Even as doctors at Bombay hospital struggle to control 24-year-old Colaba resident’s dipping platelet count, medical and legal experts debate on what needs to be done in such emergencies.
On September 7, dna reported on how Mary’s (name changed) family members, who belong to the Christian sect Jehovah’s Witnesses, strictly warned the doctors against any kind of blood transfusion. The sect, which has about 8,000 members in Mumbai, doesn’t believe in donating or accepting blood.
Dr Mukesh Sanklecha, Mary’s consultant physician said, “Her platelet count today is 50,000. When she came in, her platelet count was 1,15,000 which dipped to 80,000 on Friday. We are hoping that the count will rise in a day or two and not dip further.
Meanwhile, we are giving all possible medical care and are ensuring that she doesn’t have any external or internal bleeding.”
Her mother, according to the doctors, was worried about the dipping platelet count but remained firm on her decision to not agree to blood transfusion. Bombay hospital is monitoring Mary’s medical condition. “If required, we will have to take a written consent from the family about its refusal to accept blood transfusion and that they know about the potentially life-threatening complications of dengue,” said Dr Sanklecha.
Dr Aliasagar Bahrainwala, cardiac surgeon at Saifee hospital, had one such case last month when a 50-year-resident of the western suburbs walked into the hospital with a 100 per cent blocked artery and needed an urgent open heart surgery. “He belonged to Jehovah’s Witnesses community and requested for a bloodless surgery,” said Dr Bahrainwala.
According to Dr Bahrainwala, they managed to conduct a successful open heart surgery because the patient had a very good haemoglobin count. Many Jehovah’s Witnesses carry a signed and witnessed advance directive card that absolutely refuses blood, hence releasing doctors from any liability.
The community also believes in autologous blood transfusion where they bank their own blood and use it if they need it in future. However, this kind of banking has a limited window period and is not applicable to emergency cases.
From a legal point of view, doctors can’t be held responsible if the patient refuses medical help in the name of faith. Rebecca Gonsalves, an advocate, said, “I don’t think anything can be done legally as the girl and family are refusing blood transfusion. It is their belief. The Constitution of India provides the right to freedom of religion.”
Agreeing with Gonsalves, another advocate Ganesh Sovani said, “The doctors and the police can’t do anything on their own without a complaint. The doctor should immediately inform the police about the situation. The doctor should also give a letter to the family, expressing that their consent is required for blood transfusion. This is to protect the doctor from any legal hassle, in case something goes wrong.”
Legal experts also think that in case of an emergency, the government should intervene and counsel the family. Advocate Arfan Sait said, “In such a case, the state government should intervene and counsel the family, just as how when a person goes on an indefinite hunger strike, the government force feed them if necessary.
Saving a life is of paramount importance and all religious texts say that saving a human life is divine. The Constitution of India gives right to life and this also means right to protect life which is the duty of the state government.”