Religious mother turned down life-saving treatment

Harrow Times/May 11, 2004

A mother died after refusing medical treatment involving blood products because of her religious beliefs, an inquest heard.

Jehovah's Witness Angela Jean Shipperley, 36, died on August 20 last year, 12 days after giving birth by caesarean section to a premature baby boy at Northwick Park Hospital.

Dangerous complications of pre-eclampsia, which had caused the early birth, set in after the delivery, which caused Mrs Shipperley to suffer fatally low levels of haemoglobin in her blood.

Doctors told Hornsey Coroner's Court that treatment with plasma would have given her a "fighting chance" of survival.

Her husband, Alvin, of Pinner Green, said he had given up his job as a computer programmer to look after his wife's 11-year-old daughter and the couple's young son.

The court heard that early in her pregnancy Mrs Shipperley had discussed her religion with consultant Sian Kerslake, and expressed her wish not to be treated with blood or blood products, whatever happened.

Mrs Shipperley, a civil servant, had suffered with pre-eclampsia during her first pregnancy and early signs of the condition led to her admission to hospital on August 5.

Three days later, the baby's heartbeat was not satisfactory, said Miss Kerslake. The only way to prevent potentially fatal pre-eclampsia was to deliver the baby, so Mrs Shipperley underwent an operation, giving birth to her 3lb 6oz son at 33 weeks.

She developed a rare and dangerous complication, HELP syndrome, which causes the body to destroy its own blood, but the mother signed a further directive on August 8 refusing treatment with blood or blood products.

Her haemoglobin level became very low: an average level is around 15, but on the day of her death hers was undetectable. Haemoglobin carries oxygen to the organs.

Miss Kerslake said: "Despite being told a blood transfusion could mean the difference between life or death, the patient refused a blood transfusion.

"She was an intelligent lady who understood the consequences of refusing the treatment."

As Mrs Shipperley's condition deteriorated, she developed more and more difficulties, including lung and liver problems, anaemia and swelling. Despite the very best efforts of the medical staff and advice from dieticians, liver specialists, and other experts, she suffered a cardiac arrest from which she could not be resuscitated.

Pathologist Dr Ashley Fegan-Earl gave the cause of death as a cardio-respiratory arrest due to multi-organ failure, and other complaints. The pregnancy was a contributory factor, since had she not been pregnant she would not have suffered pre-eclampsia.

Coroner Dr William Dolman recorded a narrative verdict that "Angela Shipperley died from the consequences of complex disease changes following pregnancy and caesarean section, having made the informed decision to refuse blood or blood products against medical advice."

He added: "Everyone has the freedom to accept or refuse assaults on their body. For a doctor to give treatment without consent is undoubtedly an assault.

"Mrs Shipperley made her wishes absolutely clear and the hospital abided with those wishes."