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Chemotherapy for haematological malignancies can be fatal
EDITOR,--Those of us who treat haematological malignancies are sometimes faced with equivalent dilemmas to that discussed by Simon Finfer and colleagues, although the time scale is different from that in acute trauma.1 A few years ago I attempted chemotherapy in a 19 year old woman who was a practising Jehovah's Witness. The implications of chemotherapy without the support of blood and blood products were fully discussed with her and her family. All remained steadfast in their refusal to accept any form of red cell transfusion. The patient received chemotherapy but, almost inevitably, died.
Managing such a patient proved difficult for all the staff concerned with the case. Nevertheless, the beliefs of the patient and her family were respected. It was therefore some comfort to the staff that the family wrote to the unit specifically to thank the staff for the way in which they had handled the difficult situation. The
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- Managing patients who refuse blood transfusions: an ethical dilemma: Major trauma in two patients refusing blood transfusion
- S Finfer, S Howell, J Miller, K Willett, and J Wilson-MacDonald
BMJ 1994 308: 1423-26.[Extract] [Full Text]
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