Expert Opinions > Expert Medical Opinions > Professor Aryeh Shander

Professor Aryeh Shander

North America | United States

EXTRACTS FROM OPINION, DATED DECEMBER 15, 2023:

“… I have had the privilege of caring for hundreds of patients who decline blood transfusion for personal or religious reasons. … Our patient population has ranged from pediatric patients to those of very advanced age. Our services include obstetric care, including high-risk pregnancies, gynecologic oncology, as well as complex cardiac and vascular surgery.

The clinical outcomes in the population of patients who declined allogeneic blood transfusion were so positive that we adopted these clinical pathways for all patients. This resulted in health benefits to all patients …

Despite the rapid advances in BMS [bloodless medicine and surgery] over the past two to three decades, including the adoption of BMS strategies by prestigious university-affiliated adult and pediatric hospitals worldwide, some clinicians still think that it is challenging to care for patients who decline blood transfusions. This is due either to clinician inexperience or to a failure to approach clinical care with an open mind. In addition, those with an open mind have found that the JW [Jehovah’s Witness] community is not only well informed about medical issues, specifically about their individual ailments, but they are always seeking the most advanced and best clinical care available as long as it is without allogeneic blood transfusions. …

… To state that JW parents desire to secure the best care for their child/children is an understatement. Any added challenge that JW patients may sometimes present to the clinician by requesting the use of therapeutic strategies that preempt blood transfusion in adults and children is not a sign of carelessness or medical neglect. Rather, it is based on the knowledge that virtually all procedures, including those for pediatric patients, can be successfully performed without allogeneic blood transfusions.”

“In conclusion, my several decades of experience in caring for JW patients and their families has been the most rewarding experience of my medical career. It has promoted professional growth, and enhanced my ability to care for other patients with special medical needs. The needs of JW patients have also led to advancements in science and the publication of thousands of medical studies on the diagnosis and treatment of anemia, management of coagulation, and the function and shortcomings of banked (stored) blood. There is considerable scientific evidence that blood transfusions can be preempted by implementing a multidisciplinary, multimodality, and systematic approach to care and by optimal use of multiple strategies to manage anemia and minimize blood loss. In 2021, the World Health Organization (WHO) published a policy brief urging all member nations to encourage clinicians and hospitals to make wider use of strategies that conserve and manage patients’ own blood.

A large number of medical studies confirm that patients treated using BMS strategies, both adults and children, often do as well as, if not better than, patients treated with reliance of allogeneic blood transfusion therapy. Use of such strategies is also associated with significant cost savings to the health care system. …” (Original in English.)