title: Operating one-handed: emergency treatment of Jehovah's Witnesses.
abstract: An elderly woman was brought to the emergency room (ER) hypotensive in a confused mental state from what turned out at exploration to be a ruptured splenic artery aneurysm. You are in the operating room, and the anesthesiologist has just hung the first unit of blood but has not started infusion when the ER calls. The patient and her husband were visiting their children and live in another state. Her husband, an elder in a Jehovah's Witness congregation, arrived and is adamant that she have no transfusions. Her blood pressure is dangerously low. It is being maintained by a high-dose Levophed (leave-um dead) drip and continues to slip. You have avoided operating on Jehovah's Witness patients because of the added unnecessary risk they pose. Your assistant is of like mind. What is the best ethical course at this time?
authors: Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, Tex. Electronic address: jwjones@bcm.tmc.edu.
authors: James W
authors: JW
authors: Jones
authors: Laurence B
authors: LB
authors: McCullough
mesh_terms: D017542:Aneurysm, Ruptured / Q000601:surgery*; D001803:Blood Transfusion / Q000941:ethics*; D057668:Bloodless Medical and Surgical Procedures / Q000009:adverse effects / Q000941:ethics*; D003469:Culture; D004630:Emergencies; D004632:Emergency Medical Services / Q000941:ethics*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033221:Jehovah's Witnesses; D008297:Male; D061214:Patient Safety; D012068:Religion and Medicine; D018570:Risk Assessment; D012307:Risk Factors; D013157:Splenic Artery / Q000601:surgery*; D020458:Third-Party Consent / Q000941:ethics; D014342:Truth Disclosure; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000941:ethics*