conscious, would there be time to have a long and in-depth conversation about the dangers of not having the transfusion? Surely the patient is bleeding profusely and this is an emergency, so action must be taken as soon as possible?
I’m so happy this helps! Good question - in the case where the patient has capacity (which could be likely if they’re conscious) and they still refuse the transfusion, it’s a case of what the patient wants. However, if the patient is bleeding profusely and it’s an emergency, the patient is more likely to be unconscious in which case a clinical decision is made based on what’s in the best interests of the patient :)
If the patient has an Advance Health Directive, it would speak for them if they can’t speak for themselves. A GUIDE TO GOOD PRACTICE FOR THE SURGICAL MANAGEMENT OF JEHOVAH’S WITNESSES AND OTHER PATIENTS WHO DECLINE TRANSFUSION” produce by The Royal College of Surgeons in England. It reads as follows: “If a patient is unable to give an informed, rational opinion, and when an applicable advance directive does not exist, the clinical judgement of a doctor should take precedence over the opinion of relatives or associates. Such relatives or associates may be invited to produce evidence of the patient’s Jehovah’s Witness status in the form of an applicable advance-decision document.”
I believe for children under the age of 16, Gillick competence applies. For those 16 or over, they’re presumed to have sufficient capacity unless proven otherwise :)
Wasn't the Childrens Act a movie, not a series? JWs don't refuse blood because it's impure. That's completely incorrect. They refuse it for religious reasons. The bible tells them that "life is in the blood" and it is a sin to take life-blood from another. They believe that its faith in Jesus 'shed blood that grants them life, and not taking in blood from another human. They don't refuse blood because they don't understand the transfusion procedure or are afraid of it. They believe that they will lose everlasting life if they disobey God and accept it. You can explain to them all the risks you like, but the greatest risk to them is losing everlasting life. Also yoy made no mention of the signed legal document, the "Advanced Medical Directive" which all baptised JWs are instructed to carry on their person at all times. The only problem with this card is that JWs are coerced into carrying one. I was a JW for 25 years and at times elders would do a spot check to see if you were carrying your "blood card". There is a huge amount of pressure to have this card and there is no option to say you dont believe in the blood prohibition. All JWs MUST refrain from whole blood transfusions, otherwise they cannot remain a JW. Its quite a dilemna, one that I faced for a number of years . I had to keep my views secret or else be ousted from the organisation and be shunned by my entire social network. You also made no mention of the interfering "Hospital Liason Committees" that show up to "support" JWs in their "choice" to refuse blood . Except when they are present it feels like no choice, or choose blood to live, but lose your jw friends and family in the process. Its a dreadful ethical dilemna for doctors.
fair points made you dont need to deep it like that in these interviews , you can only say so much in the 5 mins given and the interviewer also wants to ask some follow up qs
The scriptural reason for refusing blood transfusions is in Acts 15:28,29 “keep abstaining from ….from blood…” Advance health directives vary in which part of the earth a person lives. Where I am, a Dr and Justice of the Peace both need to sign it - this demonstrates to them the patient has capacity to understand the ramifications of what their decision is prior to ending up in hospital. Hospital Liaison Committees bridge the communication gap between patients and Drs, arrange peer to peer consultation between medical professionals, as well as relevant published medical abstracts on blood management the treating team may be unaware of. They facilitate cooperation, not confrontation.
Hi, this is very informative!
Just have a quick case I’ve been trying to understand. A lady scheduled for caesarean expresses her wish to refuse blood transfusion because she is concerned about the health risks having heard about historic infection issues. So she also express refusal of blood transfusion to the baby at delivery if required.
1) flowing both legal and ethical considerations what would the clinical team require deciding about any potential blood transfusion
This was very helpful! I really appreciate your explanations. I can tell you love ethics!
Best content ever! Thanks so much.
This was very helpful, thank you
Such a great and lovely explanation:)
I have my HYMS interview next wednesday. I love your videos. wish me luck!
How did it go!! Hope it went well
This is such a great video, thank you!!
I’m glad it helped Dina :)
hi where is the vaccination one u said u was gonna do ???????? THESE VIDS R SO SO HELPFUL
This is so helpful! Thanks
I’m so happy I could help :)
It’s concerning that the inference postulated is that refusing allogeneic blood transfusions automatically result in the death of a patient.
That’s an oversimplification of a very complicated scenario.
Every case no doubt is unique, as is the Drs experience in patient blood management, tools and resources of the treating facility, as well as other factors.
Regarding the ethical component; is over riding the deeply held religious conviction, expressed verbally or in writing,(given capacity is demonstrated) “In the best interest of the patient”?
Drs may feel blood transfusion is the quickest and simplest solution to help a patient; it’s not the only solution.
It isn’t the forum to discuss strategies that make blood transfusion redundant, being aware of such erodes the ethical questions Drs face. Ie if I can’t transfuse, what can I do to improve the chance of a positive outcome for this patient?
