Zowonjezeredwa

Mboni za Yehova—Chitokoso cha Opaleshoni/Makhalidwe

Kusindikizanso mwa chilolezo cha American Medical Association kuchokera mu The Journal of the American Medical Association (JAMA), November 27, 1981, Voliyamu 246, Na. 21, tsamba 2471, 2472. Chilolezo cha kulembanso 1981, American Medical Association.

Madokotala amayang’anizana ndi chitokoso chapadera posamalira Mboni za Yehova. Ziŵalo za chipembedzo chimenechi ziri ndi zikhulupiriro zakuya zachipembedzo pakulandira mwazi wa munthu wina kapena mwazi wa iwo eni wathunthu, wokhala ndi ma RBC [“red blood cells” (maselo a mwazi ofiira)], ma WBC [“white blood cells” [maselo a mwazi oyera)], kapena zinthu za m’mwazi. Ambiri adzalola kugwiritsiridwa ntchito kwa (chipangizo chopanda mwazi) choyendetsera mtima ndi mapapu, choyeretsera mwazi, kapena chofanana nacho ngati mphamvu ya kupopedwa kwa mwazi iri yosadodometsedwa. Ogwira ntchito zachipatala safunikira kudera nkhawa ponena za kupezeka ndi mlandu, popeza kuti Mbonizo zidzatenga masitepe apalamulo oyenerera kuchotsa mlandu ponena za kukana kwawo mwazi kodziŵa. Iwo amavomereza zoloŵa m’malo za madzi zosakhala mwazi. Pogwiritsira ntchito zimenezi ndi njira zina za luso zosamalitsa, madokotala akuchita maopaleshoni aakulu a mitundu yonse pa Mboni zodwala zachikulira ndi ana. Motero muyezo wa mchitidwe kaamba ka odwala oterowo wabuka umene umagwirizana ndi chikhulupiliro cha kuchiritsa “munthu yense.” (JAMA 1981;246:2471-2472)

MADOKOTALA amayang’anizana ndi chitokoso chosatha chimene chiri nkhani yaikulu yathanzi. Mu United States muli Mboni za Yehova zoposa theka la miliyoni zimene sizimavomereza kuthiriridwa mwazi. Chiŵerengero cha Mbonizo ndi awo amene amagwirizana nazo chikuwonjezereka. Ngakhale kuli kwakuti kalero, madokotala ambiri ndi akuluakulu azipatala analingalira kukanidwa kwa kuthiriridwa mwazi monga vuto la lamulo nafunafuna chilolezo cha bwalo la milandu kuti apitirize monga momwe iwo anakhulupilira kuti kunali kwabwino mwamankhwala, mabukhu aposachedwa a zamankhwala amavumbula kuti kusintha kowonekera m’lingaliro kukuchitika. Kumeneku kungakhale kochititsidwa ndi zokumana nazo za maopaleshoni owonjezereka ndi odwala okhala ndi milingo ya hemoglobin yotsika ndiponso kungasonyeze kuzindikiridwa kowonjezereka kwa njira yalamulo ya kuvomera kodziŵa.

Tsopano, ziŵerengero zazikulu za maopaleshoni osankhidwa ndi zochitika zangozi zokhudza ponse paŵiri Mboni zachikulire ndi ana zikupangidwa popanda kuthiriridwa mwazi. Posachedwa, oimira Mboni za Yehova anakumana ndi ogwira ntchito zaopaleshoni ndi za muofesi pa ena a malo aakulu azachipatala m’dzikolo. Misonkhano imeneyi inakulitsa kumvetsetsana ndi kuthandiza kuthetsa mafunso onena za mwazi woti ugwiritsiridwenso ntchito, kuikiliridwa ziŵalo, ndi kupeŵedwa kwa mikangano ya zamankhwala ndi lamulo.

