Bloodless lung transplant.

Oh, for Pete’s sake

Last April, after being told that only a transplant could save her from a fatal lung condition, Rebecca S. Tomczak began calling some of the top-ranked hospitals in the country.

She started with Emory University Hospital in Atlanta, just hours from her home near Augusta, Ga. Then she tried Duke and the University of Arkansas and Johns Hopkins. Each advised Ms. Tomczak, then 69, to look somewhere else.

The reason: Ms. Tomczak, who was baptized at age 12 as a Jehovah’s Witness, insisted for religious reasons that her transplant be performed without a blood transfusion. The Witnesses believe that Scripture prohibits the transfusion of blood, even one’s own, at the risk of forfeiting eternal life.

Literally, her position is: “My beliefs are insufficient to save me, but obviously medicine can so I need it.  But I want medicine to comply with my beliefs anyway.”

Given the complexities of lung transplantation, in which transfusions are routine, some doctors felt the procedure posed unacceptable dangers. Others could not get past the ethics of it all. With more than 1,600 desperately ill people waiting for a donated lung, was it appropriate to give one to a woman who might needlessly sacrifice her life and the organ along with it?

Easy answer: no.  Absolutely not.  There are plenty of people eager to avail themselves of the wonders of modern medicine without demanding that doctors take more time to do a transplant with their hands effectively tied.  You want medicine?  Then get the medicine.  You don’t?  Try prayer.

By the time Ms. Tomczak found Dr. Scott A. Scheinin at The Methodist Hospital in Houston last spring, he had long since made peace with such quandaries. Like a number of physicians, he had become persuaded by a growing body of research that transfusions often pose unnecessary risks and should be avoided when possible, even in complicated cases.

By cherry-picking patients with low odds of complications, Dr. Scheinin felt he could operate almost as safely without blood as with it. The way he saw it, patients declined lifesaving therapies all the time, for all manner of reasons, and it was not his place to deny care just because those reasons were sometimes religious or unconventional.

Nobody is denying someone care.  In fact, if anybody is denying a lung transplant to Ms. Tomczak, it’s her.  People like Ms. Tomczak are free to go get a lung transplant.  They are not free to dictate the status of the medical discipline to doctors.  Imagine if a patient was saying they wouldn’t take pain killers unless it was morphine.  It’s clearly the patient denying himself medicine, not the doctor.  Ditto for Tomczak.

“At the end of the day,” he had resolved, “if you agree to take care of these patients, you agree to do it on their terms.”

Which is why hospitals prescribe homeopathy.  Wait, no they don’t, because that makes absolutely no sense given our understanding of medicine.  You go to a doctor because you don’t know enough to fix the problem yourself.  That’s the whole point of hiring an expert.  If the expert in the room is you, then you don’t need the doctor.  If it’s the doctor, you need to listen to what she’s telling you.

The article expresses optimism that this type of treatment could become the standard.

Ms. Tomczak’s case — the 11th so-called bloodless lung transplant attempted at Methodist over three years — would become the latest test of an innovative approach that was developed to accommodate the unique beliefs of the world’s eight million Jehovah’s Witnesses but may soon become standard practice for all surgical patients.

Tomczak is the 11th person to have a bloodless transplant attempted.  However, she had specific instructions for the doctor.

Unlike other patients, Ms. Tomczak would have no backstop. Explicit in her understanding with Dr. Scheinin was that if something went terribly wrong, he would allow her to bleed to death. He had watched Witness patients die before, with a lifesaving elixir at hand.

You know what the backstop is?  Using a fucking blood transfusion like everybody else.  You know why?  To keep people from fucking dying.  That’s why blood transfusion is the standard and this is highly, needlessly risky bullshit.  That’s why using blood transfusions during transplants will remain the standard.

Religion of humility, but you’re going to need all of medicine to bend to your ancient beliefs.  Gag me.

(Thanks to Amy for the link)

About JT Eberhard

When not defending the planet from inevitable apocalypse at the rotting hands of the undead, JT is a writer and public speaker about atheism, gay rights, and more. He spent two and a half years with the Secular Student Alliance as their first high school organizer. During that time he built the SSA’s high school program and oversaw the development of groups nationwide. JT is also the co-founder of the popular Skepticon conference and served as the events lead organizer during its first three years.

  • Jeff

    Any explanation on how or why the JWs forbid blood transfusions but allow *lung transplants*?

    Also: If there *is* a growing body of research that blood transfusions aren’t all hunky-dory, then there is benefit in learning how to perform surgeries without them. It’s very kind of this woman to offer herself up as a guinea pig for exciting, if ridiculously dangerous, experimentation.

    • Loqi

      According to an Ex-JW friend, the blood transfusion thing comes from Acts 15:29.

      that you abstain from things offered to idols, from blood, from things strangled, and from fornication. If you keep yourselves from these, you will do well.

