TREATMENT of blood loss anemia in patients who, for religious beliefs, refuse blood transfusion is vexing. Three schools of thought exist. The "aggressive" school would remove from the patient, by court order, the right to refuse transfusion. The "passive" school would let the patient lapse into coma, whereupon the nearest of kin would adjudicate the application of blood products. The third school would give blood to the patient when unconscious, but deny the fact if he or his family inquires.
Damage to the central nervous system could occur from lack of oxygen if the last two approaches are adopted. Philosophically, the author agrees with Fitts et al,1 who advocate the exploration of alternative treatment methods.
Boerema et al2 demonstrated that when treated with hyperbaric oxygen, pigs could survive otherwise intolerable reduction of red blood cell (RBC) mass for brief periods without neurological deficits. Lambertsen et al3 observed
Hart GB. Exceptional Blood Loss Anemia: Treatment With Hyperbaric Oxygen. JAMA. 1974;228(8):1028–1029. doi:10.1001/jama.1974.03230330058026
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: