Dissertation

[NOTE: Please find below the dissertation abstract. Check Scholar Google or ProQuest for more information.)

Exploring Surgeons’ Attitudes and Behaviors Toward the Bloodless Policy and
Emergency Treatment of Jehovah’s Witnesses Relative to
Patient-Centered Care and Evidence-Based Medicine:
A Multiple-Case Study

© 2018 Firpo Carr

ABSTRACT

The American Medical Association, as well as other reputable sources, charge that blood transfusion is the most common and the most overutilized medical treatment procedure performed in the U.S. Because of their refusal to accept blood transfusion the 8.3-million-plus worldwide Christian group known as Jehovah’s Witnesses (“JhW”) run the risk of not receiving adequate medical attention in the case of a medical emergency wherein the surgeon would otherwise order a blood transfusion. For decades JhW and their children have died on the operating table as confused and frustrated surgeons have panicked when forced to treat them. As patients, the JhW have garnered the attention of the global medical community like no other religious or cultural group and have influenced treatment protocol on an unprecedented scale. The surgeon becomes vulnerable to Cognitive Dissonance when, in a medical emergency, his or her attitude and behavior are negatively affected as an attempt is made to balance the maxim to do no harm and the bloodless policy of JhW. The purpose of this study is to explore surgeons’ attitudes and behaviors toward the bloodless policy and emergency treatment of JhW relative to Patient-Centered Care (PCC) and Evidence-Based Medicine (EBM). This qualitative study employed a multi-case approach which involved two surgeons. The results of the study demonstrate that surgeons experience Cognitive Dissonance as a result of Belief Bias in connection with the bloodless policy of JhW. It was also discovered that Forced Compliance caused mental anguish and distress in surgeons who sought to assuage through Cognitive Dissonance Theory (CDT). Surgeons seemed to be positively affected by the introduction of an eight-pronged educational intervention based on EBM and related themes. This educational intervention is recommended for inclusion in medical school curriculums and continuing education courses which would ultimately improve PCC. Future research could explore Cognitive Dissonance in the JhW patient who believes that blood transfusion will save his or her life, but declines one due to Belief Bias. A future study could also investigate Forced Compliance in the patient who may feel compelled to accept the bloodless policy to remain in good standing with the group.