Friday, December 14, 2007

Right to Body Autonomy

First things first, Friday ! Yeah!
And if you haven't already, do head on over here and have a gander. It would be most amusing to see if the power of the blogs compels you, I mean works in mysterious ways. Also it would mean a lot to Gimmie.

Twenty major has a post up yesterday about a Jehovah's Witness who has taken an action against the Coombe Women's Hospital. She has brought them to court for giving her a blood transfusion against her will. The woman a 24-year-old French-speaking woman, known as Ms K said she believed a blood transfusion was a transgression of "an order from God'' and she was "prepared to die'' for her faith.

It's a messy case to begin with, the woman, an asylum seeker, initially lied to the hospital about her husband's whereabouts, leading the hospital to conclude she was the only biological parent to her newly born child.
But either way, one thing seems to be clear, she was-despite losing 80 percent of her blood- adamant she did not want a transfusion and the Coombe rode roughshod over her wishes.

Now I understand the befuddlement and consternation involved here. She was probably going to die and she didn't probably as a result of her treatment. It might seem totally off the charts for us to comprehend a woman who will willingly die because some religious book has a rather broad anti-blood message, but surely this has got nothing to do with the actual case at hand.
This woman was 24 years old, an adult. It must surely be up to her to accept or refuse medical assistance.
What if I went into hospital and was told I had breast cancer, and the only hope of my survival was the removal of my breasts. What if, after I declined for some reason they went ahead, drugged me and removed both breasts. Would I have a case against the hospital? Of course I would, it's my body I have the right to refuse treatment.
As far as I can see this case is no different, as unpalatable as it might seem to watch a young mother die because of a religious belief, we must accept that it is her belief and her right to follow it.
She might seem ungrateful, and I don't really understand any woman prepared to die and choose a religion over watching her child grow up, but there you go. I'm not her. But I could be. And as such I want my rights to decide what to do with my own body respected.
The Coombe-in my opinion- completely overstepped its boundaries in this case.
What do you think?



Blogger Conan Drumm said...

Classic medical dilemma... you're sued if you do and you're sued if you don't.

And your theme for the afternoon might be: Should you attempt to stop a suicide?

11:27 a.m.  
Anonymous sheepworrier said...

I was reading that earlier over at twentys but didn't want to get involved in the racist shite.

Yeah, it definately is a tricky one. I think I would back the hospital.
She apparently lied up until the very last minute, after the time the doctors could've prepared for an alternative.
What would've happened to the child if the mother died and the father was in Africa?
Did she not come here to secure a better life for her and by extension her family?
I can see the hospital's actions could set a dangerous precedent, but if she didn't want full and proper medical attention, why bother with the hospital?

Religion should be left at the door in any public institution.

11:30 a.m.  
Blogger Conan Drumm said...

Oh, and remember a lawyer can make a lot of hay for a bereft relative with the likes of 'diminished responsibility'.

11:34 a.m.  
Blogger fatmammycat said...

Hard to call Conan, I see what you mean though. An argument could be put forward that a person committing suicide is not of their right mind, but then I think people in the throes of religious fervour are not of their right minds too. But then we don't allow euthanasia, or rather we do in some cases, but never legally admit to it.

Monring Sheepie, yeah, a lot of the commentariat were way out of line so I didn't bother swimming in that particular pool myself.
The thing is she did want medical treatment, just not a blood transfusion. She wanted to deliever a healthy baby, but not to be violated against her wishes in the process.
Morally speaking, I find it awfully hard to fault the hospital and their actions, but then I think, hold on, her choice is her choice. And that must be respected-however daft it must appear to me and thee.

11:39 a.m.  
Blogger The Bad Ambassador said...

Hmmm, tricky one alright.

In my opinion, the hospital's duty of care is limited to the patient. They should not wade in, metaphorical fists flying, to fight in the corner of the patient's offspring.

Perhaps in such cases the hospital should suggest a course of treatment and if the patient refuses (in the knowledge that to do so will more than likely prove fatal) the hospital can call the gardaí or social services and report the patient for suspected neglect of his/her children.

