A CORONER has called for hospital managements to consider seeking a court ruling in contexts “similar to this case”, following the death of a woman who refused a blood transfusion on religious grounds.
Anita Baxter (56), Tudor Court, Coill Dubh, Naas, Co Kildare, died of acute cardiac failure due to low blood volume secondary to blood loss in Tallaght Hospital on September 15th last. Her death occurred five days after Ms Baxter, a Jehovah’s Witness, suffered a significant bleed following surgery to remove a tumour from her colon.
There was a “98 to 99 per cent chance she would have survived if she was given the appropriate blood transfusion at the appropriate time”, surgeon Diarmuid O’Riordan told an inquest at Dublin County Coroner’s Court yesterday.
It heard yesterday that Ms Baxter signed an informed consent form prior to surgery stating she did not want blood or blood products, even if required as a life-saving measure.
Detailed consents were given to doctors on three separate medical teams, including Mr O’Riordan, consultant haematologist Dr Helen Enright and anaesthetist Dr Fergal Day.
“She was extensively counselled pre-operatively regarding the potential consequences of her refusal for religious reasons to accept blood or blood products even in the event of a life-threatening haemorrhage,” Dr Enright said.
“She explicitly indicated she did not want transfusion of blood products even if it cost her her life,” Mr O’Riordan said.
Mrs Baxter’s condition deteriorated after a successful five-hour keyhole procedure on September 10th, with a drop in blood pressure. She underwent open surgery less than three hours later for a suspected bleed.
Significant blood loss was confirmed and a small bleeding point was cauterised, but there was no significant active bleeding. She remained unconscious following the procedure and for the five days up to her death.
Following her return to theatre, anaesthetist Dr Day explained to her family the “critical nature of events and that without a blood transfusion it was unlikely that Mrs Baxter would survive”. If she had received the transfusion, “the overwhelming likelihood is that she would have survived”.
Coroner Dr Kieran Geraghty called on the management at the hospital to consider seeking a court ruling in future similar cases, where a person is unconscious and not in a position to affirm their decision and where there is time to do so, so that the situation could be clarified.
“It’s putting doctors in an incredible position – where they can save a person – that they have to stand there and let them die,” he said.
Solicitor for the hospital Kevin Power said that under Irish law, a patient had the right to “choose their medical treatment and can give a directive . . . as long as they are informed of the relevant risks and . . . if they are unconscious that that consent would carry through”.
The dead woman’s husband Philip Baxter told the inquest that he had asked a doctor that if he overturned his wife’s decision, would the doctor “put in writing” that the blood transfusion would save her life.
“She said she couldn’t say that,” he said. “I would not change my wife’s decision. She had signed it and she was quite adamant she did not want a blood transfusion.”
Dr Geraghty recorded a verdict of death by natural causes.
“Death came about as a result of a cancer that had to be operated on. It was a necessary surgical procedure.”
Moderate coronary artery disease was a contributory cause.
