“He’s refusing any blood product transfusions. He’s a Jehovah’s Witness.”
The Jehovah’s Witnesses are a religious group that believes, among other things, that only a minority of people reach heaven. They also believe that it is wrong to receive the tissue of another human being, and that doing so violates God’s law, even if potentially lifesaving. …“I have different beliefs from you, so I can’t say I totally understand where you’re coming from, but I respect your faith, and we’ll follow your lead on what you want to do,” I told the patient. “You’re the boss.”
“No, he’s the boss,” he said, pointing toward the ceiling, and beyond. Others in the room nodded in agreement.
He declined transfusions, but he did want to receive chemotherapy, so we compromised on a lower-dose treatment, and minimized our lab draws to one per week, to preserve what blood he had. After two weeks his hemoglobin dropped to 2.1; after three weeks, it fell to 1.8. One month into his hospitalization, he became too dizzy to stand, and his heart, starved for the oxygen his missing red blood cells would have carried, just stopped beating. He had cardiac arrest and died.
The staff on the leukemia floor took his death hard, all plagued by the same question: Had we done enough for him?
We enter our chosen profession to kill that malignant golem, leukemia. But our patient approached his leukemia focusing more on eternity than his time on earth. While many felt his belief had tied our hands so that we couldn’t treat his leukemia optimally, ultimately our responsibility must be to our patient’s goals more than to our own: in this case, his relationship to God, and his desire to reach heaven. I hope he made it. More.