The only problem is that this approach may not change the outcome - simply the organisation that performs the roughshod riding. Although, at least the patient would have the chance to legal representation, to have their voice heard - and listened to.

Of course this also relies upon us having a reasonably functioning health service and a legal framework to handle such cases can be completed within a minutes/hours as time will no doubt be of the essence.

11:43 a.m.  
Blogger Conan Drumm said...

Well let them open their own hospitals where they can stroke their stethescopes and say "It's God's will" as another patient dies for want of some blood.

11:46 a.m.  
Anonymous sheepworrier said...

"her choice is her choice" yeah, if it's only her who is directly affected, Ive no problem with that, but what happens to the baby?

It's a bit of a minefield alright.

If someone slit their wrists in a suicide bid yet still recieves unwanted medical treatment, is this wrong?

What therefore makes it an issue when an equally dubious belief in "god's will" produces the same result?

Sanction someone for a sucide attempt for personal reasons yet tread on eggshells when its religion?

12:00 p.m.  
Blogger Dr Maroon said...

Stop disappearing up your asses.

if she's dying in a hospital and can't discharge herself tough fucking shit.

The hospital's hands are clean

I keep telling everyone, there's 6500000000 people on the surface all trying to live, we don't have the time for prima donnas.

she don't like it she can fuck off. The right of the individual only goes so far. No Irish judge will entertain her claims. Trust me.

12:21 p.m.  
Anonymous sheepworrier said...

I like disappearing up my ass. Its nice and warm and I've got sky+ installed...

12:25 p.m.  
Blogger Dr Maroon said...

Maybe, but the reception's shit.

12:29 p.m.  
Blogger Andraste said...

I thought I had something useful to say, but that last exchange made me laugh so hard I forgot it.

1:22 p.m.  
Blogger gimme a minute said...

Thank you, Ms Cat. The Waits for Christmas campaign appears in the Irish Times and Fatmammycat in one day.

How can we fail?

And on the transfusion thingie, doesn't the Hippopotamus Oath 'say that thou must savest muppets from killing themselves'? Something like that anyway...

1:41 p.m.  
Anonymous Anonymous said...

I would like to give the viewpoint of Jehovah’s Witnesses, who love life as much as anyone, and do everything God will allow to preserve it, but who also know that obedience to the principles God has made known come first.

To those who inclined to insist, or demand that by court order or social pressure or convention, Jehovah's Witnesses should be prevented from "committing suicide".

Would you suggest that Jesus, who willingly and knowingly walked into a trap, knowing he would be executed, should have been prevented from "committing suicide"?

There are two world views .... those who fear death so much they are willing to do anything not to die ...and those who fear death, but realize that some principles are necessary to die for.

Ever notice that the civilizations that have a casual viewpoint on blood, blood puddings, blood sausages, blood food additives, are also casual about shedding mankind's blood on the battlefields, cities, and nations of Earth?

Jehovah's Witnesses have adopted God's viewpoint on blood ... and that It has resulted in men, women and children that value integrity more than expediency ... and even their own lives.

Ever had a relative killed by an "enemy" in war? Many people have. Regardless of whatever else may be the case, Jehovah's Witnesses did not do that, support that, or give moral support to that. They are free of the bloodguilt of all men.

Those that think blood is “just” a medical liquid have historically, slaughtered each other with unceasing regularity on the battlefields of Earth, and have brought horror and hell to the experience of normal mankind.

Let's assume for a moment that God's viewpoint on all blood belonging to him is set aside.

JWs are forcing massive advances in bloodless surgery, which you will benefit from, and by their being absolutely Neutral as to politics, a more peaceful civilization, everywhere.

Everywhere. And everyone knows this.

Suchlike things are often specious reasoning for those to whom life is more important than principle.

JWs were shot, frozen, starved and slaughtered because they would not sew buttons on Nazi uniforms. Who else would do that, except people who viewed not contributing to bloodguilt, and obeying God, of more value than their personal lives?