LINGALIRO LA MBONI ZA YEHOVA PANJIRA YOCHIRITSIRA

Mboni za Yehova zimavomereza chisamaliro cha zamankhwala ndi cha opaleshoni. Kunena zowona, ochuluka a iwo ndimadokotala, ngakhale madokotala a opaleshoni. Koma Mboni ndizo anthu achipembedzo kwambiri amene amakhulupilira kuti kuthiriridwa mwazi nkoletsewa kwa iwo ndi mawu Abaibulo akuti: “Nyama, mmene muli moyo wake, ndiwo mwazi wake, musadye.” (Genesis 9:3-4); “[Muyenera] kukhetsa mwazi wake ndi kuufotsera ndi dothi” (Levitiko 17:13-14 NW); ndi “Kudzipatula . . . padama ndi zimene ziri zopotoledwa ndi mwazi” (Machitidwe 15:19-21).⁠¹

Pamene kuli kwakuti mavesiwa sananededwe m’mawu a zamankhwala, Mboni zimawalingalira kukhala oletsa kuthiriridwa mwazi wathunthu, wa ma RBC oikidwa m’mapaketi ndi madzi a m’mwazi ndiponso WBC ndi kupatsidwa zinthu za m’mwazi. Komabe, kuzindikira kwachipembedzo kwa Mboni sikumaletseratu kugwiritsiridwa ntchito kwa zopangidwa za zinthu zonga albumin, ummune globulins, ndi zosungunula mwazi; Mboni iriyonse iyenera kudzisankhira ngati ingavomereze zimenezi.⁠²

Mboni zimakhulupilira kuti mwazi wochotsedwa m’thupi uyenera kutayidwa, motero sizimavomereza kuloŵetsedwanso kwa mwazi umene wachotsedwa m’thupi. Maluso a kusunga mwazi wochucha mkati mwa opaleshoni kapena kusungunula mwazi kumene kumaphatikizapo kusunga mwazi ngokanidwa ndi iwo. Komabe, Mboni zambiri zimalola kugwiritsiridwa ntchito kwa chipangizo choyeretsera mwazi ndi chothandizira kugwira ntchito kwa mtima ndi mapapu (chopanda mwazi) ndiponso kugwiritsiridwanso ntchito kwa mwazi mkati mwa opaleshoni kumene sikumadodometsa kupopedwa kwa magazi m’thupi lonse; dokotala ayenera kukambitsirana ndi munthu wodwalayo ponena za chimene chimavomerezedwa ndi chikumbumtima chake.⁠²

Mboni sizimalingalira kuti Baibulo limanena mwachidunji za kuikiliridwa kwa ziŵalo; chifukwa cha cimenecho, zosankha zonena za kuikilirdwa diso, impso, kapena ziŵalo zina ziyenera kupangidwa ndi Mboni iri yonse pa yokha.

OPALESHONI YAIKULU YOTHEKERA

Ngakhale kuli kwakuti kaŵirikawiri madokotala akana kusamalira Mboni chifukwa cha kaimidwe kawo pakugwiritsiridwa ntchito kwa zinthu za mwazi kunawonekera kukhala “kukumanga manja a madokotala,” madokotala ambiri tsopano asankha kulingalira mkhalidwewo kokha monga vuto limodzi lowonjezereka lotokosa luso lawo. Popeza kuti Mboni za Yehova sizimakana kubwezeretsedwa kwa madzi a colloid kapena crystalloid, kapenanso kuimitsa mwazi ndi magetsi, kuchititsa dzanzi kochedwetsa kuyenda kwa mwazi,⁠³ kapena kuchepetsa kutentha kwathupi kosakhala kwanthaŵi zonse, zimenezi zagwiritsiridwa ntchito mwachipambano. Kugwiritsiridwa ntchito kwatsopano ndi kwamtsogolo kwa hetastarch,⁠⁴ majakisoni a dextran apamtsempha okhala ndi mankhwala ambiri a iron,⁠^5,6 ndi “lumo”⁠⁷ zikulonjeza ndi zosakanidwa mwachipembedzo. Ndiponso, ngati zoloŵa m’malo mwa mwazi zonga ufa zopezedwa tsopano (Fluosol-DA) zitsimikizira kukhala zabwino ndi zamphamvu,⁠⁸ kugwiritsiridwa ntchito kwake sikudzawombana ndi zikhulupiliro za Mboni.

