Parents deny daughter life-saving transplant

An Auckland girl suffering a rare kidney disease has been put into the guardianship of the High Court because her Jehovah's Witness parents will not consent to her receiving a life-saving kidney and liver transplant.

The 2-year-old girl, whose name and identifying details are suppressed, has had her kidneys removed and is being kept alive by dialysis. Because of her precarious health, she is at risk of infection and doctors believed she needed to have an urgent kidney and liver transplant or she would die from infection.

Jehovah's Witnesses allow transplants but the faith is strict in rejecting the inevitable blood transfusions that would accompany such an operation. They believe blood that leaves the body must be disposed of and not consumed or transfused.

The Auckland District Health Board went to the High Court last month and sought urgent orders placing the girl under the care of the court. A team of doctors including renal, blood, liver and gastroenterology specialists care for the girl.

Justice Helen Winkelmann, who heard the application, said the team agreed the day before the court hearing that "without a liver and kidney transplant M will most likely die from infection within weeks to a couple of months.

"She will most certainly become so unwell within a few weeks that it will not be possible to consider her for a transplant.

"Dr K says that at the moment M is relatively well and a transplant is viable."



The girl was not able to be placed on the organ recipients' waiting list until consent was obtained.
Justice Winkelmann's judgment indicated the parents of the girl were in step with the hospital apart from the one issue of blood transfusion. They accepted the girl needed the transplants to live but were unable to consent to the transfusion.
Fairfax understood the girl had blood transfusions before, given to her by the hospital under emergency provisions in the Care of Children Act. That provision is unable to be used, as the operation is planned and not an unforeseen emergency.

"Dr K says the medical team has worked closely with M's parents to date and she has no doubt that they have acted throughout in M's best interests but the point has come where there is a critical difficulty for the parents, the conflict between their faith, and what the medical needs of their daughter require of them."

Dr K, appearing in support of the application, said the girl would not just need a blood transfusion during the operation but also in the lead-up and possibly after the operation. The doctors estimated she had a greater than 50% chance of a transplant being successful and, if successful, she would have a normal life expectancy and quality of life.

Justice Winkelmann ruled the girl should be placed under the court's care but both her doctors and her parents would be appointed as agents for the court.
The doctors would be in charge of giving consent and treating the girl as they saw fit but her parents would be in charge of all other aspects of their daughter's life.

"By making the orders which are sought, this resolves for M's parents what must be an agonising conflict between their firmly held religious beliefs and the pressing needs of M," the judge said.
Professor of surgery at Otago University, Dr John McCall, said about a quarter of liver transplants were possible without using blood or blood products but the girl's medical team must have determined they would likely be needed.

McCall said he had performed transplants on Jehovah's Witnesses in the past, including surgeries that did not use blood transfusions, but the blood products the patient accepted changed from person to person.

Some Jehovah's Witnesses would accept a bypass, where their own blood was taken out and pumped back into them in a "complete circuit" during surgery. But very few would accept a blood bank system where the person gave their own blood for storage in the weeks leading up to the operation for use during their surgery.

McCall said he had known cases where Jehovah's Witnesses who accepted blood transfusions had been disowned by their parents and church.