Responses of advanced directives by Jehovahç Witnesses on a gynecologic oncology service

Nimesh P. Nagarsheth, Nikhil Gupta, Arpeta Gupta, Erin Moshier, Herbert Gretz, Aryeh Shander

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Objectives: To review the responses of advance directives signed by Jehovah’s Witness patients prior to undergoing surgery at a gynecologic oncology service.

Study design: A retrospective chart review of gynecologic oncology patients undergoing surgery at a bloodless surgery center from 1998-2007 was conducted. Demographic, pathologic, and clinical data were recorded. The proportion of patients who accepted and refused various blood-derived products was determined and was compared to previously published results from a similar study of labor and delivery unit patients.

Results: No gynecologic oncology patients agreed to accept transfusions of whole blood, red cells, white cells, platelets, or plasma under any circumstance, whereas 9.8% of pregnant patients accepted transfusion (P=0.0385). However, 98% of gynecologic oncology patients agreed to accept some blood products, including fractions such as albumin, immunoglobulins, and clotting factors, while only 39% of pregnant patients agreed (P<0.0001). In addition, all gynecologic oncology patients (100%) accepted intraoperative hemodilution, compared to 55% of pregnant patients (P<0.0001).

Conclusion: Our results confirm the commonly held belief that the majority of Jehovah’s Witness patients refuse to accept major blood components. However, Jehovah‘s Witness patients at a gynecologic oncology service will accept a variety of blood-derived products (minor fractions) and interventions designed to optimize outcomes when undergoing transfusion-free surgery. Patients presenting to a gynecologic oncology service respond differently to advanced directives related to bloodless surgery, as compared to patients from an obstetrical service.

Original languageEnglish
Pages (from-to)17-23
Number of pages7
JournalJournal of Blood Medicine
Volume6
DOIs
StatePublished - 24 Dec 2014

Keywords

  • Advanced directives
  • Bloodless surgery
  • Jehovah’s Witness

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