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What One Doctor’s Approach To Treating A Jehovah’s Witness Says About Religious Liberty In Medicine

By Sy Mukherjee  

"What One Doctor’s Approach To Treating A Jehovah’s Witness Says About Religious Liberty In Medicine"

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69-year-old Rebecca S. Tomczak suffers sarcoidosis, a condition that leads to lung scarring and can devolce into a terminal disease if left untreated. The doctors told her that without a full lung transplant, her prognosis would be dire — and while Tomczak could have qualified for transplant lists at several hospitals, she had to scour through several providers before finding one that would take up her case, since she’s a practicing Jehovah’s Witness. Her adherence to her faith prevents her from receiving blood transfusions, which are typically necessary for transplant surgeries.

As the New York Times reports, Tomczak was finally able to track down Dr. Scott A. Scheinin of the Houston-based Methodist Hospital, who agreed to treat her on her own terms. The hospital had conducted several successful bloodless lung transplants before — specifically tailored towards Jehovah’s Witnesses — and had developed an innovative, seemingly safe medical approach to treating these patients while also respecting their closely-held tenets. As Dr. Scheinin put it, “At the end of the day, if you agree to take care of these patients, you agree to do it on their terms.”

Critics might balk that tailoring medical procedures towards a patient’s religious beliefs is impractical and costly. But the new system that the doctors at Methodist developed was more cost-effective than regular transplant procedures — and arguably more safe, as there has been some evidence that blood transfusions may actually be risky in certain cases:

The economy is also helping the blood management movement. Processing and transfusing a single unit of blood can cost as much as $1,200, and many hospitals are trying to cut back. Administrators at Methodist said their bloodless lung transplants typically cost 30 percent less than other lung transplants, partly because careful management of hemoglobin levels before surgery has resulted in fewer complications and shorter stays.

Experts say they are beginning to see a measurable impact on blood usage, although the data to support it are not yet available. Dr. Richard J. Benjamin, the chief medical officer of the American Red Cross, predicted that the numbers would show the first decline in use since the AIDS scare began in the 1980s, perhaps by one million units.

“We’re changing this culture, this knee-jerk transfusion reaction,” Dr. Scheinin said. “And I think that’s been a good thing for all our patients.”

While Tomczak’s story is intriguing for its implications on medical innovation and reducing health care costs, it also highlights a positive way to reconcile the tensions between modern medical technology and religious dogma. Rather than being a case in which a doctor imposes his or her conscientious biases on a patient — such as the Irish medical team that incited global outrage after denying a life-saving abortion to a woman who later passed away — Tomczak’s experiences are an example of a doctor keeping his patient’s health at the forefront while also respecting that patient’s ethical choices through creativity and innovation. That may not be achievable in every single case — but this particular story shows that it certainly is possible.

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