Mu 1977, Ott ndi Cooley⁠⁹ anasimba za maopaleshoni a mtima 542 ochitidwa pa Mboni popanda kuthiriridwa mwazi ndipo ananena kuti njirayi ingachitidwe “limodzi ndi upandu wotsika wovomerezedwa.” Poyankha pempho lathu, posachedwapa Cooley anapenda chiŵerengero cha maopaleshoni okwanira 1,026, 22% pa ana, ndi kutsimikizira “kuti upandu wa kuchita opaleshoni mwa kagulu kodwala ka Mboni za Yehova suunali waukulu koposa mwa ena.” Mofananamo, Michael E. DeBakey, MD, anadziŵitsa “kuti muunyinji waukulu wa mikhalidweyo [yokhudza Mboni] upandu wa opaleshoni popanda kugwiritsiridwa ntchito kwa kuthiriridwa mwazi suuli wokulira koposa mwa odwala amene timawathirira mwazi” (kudziŵitsa kwaumwini, March 1981). Mabukhu amasunganso zolembedwa za maopaleshoni aakulu achipambano a dongosolo la mkodzo⁠¹⁰ ndi mafupa ndi minyewa.⁠¹¹ G. Dean MacEwen, MD, ndi J. Richard Bowen, MD, akulemba kuti kuwongola msana “kwachitidwa mwachipambano pa ana a [Mboni] 20” (chidziŵitso chosafalitsidwa, August 1981). Iwo akuwonjezera kuti: “Madokotala a opaleshoni afunikira kukhazikitsa lingaliro la kulemekeza kuyenera kwa wodwala kukana kuthiriridwa mwazi komabe nachita opaleshoni m’njira imene imaloleza kutetezera wodwala.”

Herbsman⁠¹² amasimba chipambano m’matenda, kuphatikizapo ena chokhudza achichepere, “okhala ndi kutayikiridwa mwazi kwakukulu pangozi.” Iye akuvomereza kuti “Mvoni zimakhala pangozi pang’ono pamene pamafika pa zofunika za mwazi. Komabe nkomvekeranso bwino kwambiri kuti ife tiri ndi zoloŵa m’malo mwa mwazi.” Powona kuti madokotala a opaleshoni ambiri alingalira kukhala omangika kulandira Mboni monga odwala awo chifukwa cha “kuwopa zotulukapo zake za lamulo,” iye akusonyeza kuti kumeneku sikudera nkhawa kololedwa.

NKHAWA ZALAMULO NDI ANA

Mboni zimasaina mosavuta fomu la American Medical Association lomasula madokotala ndi zipatal kukhala kwawo ndi thayo,⁠¹³ ndipo Mboni zochuluka zimanyamula kadi la Medical Alert lokhala ndi deti, lolinganizidwa mogwirizana ndi madokotala ndi boma. Ziphaso zimenezi nzomanga pawodwalayo (kapena mkhalidwe wake) ndipo zimapereka chitetezero kwa madokotala, pakuti Woweruza Warren Burger anati njira yolakwitsa “ikawonekera kukhala yosachirikizidwa” pamene chiphaso chokana chimenechi chasainidwa. Ndiponso, polankhula za zimenezi m’kupendedwa kwa ”chisamaliro chamankhwala choumiriza ndi ufulu wa chipembedzo,” Paris⁠¹⁴ inalemba kuti: “Wonenera wina amene anapenda chipasocho anasimba kuti, ‘Sindinakhale wokhoza kupeza ulamuliro uliwonse wa mawu akuti dokotala akapalamula . . . liwongo . . . laupandu mwa kulephera kwake kuumiriza kuthiriridwa mwazi pawodwala wosafuna.’ Upanduwo ukuwonekera kukhala chotulukapo cha ganizo lozikika palamulo koposa kuthekera kotsimikizirika.”

