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Willing to die, but not to transgress religion!

Willing to die, but not to transgress religion!

Author: Bala Chauhan
Publication: Deccan Herald
Date: April 30, 2007
URL: http://www.deccanherald.com/deccanherald/apr302007/state239552007429.asp

As a surgeon, it was a tough call for him to sign an undertaking that if his patient needed blood transfusion during surgery, he would not administer it. Instead, he would allow her to bleed to death.

For Dr Ajit Huilgol, Director and Chief Transplant Surgeon, Karnataka Nephrology and Transplant Institute (Kanti), it was a difficult decision when he was asked by his patient - Tsehay Gebeyehu, a 63-year-old Ethiopian lady - to sign on the dotted line that he would not give her blood transfusion even if she needed it during the course of her kidney transplant, not even her own. Instead, "he would allow her to bleed to death". It was not Tsehay alone who took the written promise from her surgeon. Her husband Zemedu Damena, a retired journalist, who donated his kidney to her, took a similar undertaking from his surgeon Karunagaran that no blood, even his own, would be transfused to him in case of an emergency, since it was against their religious principles. Tsehay and Zemedu are Jehovah's Witnesses (JWs). According to their religious belief, they cannot accept blood transfusion, not even autologous.

"JWs have definite objection to blood transfusion for religious reasons because blood is considered precious and it contains life. We believe it belongs to Jehovah - the Creator," said Minister, Hospital Liaison Committee for Jehovah's Witnesses, AG Ryan.

"Besides blood, we don't accept four primary blood components like red and white blood cells, platelets and plasma. We are, however, open to medical alternatives to blood transfusion such as plasma expander and heamostatic agents for bleeding/clotting."

Dr Ajit, who has performed over 1,500 kidney transplants, told Deccan Herald though he avoids blood transfusion during the transplant, he keeps at least two units of blood for any contingency.

"In a kidney transplant, we normally keep one unit of blood for the donor and two units for the recipient as a backup, but in Tsehay's case, I could not even do that. She is highly anaemic and her haemoglobin count was only 6.5, way below the minimum count of 12. I gave her Erythropoiten hormone to increase her haemoglobin count but that didn't help. Thankfully, the surgery went off well without any need for blood," he said.

What if she had needed blood? "I would have been forced to watch her bleed to death," he said.

Tsehay said she would rather "abide by her religious belief" than choose options that go against it, to prolong her life.

JWs carry with them an advance medical directive/release saying "no blood be administered to them under any circumstance".

There are 26,000 JWs in India, of whom hich 2,000 are in Bangalore. They follow 'The Bible' and believe Jehovah is the Creator and Jesus is "the first born of all creation..." ('The Bible') Tsehay and Zemedu got in touch with Columbia Asia Hospital online last year after Tsehay's kidneys failed. "There is no facility for kidney transplant in Ethiopia. My doctor asked me to go to India," said Tsehay.

The transplant was done at Mallya Hospital as Columbia Asia does not have the permission to conduct transplants as yet. She was put on dialysis there.

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