Jehovah’s Witness died after refusing blood transfusion

The Sydney Morning Herald/May 8, 2023

By Ben Cubby

A woman who died of blood loss after an elective hysterectomy was a Jehovah’s Witness who left conflicting requests about whether she would consent to a blood transfusion, an inquest has heard.

Heather Winchester, 75, died at John Hunter Hospital in Newcastle on September 27, 2019, after initial surgery in Maitland Hospital. The inquest is examining the medical care she received.

Heather Winchester gave doctors conflicting information over what treatments she would accept, including blood transfusions.
Heather Winchester gave doctors conflicting information over what treatments she would accept, including blood transfusions.CREDIT:EPA

Winchester, a doorstep convert to the religion, left an advanced care directive statement that said she did not consent to receive blood transfusions, but other information she supplied to medical staff suggested she was open to receiving some blood-derived products.

“There was a contradiction in documents in relation to what products she would accept,” counsel-assisting Eva Elbourne told the court.

Jehovah’s Witnesses believe the Bible prohibits Christians from accepting transfusions, or from donating or storing their own blood.

The church provides guidance to believers but ultimately leaves it up to individuals to decide whether they receive transfusions.

The Crown Solicitor’s office told the inquest that it would tender expert medical opinion that a blood transfusion may have saved Winchester’s life.

Dr Azra Naseem, a gynaecologist at Maitland Hospital who performed the first surgery on Winchester, gave evidence at the inquest that Winchester had clearly informed her that she did not want transfusions.

But after Winchester had undergone surgery and had lost an estimated 1.25 litres of blood, Naseem was made aware of two worksheets in Winchester’s patient file, which showed she had consented to treatment with some blood-derived products.

Deputy State Coroner David O’Neil asked if she had previously questioned Winchester about the use of various blood-derived treatments, or “blood fractions”.

“I can’t recall anything,” Naseem said. “I’m not sure if I asked about the fractions or not.”

Asked if she had questioned Winchester about whether she had signed any other treatment directives, other than the advanced care directive in which she withheld consent for transfusions, Naseem again replied “I cannot recall”.

Naseem said “I agree” when questioned if it would have been better to have resolved any ambiguity around the use of blood-related treatments, and discussed a plan to stem possible bleeding with other doctors before surgery.

She told the inquest she had performed more than 3500 hysterectomy surgeries, in Australia and overseas, and until September 2019 she had never had a patient who required a blood transfusion as a result.

Naseem offered her condolences to Winchester’s family, and described her as “a very decent, very conservative type of person, a lovely woman”.

After a second surgery at Maitland Hospital failed to stem Winchester’s bleeding, she was transferred to John Hunter Hospital in Newcastle.

After her condition deteriorated, staff consulted the Jehovah’s Witnesses liaison committee and sought legal advice.

But no transfusion took place and Winchester died about 4.30pm on September 27.

The deputy state coroner told the court that “the purpose of the inquest is not to attribute blame or fault”.

“It is to look at issues surrounding the death and see what, if anything, could be put in place for the future to minimise the prospect of similar circumstances surrounding the passing of a loved one.”

There are an estimated 68,000 Jehovah’s Witnesses in Australia.

The inquest continues.

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