Kusamaliridwa kwa ana kumapereka nkhawa yaikulu koposa, kaŵirakaŵiri kochititsa kuimbidwa mlandu kwa makolo pansi pa malamulo a kulekelera mwana. Koma machitidwe oterowo akukayikiridwa ndi madokotala ambiri ndi maloyala amene ali ozoloŵerana ndi milandu ya Mboni, amene amadziŵa kuti makolo a Mboni amafunafuna chisamaliro chabwino chamankhwala kaamba ka ana awo. Samakhumba kupeŵa thayo lawo laukholo kapena kulikankhira kwa woweruza kapena kwa munthu wina wachitatu, Mboni zimapempha kuti kulingalira kuperekedwe kuzikhulupiliro zachipembedzo zabanja. Dr. A. D. Kelly, amene kale anali Mlembi wa Canadian Medical Association, analemba⁠¹⁵ kuti “makolo a ana achichepere ndi achibale awo apafupi a odwala osazindikira ali ndi kuyenera kwa kufotokoza za chifuniro cha wodwala. . . . sindikukondwera ndi njira ya bwalo la milandu lokayikira limene linasonkhana pa 2:00 AM kulanda mwana m’manja mwa makolo ake.”

Nkwachiwonekere kuti makolo ali ndi mawu m’kusamaliridwa kwa ana awo, monga ngati pamene ayang’anizana ndi kuthekera kwa upandu kapena mapindu a opaleshoni, kuwotcha ndi getsi, kapena kuchiritsa ndi mankhwala. Kaamba ka zifukwa zamakhalidwe zimene zimaposa nkhani ya upandu wa kuthiriridwa mwazi,⁠¹⁶ makolo a Mboni amapempha kuti njira zochiritsira zigwiritsiridwe ntchito zimene siziri zoletsedwa mwachipembedzo. Zimenezi zimagwirizana ndi chiphunzitso chamadokotala cha kusamalira “munthu wathunthu,” osanyalanyaza kuvulaza kothekera kwa malingaliro amkati kosatha kwa njira youkira imene imaswa zikhulupiliro zazikulu zabanja. Kaŵirikaŵiri, malo apakati aakulu m’dziko okhala ndi zochita ndi Mboni tsopano amalola odwala osamuka m’zipatala zosafuna kusamalira Mboni, ngakhale matenda a ana aang’ono.

CHITOKOSO CHA DOKOTALA

Momvekera bwino, kusamalira Mboni za Yehova kungawonekere kukhala kukukpereka vuto kwa dokotala wodzipereka kukusungitsa moyo ndi thanzi mwa kugwiritsira ntchito maluso onse amene ali nawo. Mwamawu amkonzi ofotokoza mpambo wa nkhani zonena za opaleshoni yaikulu wochitidwa pa Mboni, Harvey⁠¹⁷ anavomereza kuti, “Ndimawona kukhala zokwiyitsa zikhulupiliro zimenezi zimene zingadodometse ntchito yanga.” Koma, iye akuwonjezera kuti: “Mwinamwake nafenso timaiŵala mosavuta kuti opaleshoni ndintchito yodalira paluso la munthu aliyense payekha. Luso lingawongoleredwe.”

Pulofesala Bolooki⁠¹⁸ anazindikira lipoti losakondweretsa lakuti chimodzi cha zipatala zotanganitsidwa kwambiri cha ovulala mu Dade County, Florida, chinali ndi ”lamulo lophimbira kukana kusamalira” Mboni. Iye anatchula kuti “njira zambiri za opaleshoni m’kagulu kameneka ka odwala nzogwirizanitsidwa ndi upandu wochepa koposa wozoloŵereka.” Iye anatinso: “Ngakhale kuli kwakuti madokotala a opaleshoni angalingalire kuti kaumanidwa chiwiya chamakono cha mankhwala . . . ndikhulupilira kuti mwa kuchita opaleshoni pa odwala ameneŵa adzaphunzira zambiri.”