God ignores those who live a life for "Now" … and "Now" is all they get.

Those God invites to live forever are those that love the things God loves.

Jesus sacrificed his life for an abstract principle ... sometimes we have to do the same.

And that, in abbreviated form, is why Jehovah’s Witnesses “abstain from blood”.

1:48 p.m.  
Anonymous Shebah said...

Anonymous, what a load of complete bollocks. A doctor's duty under the oath he takes when he qualifies is to save life. It is not just the mother involved here, but also a baby. Should they safely deliver the baby, let the mother die and leave the rest of us to support her baby financially and pick up the emotional pieces? The child is her responsibility, and a doctor should have the power to override stupidity. Just such a rule is being fought for at present in the UK, when a young JW mother's life was lost recently because the doctor respected her wishes to withhold blood. The young woman who died has left a huge amount of collateral damage behind - her family have to live with it, which I guess they will, hiding behind that ridiculous interpretation of their religious rules, the child will unnecessarily grow up motherless, and the doctor and medical staff will feel guilty forever about her death. If I were managing a hospital, I would refuse to admit JW patients who refused to take medical advice in this kind of situation.

2:00 p.m.  
Blogger Medbh said...

I agree completely, FMC. Every adult has the right to decide what happens with their bodies. Even if driven by the lunacy of bad mythology.

2:00 p.m.  
Anonymous sheepworrier said...

"Jehovah's Witnesses have adopted God's viewpoint on blood". No, you've adopted YOUR viewpoint on blood.

Well said Shebah.

Medbh: Same as I said before - when a child is involved, you need to look beyond selfish interests, ideological, religious or otherwise.

2:25 p.m.  
Blogger Twenty Major said...

those who fear death so much they are willing to do anything not to die ...and those who fear death, but realize that some principles are necessary to die for.

Yes, the principle of leaving a child without a mother is most commendable.

2:34 p.m.  
Blogger Caro said...

According to
Earlier, Ms K told Mr Rogers she came here in April 2006 to have her child because of the good medical care and doctors here.

Are we to believe she was "compos mentis"?

I do believe it's anyone's right to refuse treatment, but the judge in this case made his decision based on the child's right to have someone to look after him. If she hadn't lied and said her husband was still in the Congo they probably would not have gone against her wishes. She also lied about her religion on her application for asylum, stating her religion as Catholic because "it was known that Jehovah Witnesses are politically neutral" (If anyone can explain the reasoning behind this I'd be interested in hearing it).

They should have let her die if that was her wish, and let the child be adopted. But the whole thing smacks of ambulance chasing to me.

2:40 p.m.  
Anonymous Shebah said...

Caro said "I do believe it's anyone's right to refuse treatment"
She went into the Coombe hospital - what for if not for "treatment" - by going into hospital, she had already made a choice to receive medical treatment. And you are probably right - this is ambulance chasing stuff, she wants to get her hands on some of the Irish taxpayers hard earned.

2:49 p.m.  
Blogger The Bad Ambassador said...

I'm not sure you can say its just about money. She is entitled to her beliefs and to make decisions based on them - no matter how warped those beliefs/decisions may seem to us. Her religous beliefs were not respected by the hospital.

She obviously attended the hospital for treatment but I don't think that should give the hospital license to treat her anyway they saw fit.

I know its in the extreme, but imagine somebody going in for a bit of a tummy tuck and the surgeon deciding she needs bigger breasts into the bargin. Or giving somebody "vegetarian" lasagna and then saying "well actually, I put meat in it because I thought you looked a bit weak"

To be honest I don't know where I stand on the whole thing. I don't have any religous beliefs but I believe everybody is entitled to them if they so wish. I believe a person should be in complete control of their body and what is done to it - but I also believe that, when her child is taken into consideration, what she did was irresponsible in the extreme.

Bloody religon eh?

3:08 p.m.  
Blogger aquaasho said...