If the clock is ticking, time isn’t wasted arguing or threatening the patient with death if they refuse blood transfusion.
The treating team does the best they can in the circumstances they’re in.
Very very useful video
This is amazing!! So so helpful
I wanted to ask if you could possibly do one on euthanasia or abortion please?
Thank you very much!
Thank you I’m glad it’s helped! I’m still unsure whether to get back into filming but if I do, that’ll be the video I upload :)
Are there any jehovah witness doctors or nurses who would refuse to give or even suggest a transfusion because of their beliefs.! Cos that's a really scary thought😮
Yes, but their stance would be known by the hospital and other practitioners would be at the standby to administer blood if needed.
This was super helpful, thank you!! Where did you learn all this from?
I’m glad it helped! It’s outlined quite well in this book 😊 www.amazon.co.uk/Medical-Interviews-Questions-Analysed-Multiple-Mini-Interviews/dp/1905812051/ref=sr_1_1?dchild=1&keywords=medical+school+interviews&qid=1631473098&sr=8-1
Would this book be useful for someone preparing for interviews in US
Thank you so much for this video, I'm preparing for my interviews now and this has been really helpful. One question though, in the situation where the patient is conscious, would there be time to have a long and in-depth conversation about the dangers of not having the transfusion? Surely the patient is bleeding profusely and this is an emergency, so action must be taken as soon as possible?
I’m so happy this helps! Good question - in the case where the patient has capacity (which could be likely if they’re conscious) and they still refuse the transfusion, it’s a case of what the patient wants. However, if the patient is bleeding profusely and it’s an emergency, the patient is more likely to be unconscious in which case a clinical decision is made based on what’s in the best interests of the patient :)
@@hannahbourner7866 Ahhh I see. Thank you so much!
If the patient has an Advance Health Directive, it would speak for them if they can’t speak for themselves.
A GUIDE TO GOOD PRACTICE FOR THE SURGICAL MANAGEMENT OF JEHOVAH’S WITNESSES AND OTHER PATIENTS WHO DECLINE TRANSFUSION” produce by The Royal College of Surgeons in England.
It reads as follows:
“If a patient is unable to give an informed, rational opinion, and when an applicable advance directive does not exist, the clinical judgement of a doctor should take precedence over the opinion of relatives or associates. Such relatives or associates may be invited to produce evidence of the patient’s Jehovah’s Witness status in the form of an applicable advance-decision document.”
Gillick competence which can apply less than 18 or 16
I believe for children under the age of 16, Gillick competence applies. For those 16 or over, they’re presumed to have sufficient capacity unless proven otherwise :)
Wasn't the Childrens Act a movie, not a series? JWs don't refuse blood because it's impure. That's completely incorrect. They refuse it for religious reasons. The bible tells them that "life is in the blood" and it is a sin to take life-blood from another. They believe that its faith in Jesus 'shed blood that grants them life, and not taking in blood from another human. They don't refuse blood because they don't understand the transfusion procedure or are afraid of it. They believe that they will lose everlasting life if they disobey God and accept it. You can explain to them all the risks you like, but the greatest risk to them is losing everlasting life.
Also yoy made no mention of the signed legal document, the "Advanced Medical Directive" which all baptised JWs are instructed to carry on their person at all times. The only problem with this card is that JWs are coerced into carrying one. I was a JW for 25 years and at times elders would do a spot check to see if you were carrying your "blood card". There is a huge amount of pressure to have this card and there is no option to say you dont believe in the blood prohibition. All JWs MUST refrain from whole blood transfusions, otherwise they cannot remain a JW. Its quite a dilemna, one that I faced for a number of years . I had to keep my views secret or else be ousted from the organisation and be shunned by my entire social network.
You also made no mention of the interfering "Hospital Liason Committees" that show up to "support" JWs in their "choice" to refuse blood . Except when they are present it feels like no choice, or choose blood to live, but lose your jw friends and family in the process. Its a dreadful ethical dilemna for doctors.
fair points made you dont need to deep it like that in these interviews , you can only say so much in the 5 mins given
and the interviewer also wants to ask some follow up qs
but'
@@Eashel.m Accuracy is very important.
@@Rupunzelsawake whatever floats your boat
The scriptural reason for refusing blood transfusions is in Acts 15:28,29
“keep abstaining from ….from blood…”
Advance health directives vary in which part of the earth a person lives. Where I am, a Dr and Justice of the Peace both need to sign it - this demonstrates to them the patient has capacity to understand the ramifications of what their decision is prior to ending up in hospital.
Hospital Liaison Committees bridge the communication gap between patients and Drs, arrange peer to peer consultation between medical professionals, as well as relevant published medical abstracts on blood management the treating team may be unaware of.
They facilitate cooperation, not confrontation.
❤
Mmi interview question I 200 question can you make all that answers please
I'm a Jehovah's Witness, ask me anything