      The doctrine is that only the blood of christ can “save,” so you aren’t allowed to be saved by receiving the blood of anyone else. Personally, I wish the bible talked about the lung of christ. Would be interesting to see Catholic priests handing out consecrated balloons.

      • baal

        It’s still bizarre to accept one tissue (lung) but not another (blood).

      • Anonymous

        Nope, that’s not the doctrine. The doctrine is that blood is inextricably tied to life and therefore belongs to god, so that either wasting your own or accepting someone else’s is trying to steal that control from god. Though to be fair, Witness teachings have changed quite a lot on many, if not most, matters of doctrine over the years, and what you said may have been the official doctrine at one point. Hasn’t been in at least seventeen years, though. And the scripture is right; there are several others often used in concert with it but Acts is by far the most popular.

      • Niveau

        Nope, that’s not the doctrine. The doctrine is that blood is inextricably tied to life and therefore belongs to god, so that either wasting your own or accepting someone else’s is trying to steal that control from god. Though to be fair, Witness teachings have changed quite a lot on many, if not most, matters of doctrine over the years, and what you said may have been the official doctrine at one point. Hasn’t been in at least seventeen years, though. And the scripture is right; there are several others often used in concert with it but Acts is by far the most popular.

        • Niveau

          Ack, sorry about the double reply!

        • Andrew Kohler

          I was recently re-watching The Atheist Experience 589, the episode in which Jen Peeples called about the anti-vaccination movement. Jen mentioned an anti-vaccination doctor (Leonard Horowitz, I think–rather loopy fellow) quoting Luke 13:1-5, which is something about mixing human blood with blood of animal sacrifices (and animal products are used in vaccines or…who knows). Matt thought that this was a terrible justification and figured that he could probably find a verse that would back up their cause better (even though he opposes their cause). He shortly thereafter found Deuteronomy 12, starting at verse 21. This passage is really obsessed with consuming blood with meat, because the blood is life and you must not eat the blood with the meat.

          In fact, the Deuteronomy passage more or less explicitly lays out Ms. Tomczak’s case. Like Matt, I don’t at all support positions like this (I can’t imagine him disagreeing the consensus on this forum about Ms. Tomczak, but of course I don’t want to presume to speak for him), but I am bothered regardless when people don’t properly construct their textually based arguments. In fact, the passage from Acts (and the one from Luke) is especially ill-suited to the argument that one can’t even use one’s own blood for a transfusion: the passage is about sacrifice to idols–how is that analogous, or even relevant!?

    • Artor

      Better wring it out before transplanting it. Healthy lungs are full of blood you know. There’s that pesky pulmonary artery going right through them.
      Hey, my car needs a new engine put in it, but I want a mechanic to do it without using any fresh oil. For some reason, none of them will agree to do it that way. It’s persecution, I say!

      • http://www.thelosersleague.com The_Schwa

        If your faith was strong enough in the first place, you would not even need a new engine.

  • unbound

    Does NY Times even have any journalists left? The link in the article supporting the notion that transfusions can be bad says no such thing. The NEJM article wasn’t even about not doing transfusions at all, but rather the threshold at when transfusions should be accomplished. The article talks about setting the threshold lower as resulting in statistically the same risk. It is almost completely irrelevant to the doctor’s argument.

    Oh, that’s right, a modern “journalist”s job is to simply regurgitate what someone says…

  • http://skepticfreethought.com/tokenchristian Jaime Wise

    Wait, they can’t receive a transfusion of their own blood? Is that standard? Also, I’m all for the right for people to decide what’s done to their bodies, informed consent, etc. But it sounds like she’s demanding this doctor conform to criminal negligence.

    • Loqi

      They actually are allowed to use their own blood. I’m not sure why she isn’t.

      • Stogoe

        Must be a sub-sect.

    • Niveau

      No, they aren’t allowed to receive transfusions of their own blood. It’s fine if it stays in circulation (as with a Cell Saver), or if they thin it down, but as soon as it is no longer in contact with the body they can’t take it back.

  • KMHMD

    Blood transfusions are avoided whenever possible anyway. There are risks associated with transfusions and doctors are not just giving out blood for fun.

    Also, it is possible for an individual to give a directed donation of blood themselves prior to a procedure and they will receive that blood if necessary during the procedure. This seems like it would be a much better option for her to do this rather than waste a good set of donated lungs.

  • Rovin’ Rockhound

    The way he saw it, patients declined lifesaving therapies all the time, for all manner of reasons, and it was not his place to deny care just because those reasons were sometimes religious or unconventional.

    The difference between someone choosing a DNR (as an example of rejecting a lifesaving therapy) and a doctor not denying that person care, and this woman refusing any blood transfusions and still getting a lung transplant, is that the person with the DNR is not taking away someone else’s chance for life through his choice. It might not be criminal for her to potentially kill someone by getting those lungs, but it is immoral and unethical for the doctors to do the transplant, and at minimum hypocritical of her to be so high and mighty about “obeying” god and allowing herself to die instead of getting blood while knowingly decreasing someone else’s chances to recover.

