In some religions, people decide not to have blood transfusions because of their religious beliefs. Their understanding of spiritual teachings, which say they shouldn’t consume or use blood, influences this choice.
Different interpretations of saving a life and concerns about health risks and other healing methods also matter. Therefore, it is essential to understand and respect their beliefs for healthcare providers to give appropriate care.
What is the Importance of Blood transfusion?
Blood transfusions are critical in replacing blood loss during surgery to treat an injury, treat conditions such as anemia or hemophilia, and help with blood clotting disorders. Blood can be transfused in whole or part, like the kidney or entire body.
Why do some religions not accept blood transfusions?
Most religions do not have limitations regarding blood transfusions, but there are some exceptions. The consumption of blood as food and/or use of blood in these communities can be prohibited. For example, in the Jewish community, dietary restrictions known as “Kashrut” define which foods are acceptable based on dietary laws (kosher). These laws also forbid the consumption of blood, with clear instructions on how kosher mammals and birds must be slaughtered. Another example can be found in the Jehovah’s Witness community, which seeks out medical and surgical care without the use of blood (see below).
With any religious belief or practice, it is vital to approach the topic with sensitivity and respect for a person’s thoughts and choices. Patients should discuss any concerns or conflicts openly with medical professionals to ensure their needs are being met on multiple fronts.
What are the alternatives for these communities?
For individuals or communities with religious objections to blood transfusions, care can be provided by several medical alternatives and approaches and can be considered. Sometimes, these alternatives may only be accepted within the community, as individual beliefs and decisions vary. Therefore, discussing these alternatives with healthcare professionals to ensure they are appropriate for the specific case is essential. Here are a few possible options that can be given to such Jewish individuals.
Bloodless Surgery
Bloodless surgery is also known as blood conservation or blood management surgery. It is an approach to minimize blood loss during surgical procedures. Modern techniques such as advanced surgical techniques, meticulous hemostasis (controlling bleeding), and specialized equipment and medications can reduce the need for blood transfusions.
Autologous Blood Transfusion
Autologous blood transfusion is the collection and reinfusion of a person’s blood. Several methods exist for collecting and storing blood before a planned surgery. This technique ensures individuals receive their blood during the surgery instead of donated blood.
Pharmacological Agents
Various medications and pharmaceutics are used to promote blood clotting and increase hemoglobin levels/production of red blood cells. These are the best alternatives considered for blood transfusions in some instances.
Cell Salvage
Cell salvage is known as intraoperative blood salvage or cell autotransfusion. Simply put, it is a process in which blood lost during surgery is collected, processed, and reinfused into the patient. The collected blood is processed to remove impurities before being returned to the patient.
One point to note is that the suitability and effectiveness of these alternatives vary depending on the patient’s medical condition, surgical procedure need, and individual circumstances. Therefore, the decision to use these alternatives should be made in consultation with a medical team, which includes surgeons, hematologists, and anesthesiologists, who can provide specialized guidance and expertise.
It is crucial to emphasize that in emergencies, where rapid blood transfusions are required to save a person’s life, healthcare providers may encounter complex ethical/legal considerations if a patient refuses to take blood transfusions based on religious beliefs. In such situations, the medical team should work to provide the best possible care while respecting the patient’s religious beliefs within the rules of medical ethics and legal frameworks.
What are the risks of not taking blood transfusions when needed?
Not taking a blood transfusion because it carries certain risks or is prohibited, especially when it is medically necessary, can be risky.
Anemia
Blood transfusions are usually recommended for patients who have severe anemia. It is a condition characterized by low red blood cell count. Without a transfusion option, the body does not receive an adequate supply of oxygen, which leads to fatigue, weakness, shortness of breath, and potentially life-threatening complications.
Organ damage
In situations with excessive blood loss, for example, during surgery or trauma, blood transfusion helps restore blood volume and prevent organ damage. Without a transfusion, vital organs do not receive adequate blood supply, leading to organ failure or death.
Infection risk
Blood transfusions carry the risk of transmitting infections, but excessive screening processes have made such chances very rare. However, if a transfusion is resisted, the underlying conditions requiring blood transfusion have an infection risk. For example, the cases of severe sepsis or other blood disorders, the body’s ability to fight off infections may be compromised.
Complications in pregnancy and childbirth
During childbirth, women can have significant blood loss, and blood transfusions are essential in replenishing blood volume and preventing complications such as bleeding. Resisting blood transfusion in these situations poses a high risk to the mother and the baby.
Impaired wound healing
A good blood supply is essential for wound healing. Without blood transfusion, the body’s ability to repair and regenerate damaged tissues is compromised, leading to delayed or impaired wound healing.
Conclusion
The risks associated with transfusions include allergic reactions, febrile non-hemolytic transfusion reactions, transfusion-related acute lung injury, transfusion-associated circulatory overload, infections, and iron overload.
In summary, blood transfusions are not universally rejected, but some individuals, especially those following Orthodox religious beliefs, have concerns based on their interpretation of religious teachings. The prohibition originates from the belief that the consumption or transfusion of blood is not allowed according to the spirituality of religion.
Dr. Irfan Siddique is a GMC-registered Medical Doctor with more than four years of post-graduation experience in child and adolescent healthcare. He has done his Bachelor of Medicine and Bachelor of Surgery (MBBS) from the University of Health and Sciences, Lahore. Afterward, he was positioned at Children’s Hospital, Faisalabad, where he ran Outpatient Department for four years. Currently, he is performing his duties as Medical Doctor at St. Barts Health NHS Trust, London.