Hi FMC. I don't really see that the breast cancer analogy is the same thing. A blood transfusion is done in an emergency situation i.e do it now or die (I'd imagine). Therefore I believe the hospital had the right to go ahead in that instance (I also believe the blood transfusion stance of the JW's is nonsense but anyway). In the breast cancer scenario you mentioned things are done in a considered state with the possibility of a little time to go through all options.
We can't have doctors in an emergency situation checking everyone's religious beliefs before they proceed. Emergencies are cases where they do what they have to do to save a life in that moment. I didn't read about the case elsewhere though FMC so I may have got it wrong.
Happy Friday!

3:44 p.m.  
Blogger fatmammycat said...

I agree that in a true emergency situation where the patient cannot speak for herself a Doctor must proceed as they see fit, but if a patient signs a do not resuscitate motion it must be adhered to, if a patient expresses clearly that she does not want medical intervention it also must be adhered to. After that it is open to a legal interpretation of lawful violation. due to her own particular beliefs, and as much as I might be scornful OF those beliefs, they were hers.

4:54 p.m.  
Anonymous laughykate said...

It's such a tricky one, take religion and everything else out of the arguement - isn't it basic human nature to try and keep people alive?

Patient :" Don't treat me, I want to die."

Doctor : " But I'm a doctor, its my job to make you stay alive. And you're in, um, a hospital.If you wanted to die you should have gone to the hairdressers."

Patient: "Don't treat me, I want to die."

Doctor : "Not on my watch honey, cause then I will look like I really suck at my job. OH and by the way, you've got a passenger - and I'm picking s/he would like a shot at this life gig. So if I don't treat you, you both die and then I doublely suck."

I know i'm making it all about the doctor here, I would find it fucking hard to turn my back on that basic human instinct.

Icky icky icky.

10:21 p.m.  
Anonymous Med in Tx said...

I find the whole suicide thing absurd. I don't think this woman was pregnant for the final purpose of committing suicide. And I also love when the title of stories like the mother who died delivering her babies was that she died from not receiving a blood transfusion. Another recent news story was of a minor who died from Leukemia. But the papers ran that he died from refusal of a blood transfusion. Finally a representive from the hospital wrote that he was going to die either way but this would only prolong a painful death another few months, if that. But the papers titled it "Boy Dies from refusal of Blood Transfusion".

Huh? The boy DIED from Leukemia. The woman DIED from complications during delivery.

So no one is to say that this woman would have died if a blood transfusion were not given. Many are told that they will die only to not die from their refusal.

On the other hand, many have died from accepting blood transfusions. Many that are not involved with JWs refuse blood transfusions because it is not an exact science. 20% of blood transfusions result in complications including hepititis, AIDS and even death. A dear friend of mine was given a blood transfusion and because chronically ill from infected blood. She never recovered and the blood transfusion was not administered in a life threatening manner.

Bloodless surgeries are a way of the future and an opportunity to improve lives, not hinder them. They also offer a protection to the doctors due to complications from transfusions themselves. Do a google search on bloodless surgeries and you will see the vast improvements in the health of patients that heart patients have today as a result of these new technologies.

Just over 100 years ago blood transfusions were not a common practice and instead attaching leaches to bleed out a patient were more common place. ew!

I read where most oncologists polled would not receive chemo if they were to get cancer. Is that "suicide" too? My personal opinion is absolutely not. They are not slitting their wrists to end their life, they know of alternatives that they feel are better than chemo and would not put their bodies through this sort of suffering.

Sometimes when we actually do some research on a subject we get better informed and it is not as easy to jump to false conclusions.

1:25 p.m.  
Anonymous Max Drive said...

Anyone who ever worked in any field which deals with bleeding people knows that there is a point in blood loss beyond which the victim/patient is no longer rational. It isn't always easy to see the exact moment when the mind becomes unable to make rational decisions. This woman evidently lost a significant amount of blood during childbirth. If she refused transfusion after giving birth it would be extremely difficult to establish her rationality. Any hospital that did not transfuse her under the given circumstances would get sued out of existence.
Here's a forlorn hope for a little rationality in Court.

9:34 p.m.  
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