    Maybe a

    • Rovin’ Rockhound

      Oh man, double fail. The first paragraph should be a quote, and I thought I had deleted the “Maybe a”.

      I need more coffee. Jehovah’s Witnesses are, afaik, allowed to drink coffee. No life-saving blood for you, but go ahead and indulge in mind-altering, addicting drugs!

  • DaveL

    Ms. Tomczak’s case — the 11th so-called bloodless lung transplant attempted at Methodist over three years

    He had watched Witness patients die before, with a lifesaving elixir at hand.

    So out of these 11 attempted operations, how many resulted in him standing by while the patient died? How many preventable deaths constitute the threshold for “almost as safely without blood as with it?”

    • Randomfactor

      ” How many preventable deaths ”

      Likely almost twice as many as actually were counted. When the recipient dies, the lung dies too–and becomes unavailable for a SANE patient whom might live on with it.

  • Amyc

    “he had become persuaded by a growing body of research that transfusions often pose unnecessary risks and should be avoided when possible, even in complicated cases.”

    It’s one thing to not do a blood transfusion because it might pose an unnecessary risk in a particular situation. It’s another thing entirely to agree to not perform a procedure regardless of what the patient needs just because that patient thinks the procedure is evil. Sorry, no, you don’t get to take somebody else’s lung and play god like that. If she had an actual medical condition that made blood transfusions more risky, it would be different, but no, she just wants to use modern medicine when prayer fails and continue to claim credit for god.

    • Andrew Kohler

      “Sorry, no, you don’t get to take somebody else’s lung and play god like that. ”

      I am an organ donor; is there a way of clarifying that my organs may only be used for people who would rather die during the transplant surgery than receive a blood transfusion?

      • Andrew Kohler

        Rather, “who would NOT rather die…” (That word “not” makes quite a difference.)

        • Amyc

          yeah it does. I was really confused by your comment at first.

          • Andrew Kohler

            Ah, the joys of commenting on the interwebs! (At least FB has the “edit” feature.) It would indeed be strange to request for your donated organs only to be used in operations that will not use blood transfusions under any circumstances, but I suppose it’s a logical next step if Dr. Scheinin is successful? (“You can have my organs, but make sure you’ve drained ALL the blood!”)

  • invivoMark

    Um, exactly what does Ms. Tomczak think the lungs are for? How, exactly, does she propose that a lung be transplanted without any blood in it?

    She may as well ask for a brain transplant without getting any neurons with it.

  • mattysb

    Well, up to 1980 organ transplants were banned but apparently Jehovah had a change of heart and so allowed his Witnesses to have one too! Don’t expect anything the JWs do or say to make a lick of sense – it’s a bonkers religion.

  • ah58

    Like others here, I wonder how she expects to receive a transplant of such a vascular organ and not be exposed to the blood of the donor.

  • Sunny Day

    Newsflash!
    People use medical technology to live despite wacky religious rules. Also, butt implants.

  • Pingback: Explain this vague, scarcely believable scenario, atheist!

  • DeanS

    I was a Jehovah’s Witness for many years. The prohibition of blood is based upon a few verses in the Bible. In the Old Testament, when God first allowed mankind to eat flesh, the command was to drain the animal’s blood and pour it on the ground. The reason is because the blood is the animals soul or life. Basically, the animal’s blood is sacred so it is showing respect for the animal by not consuming its blood. Even today the Jews do not consume blood and they go to great lengths to bleed animals. For example, they go through quite an exercise to bleed animal liver. The JWs believe, as most Christians do, that Jesus Christ fulfilled the laws of Moses, so they are no longer relevent, but, in the New Testement (Acts) there continues a command to abstain from blood, so the JWs believe they should not consume blood even today like the Jews. But the odd thing is, they have taken the command to abstain from eating blood to abstaining from blood transfusions! Using the Bible’s reasoning, this does not make sense. Accepting a blood transfusion is saving a life, not taking a life. Basically, I believe the JWs want to abandon their peculiar belief but they would get sued to hell and back if they do, which is why they allow many procedures that include blood fractions, blood substitutes, and they even allow blood salvage, which is gathering spilled blood from a wound and infusing it back into the body. But they still do not allow a JW to have their blood removed, stored, and transfused at a later time. Go figure! These decisions are made by a small group of men who control the JWs. No JW is allowed to question them and they are not Biblical scholars, nor are they well educated. Their founder, in fact, only went to the 8th grade in school. It is a very highly controlled and dangerous cult and almost impossible to get out. Once inside, and brainwashed, the JW will do ANYTHING their leaders demand WITHOUT QUESTION.

    • Anonymous

      We will see who is resurrected?

      • http://smingleigh.wordpress.com Zinc Avenger (Sarcasm Tags 3.0 Compliant)

        Be sure to let us know how that turns out.


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