Mmalo mwa kulingalira Mboni yodwala kukhala vuto, madokotala owonjezerekawonjezereka amalandira mkhalidwewo monga chitokoso cha udokotala. Poyang’anizana ndi chitokosocho iwo akulitsa muyezo wa mchitidwe umene uli wovomerezeka pazipatala zochuluka kaamba ka kagulu ka odwala kameneka m’dzikolo. Madokotala amenewa panthaŵi imodzimodziyo amapereka chisamaliro chimene chiri chabwino koposa kaamba ka ubwino wonse wa wodwala. Monga momwe Gardner et al⁠¹⁹ akunenera: “Kodi ndani amene akapindula ngati nthenda yakuthupi ya wodwalayo ichiritsidwa koma mkhalidwe wake wauzimu ndi Mulungu, monga momwe iye akuwonera, wawonongedwa, kumene kumachititsa moyo wopanda tanthauzo ndipo mwinamwake zoipa kwambiri kuposa imfa yeniyeniyo.”

Mboni zimazindikira kuti, mwa mankhwala, chikhulupiriro chawo chogwiridwa mwamphamvu chimawonekera kukhala chikuwonjezera ukulu wa upandu ndipo chingacholowanitse chisamaliro chawo. Chifukwa cha chimenecho, izo kaŵirikaŵiri zimasonyeza chiyamikiro chapadera kaamba ka chisamaliro chimene zimalandira. Kuwonjezera pakukhala ndi mbali zofunika za chikhulupiliro chachikulu ndi chifuno chachikulu cha kukhala ndi moyo, zimagwirizana mokondwa ndi madokotala ndi ogwira ntchito zachipatala. Motero, ponse paŵiri wodwala ndi dokotala ngogwirizana m’kuyang’anizana ndi chitokoso chapadera chimenechi.

ZISONYEZERO

1. Jehovah’s Witnesses and the Question of Blood. Brooklyn, NY, Watchtower Bible and Tract Society, 1977, pp. 1-64.

2. Nsanja ya Olonda (Chingelezi) 1978;99 (June 15):29-31.

3. Dzanzi lochititsa kusathamanga kwa mwazi kutheketsa opaleshoni ya m’chuuno, MEDICAL NEWS. JAMA 1978;239:181.

4. Hetastarch (Hespan)—madzi owonjezera magazi atsopano. Med Lett Drugs Ther 1981;23:16.

5. Hamstra RD, Block MH, Schocket AL:Dextran iron ya mumtsempha m’mankwala a m’chipatala. JAMA 1980;243:1726-1731.

6. Lapin R: Maopaleshoni aakulu pa Mboni za Yehova. Contemp Orthop 1980;2:647-654.

7. Fuerst ML: ‘Lumo’ losafunikiritsa chipangizo. Med Trib 1981;22:1,30.

8. Gonzáles ER: Chochitika cha ‘mwazi woikilira’: Fluosol ndiyo yokondedwa ndi Mboni za Yehova. JAMA 1980;243:719-724.

9. Ott DA, Cooley DA: Opaleshoni yamtima pa Mboni za Yehova. JAMA 1977;238:1256-1258.

10. Roen PR, Velcek F: Opaleshoni yaikulu ya dongosolo la mkodzo popanda kuthiriridwa mwazi. NY State J Med 1972;72:2524-2527.

11. Nelson CL, Martin K, Lawson N, et al: Kubwezeretsa chuuno kotheratu popanda kuthiriridwa mwazi. Contemp Orthop 1980;2:655-658.

12. Herbsman H: Kusamalira Mboni za Yehova. Emerg Med 1980;12:73-76.

13. Medicolegal Forms With Legal Analysis. Chicago, American Medical Association, 1976, tsamba 83.

14. Paris JJ: Chisamaliro cha mankhwala choumiriza ndi ufulu wachipembezo: Kodi ndilamulo la yani limene lidzapambana? Univ San Francisco Law Rev 1975;10:1-35.

15. Kelly AD: Aequanimitas Can Med Assoc J 1967;96:432.

16. Kolins J: Maupandu m’kuthiriridwa mwazi. JAMA 1981;245:1120.

17. Harvey JP: Funso lonena za luso. Contemp Orthop 1980;2:629.

18. Bolooki H: Chisamaliro cha Mboni za Yehova: Chitsanzo cha chisamaliro chabwino. Miami Med 1981;51:25-26.

19. Gardner B, Bivona J, Alfonso A, et al: Maopaleshoni aakulu pa Mboni za Yehova. NY State J Med 1976;76:765-766.