Judge orders life-saving operation

Doctor wins case against parents who refused to allow a blood transfusion for their dying baby
Sunday Times (South Africa), Nov. 10, 2002
http://www.sundaytimes.co.za/
Gillian Anstey

A Johannesburg doctor went to court to force a father to approve a life-saving blood transfusion for his dying 10-day-old son.

The wisdom-of-Solomon drama played itself out in the Johannesburg High Court two weeks ago after Reuben Brown’s parents refused to give Dr Nicoletta Hay permission for a transfusion because of religious reasons and fears of tainted blood.

Hay is a paediatrician in the intensive care unit of Garden City Clinic in Mayfair, Johannesburg.

Despite the court being told that “if the blood transfusion is not administered today, the child will die”, Stephen Brown insisted that he and his wife, Tersia, did not want their firstborn to undergo the procedure.

Brown told the court that while he was not a Jehovah’s Witness (who believe taking blood into the body violates God’s laws), he had been brought up that way and had chosen it as “the moral obligation of my life”.

His wife was also a very religious person who closely followed the Bible’ s principle not to partake of blood, he testified.

Brown said that Hay could not guarantee the transfusion would save his son’s life. “They also cannot guarantee [the blood] is free of disease.” He asked if the clinic would take responsibility if his son contracted HIV .

He said he had “absolute faith” in Hay “but it comes to a point where you have to rely on a higher power to see matters through, otherwise do not believe in the higher power”.

However, Hay testified that the newborn would die without the transfusion. “I cannot state categorically that Reuben will live if he receives this blood transfusion but I can say with a high probability, with a lot of certainty, that he will die if he does not receive the blood, ” said Hay, whose application was supported by Garden City Clinic.

She said Reuben had been born extremely ill with an infection after a long, difficult labour. The infant had been mostly confined to paediatric intensive care.

Hay said Reuben had improved dramatically after being admitted, but had then picked up another infection.

“Reuben has deteriorated so much that I think he may die in the next few hours,” Hay said.

His heart, brain and blood pressure were under strain.

Hay said the baby desperately needed the transfusion to improve the capacity of the blood to carry more oxygen to the liver which would produce antibodies to help him fight the infection.

She also insisted that while people might believe “these parents do not care about their child by refusing this blood transfusion”, this was not the case.

Brown told the court he would abide by its decision. “As a separate and unemotional body, I feel it is for the court to make up their minds.

“Whatever the outcome is, let us hope it is going to be the best for the baby,” he said.

Judge Mohamed Jajbhay said he did not profess to have the wisdom of Solomon needed to make the decision.

“I commence with a prayer that baby Brown be given the health, the dignity and that his parents be given the peace of mind that they deserve,” he said.

He then ruled that Reuben have the transfusion urgently.

“One day, God willing, when he grows up you will explain to him that the decision was mine, that I had a decision to make,” the judge said. “That you as his parents did all that was in your power and ability to make sure that you did not compromise on your decision . . . But baby Reuben needs a second chance, he needs whatever chance he has, let us give him that chance.”

The judge also asked to be kept informed of Reuben’s progress.

The ruling was immediately conveyed to the clinic and before Hay and the Browns had even left the court, the transfusion had started .

Reuben’s mother hugged Hay after the ruling.

On Friday, Hay said that the baby was off the ventilator and “looking very well”.

Brown said yesterday the family wished to thank those who had supported them with their prayers. “We thank God for placing our child in the care of such capable medical people and hope for a speedy and uncomplicated medical recovery.”

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