Monday, 8 December 2014

Jehovah Witnesses and Blood Transfusions

For some strange reason the press today are covering two stories about cases that happened months ago see the Guardian &  the Telegraph  for example.

The cases both relate to Jehovah Witnesses and their well known disapproval of  Blood Transfusions.  

In NHS v Child B [2014] EWHC 3486 (Fam)(01 August 2014) Mr Justice Moylan permitted Doctors to give a Blood Transfusion to, what he described as "a very young child" against the wishes of the childs devout Jehovah Witness parents. 

In para 5 the Judge noted
"It is the unanimous view of the clinical team that the best practice treatment of B is skin grafting and that there is a significant risk that he will require a blood transfusion during this procedure."

and in para 10
"the consultant expresses the opinion that, in the event of a skin graft taking place without the ability to give a blood transfusion, there is a risk of death."

The Judge summed up his decision in para 18
My decision must be determined by my assessment of what is in B's best interests because my paramount consideration is B's welfare. In reaching my decision, based on balancing all the factors bearing on the issue of B's welfare, I must weigh in that balance the wishes, opinions and views of B's parents. They alone have parental responsibility. But, as Ward LJ said in In re A (Children)(Conjoined Twins: Surgical Separation) [2001] Fam 147, although I must give "very great respect" to the parents' wishes, they are "subordinate to welfare".

This decision therefore was predictable because the Court was having to take a decision on behalf of a child who could not make his own informed decision

By contrast in Newcastle Upon Tyne Hospitals Foundation Trust v LM [2014] EWCOP 454 (26 February 2014) Mr Justice Peter Jackson refused to allow Doctors to administer a Blood Transfusion to a  "gravely ill 63-year-old female Jehovah's Witness." known as LM, in para 11 he noted 

"On 12 February, LM was seen by two doctors in the gastroenterology team. She told them that she was adamant that she would not want treatment with any blood products. They felt that she had full capacity to make this decision with an awareness of the consequences.".  

Following this condition of LM deteriorated so that she could not communicated. The Hospital was concerned as to whether she could be given a Blood Transfusion which might help her or whether to respect her wishes and see her die.  

The Judge decided para 21
"I am satisfied that LM understood the nature, purpose and effects of the proposed treatment, including that refusal of a blood transfusion might have fatal consequences."

and on that basis the Judge ruled that a Blood Transfusion should not be given and subsequently LM died.

Neither case creates any new law or sets out any new principle.  The question in both cases was the same namely is the person needing the Transfusion in any position to make a decision refusing the treatment.  In the case of a child the answer was No so the Court made the decision but in the case of the adult the answer was yes so their decision was respected.  

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