Questions arise over sextuplets' care

Possible need for blood transfusions clashes with Jehovah's Witness belief

Toronto Star, Canada/January 10, 2007
By Isabel Teotonio

Vancouver -– As Canada's first sextuplets continued to fight for survival in a Vancouver hospital yesterday, questions surfaced about what medical interventions would be taken if the babies need blood transfusions, which would conflict with the faith of their parents, who are Jehovah's Witnesses.

Dr. Brian Lupton, a neonatologist who is part of the medical team caring for the siblings, would not divulge specific details about this case, but did say yesterday that many premature babies born at 25 weeks gestation do require blood transfusions.

There are several reasons for this. According to the Hospital for Sick Children's kids' health website, premature babies become anemic sooner than full-term infants because they start out with fewer red blood cells. They also lose blood from frequent blood tests.

Many premature babies become anemic before their bodies can make red blood cells, so they may need a transfusion. The smaller a premature baby is, the more likely he will need one or more blood transfusions in the first two months of life.

Citing the family's desire for privacy, Peter Cech, a spokesperson for B.C. Women's Hospital and Health Centre, would not reveal if any of the babies need transfusions, or if the parents have signed directives forbidding them.

However, Cech said, "the hospital involves the family in all decisions regarding patient care."

Dr. Timothy Rowe, head of reproductive endocrinology and infertility at the University of British Columbia, said it's "not common these days for any medical intervention to seek legal muscle to enforce it."

"Dealing with babies of this size, I think the parents' wishes would always be accepted," Rowe said.

No updated information on the babies' status was released yesterday, but during a media conference Monday night, doctors listed their condition as fair, meaning their vital signs were stable and within normal limits.

The greatest hurdles facing the four boys and two girls, each about the size of an outstretched hand and weighing around 1.8 pounds, are difficulties breathing and a greater susceptibility to infection. Long term, the babies are at risk of suffering neurological and developmental deficiencies as well as hearing and vision problems.

Yesterday, the parents, who are reportedly from the Vancouver area but whose identities have not been made public, refused to speak with reporters and asked for privacy.

According to Jehovah's Witnesses, all blood transfusions are forbidden. All Jehovah's Witnesses are expected to carry with them an Advance Medical Directive card ordering that no blood transfusions be given under any circumstances.

When entering hospitals, Jehovah's Witnesses sign forms releasing physicians and hospitals of any possible damage caused by their refusal to have transfusions.

But refusing blood does not make Jehovah's Witnesses anti-medicine, said Mark Ruge, director of public information at the Canadian headquarters for Jehovah's Witnesses.

There are many effective non-blood medical alternatives, such as non-blood volume expanders, he said, adding their beliefs are rooted in Biblical Scripture.

"Non-blood treatment is way superior in every situation and many doctors in hospitals worldwide are calling it the gold standard," Ruge said from his office in Georgetown, Ont.

"Even for young children and babies, there are alternatives – no (blood) transfusion doesn't mean you're going to die. ... To have blood is not the superior way, even though the little jingles on TV say blood gives life.

"Parents want the best for their children and so do we; we consider life very precious," said Ruge. "We love our children dearly; we're very family oriented... but there can be a public misperception."

Few details about the actual births of the sextuplets have been made public. Hospital officials will only say that one child was born Saturday around 8:30 p.m. and the other five were born Sunday morning.

Citing the family's desire for privacy, the hospital will not even confirm the sex of the babies, their birth weights, or how many physicians and nurses were involved in the delivery. Nor will officials say if the mother underwent fertility treatments, which often result in multiple births.

What surprised many was the hospital's decision to reveal the family's religion, a move that was made specifically at the request of the parents, said Cech, adding that information had already been leaked to media.

"I'm very curious about that," remarked Elder Fred Sherman of the Jehovah's Witnesses Assembly Hall in Surrey, B.C. "So what if they're Jehovah's Witnesses? What difference does it make? If they were Catholic would the hospital have said that?"

His comments were echoed by Ruge, whose office yesterday was flooded with calls.

"If a Catholic had sextuplets would people call the Vatican?" he asked, adding he found it "highly unusual" that the family requested their religion be made public.

"When there's a car crash or someone has won the lottery, do they mention religion? This isn't a religious issue."