When doctors at Vanderbilt University Medical Center rushed to operate on a baby born last week with a life-threatening heart condition, they faced one giant hurdle: the child's parents.
They refused to consent to the surgery, saying it would involve the use of blood products - a violation of their religious beliefs as Jehovah's Witnesses.
The hospital went to court and a Nashville judge ordered the surgery, along with the use of blood products deemed necessary to save the child's life, in spite of the parents' belief.
Hospitals and Jehovah's Witnesses say great strides have been made to understand and accommodate each other, but this case shows that the conflict between medicine and religion remains.
"It's a scriptural command to abstain from blood," said Fred Haston, a Jehovah's Witness.
"The reason is that the life of a person is in that blood. We believe that blood is life. There's no question about it. But we wouldn't use that life - in a way that would be in conflict with God's laws."
Haston is chairman of the faith's Hospital Liaison Committee, which works with doctors to promote surgery that doesn't require blood transfusions.
There is much more cooperation between hospitals and Jehovah's Witnesses about that than there used to be, he says.
Jehovah's Witnesses believe that the Bible forbids them from getting blood or any of its major components, such as plasma and white or red blood cells.
But when the girl was born Dec. 18 at the children's hospital, doctors knew they couldn't get around the blood issue.
The child, identified in court documents as Baby Girl Doe, was born with a life-threatening congenital heart condition. Doctors wanted to perform a cardiac catheterization within 48 hours and promised to make their best effort to avoid using blood products.
But to perform the cardiac surgery, the baby had to be put on a cardiac bypass pump primed with blood and blood products, an affidavit signed by Dr. David Parra said. "There are no other alternatives to priming the by-pass pump in order to perform this surgery," the doctor's statement said.
Without the surgery, there was an 80% chance the baby would die, Parra said.
Facing the probability that their little girl might die, the parents kept their faith, refusing to allow the operation. Davidson County Chancellor Richard Dinkins ordered doctors to go ahead with surgery.
Medical center officials said federal privacy laws forbid them from saying how the child is doing and whether she received blood.
The hospital typically has to go to court two or three times a year to force parents, most of them Jehovah's Witnesses, to allow blood-related treatment for their children, Vanderbilt spokesman John Howser said. Sometimes it's a pre-emptive move on the hospital's part in case complications during a medical procedure require im mediate use of blood products.
Adults can refuse
Doctors respect religious beliefs that may conflict with medical care, an ethical adviser to two local hospitals said.
Adults can refuse blood products, and hospitals will honor that, said Dr. James Sullivan, chairman of the ethical committees for Nashville General Hospital at Meharry and Centennial Medical Center.
"I know that there have been Jehovah's Witnesses who have been on the operating table who have died" after their refusal, Sullivan said. But a child is not old enough to make a decision on her own behalf, he said, so courts are called on to step in. Sullivan said he would advise doctors at his hospitals to go to court if faced with such a dilemma.
Despite the court battle, both Vanderbilt officials and Haston, the liaison committee chairman, said they would continue to work together to resolve such issues. Jehovah's Witnesses "have no problem with medical treatment," Haston said. "That's why we take our kids to the doctor."