Ottawa — Canada's first sextuplets, born more than a week ago, are facing an additional complication to the usual premature baby's struggle for survival: Their parents' religion forbids blood transfusions, a typical part of a preemie's treatment.
The babies' condition remains a mystery, and the hospital refuses to confirm reports that one infant has died.
The six babies were born Jan. 5 and 6 in Vancouver, British Columbia, to parents who are Jehovah's Witnesses. Delivered at 25 weeks, more than halfway through the typical 40-week pregnancy, the four boys and two girls averaged 1.6 pounds and can rest in the palm of an average man's hand. The survival rate for such births is about 80%.
The parents have asked to remain anonymous, and the hospital has not provided information since shortly after the births, when a spokesman reported that the babies were in fair condition.
On Tuesday, hospital officials would not comment on a media report citing sources in the hospital that one of the boys had died.
"The family asks that their privacy be respected," said a spokeswoman for B.C. Women's Hospital in Vancouver. "They haven't provided instructions for releasing a statement."
The news of Canada's first sextuplets and the role of the parents' religion in their children's chances for survival have riveted a nation that prides itself on tolerance.
The infants face months in intensive care as their nascent organs, muscles and immunities develop enough for them to live on their own. Blood transfusions are a typical part of a preemie's treatment, experts say, because of their low blood volume and vulnerability to anemia. They also must have their blood drawn repeatedly for tests.
Although Jehovah's Witnesses can receive almost any medical intervention, including fertility treatments, organ transplants and vaccinations, the religion's interpretation of the Bible prohibits blood transfusions.
A passage in the Bible cited as the basis for the prohibition is from Leviticus: "And you must not eat any blood in any places where you dwell, whether that of fowl or that of beast. Any soul who eats any blood, that soul must be cut off from his people."
The prohibition probably was meant to prevent the contamination of water supplies, wrote religious scholar Michael Duggan of St. Mary's University College in Calgary, Alberta. But the religion, which uses 1st century Christianity as its model, has interpreted it literally to forbid the "consumption" or spilling of blood.
Mark Ruge, spokesman for the Jehovah's Witnesses in Canada, said, "It mentions in the Bible to abstain from blood, and so we follow that. We want the best for the children, but without blood."
Asked about the consequences of accepting a transfusion, Ruge said that those who did not follow the Bible's teachings would no longer be Jehovah's Witnesses "by their own accord."
Canada's child protection laws ensure that babies get the medical treatment necessary to keep them alive, even if it takes a court order.
A 1995 decision by Canada's Supreme Court in a similar case of a premature baby born to a Jehovah's Witnesses couple concluded that the infant's medical interests trumped the parents' religious rights.
Neither Vancouver's Child Welfare Department nor the hospital have applied for a court order, a provincial court official said.
Even if they don't have a choice, the parents face a conundrum. If they accept blood transfusions to save the babies' lives, it could cut them off from their religious community at a time when they needed its support.
When Lawrence Hughes, 56, was a Jehovah's Witness, he faced a similar problem. In 2002, his 16-year-old daughter, Bethany, needed blood transfusions as part of her treatment for leukemia. His wife, daughter and the Jehovah's Witnesses community in Calgary opposed the transfusions. After much struggle, he signed the consent forms, and was cut off from his family and congregation.
Jehovah's Witnesses typically live and pray together and discourage association with people outside the congregation.
"I was completely isolated," Hughes said.
After Bethany had 38 transfusions, her mother took her into hiding, and the girl eventually died. Hughes is suing the Jehovah's Witnesses, claiming the lawyers who fought the forced treatments did not act in his daughter's best interests.
"I knew that once I signed the consent form, that was it. I knew I'd lose my family, my friends and my faith," he said. "I did it to try to save my daughter, but I lost her too."
Hughes, who works at an architectural firm in Calgary, has joined with other former Jehovah's Witnesses and dissenters in the church to seek a change in policy regarding blood transfusions. In recent years, the religion has allowed patients to receive what it calls "fractions," or components of blood, but not whole blood.
The prohibition presents a problem for doctors as well, said Juliet Guichon, a medical bioethicist at the University of Calgary.
"The consequences of refusing blood in certain situations are fatal," Guichon said in a telephone interview. "There must be something to make people choose that. If it's coercion or fear, the physician must be aware of that."