Medical And Dental Practitioners Disciplinary Tribunal V. Dr. John Emewulu Nicholas Okonkwo (2001)

LAWGLOBAL HUB Lead Judgment Report

AYOOLA, J.S.C.

Of the several issues raised by this appeal the central issue is whether a medical practitioner is guilty of infamous conduct when in defence to the patient’s religious objection to blood transfusion, he failed either to adopt such course of treatment; or, terminate his medical contract; or refer the patient to another health institution or another medical doctor.

The facts which led to this question are largely undisputed and can be briefly stated. Mrs. Martha Okorie (“the patient”) and her husband belonged to a religious sect known as Jehovah’s Witnesses who believe that blood transfusion is contrary to God’s injunction. They take their stand from the scriptures. In Leviticus 17: 10-11 God said:

“And I will turn my face against anyone, whether an Israelite or a foreigner living among you who eats blood in any form. I will excommunicate him from his people. For the life of the flesh is in the blood, and I have given you the blood to sprinkle upon the altar as an atonement for your souls; it is the blood that makes atonement because it is the life.”

They believe that the prohibition was passed to the “Gentiles”, that is, non -Jews in Acts 15: 29 where it is stated that “ye abstain from meats offered to idols, and from blood, and from things strangled, and from sexual immorality”, they believe that blood transfusion is “eating” of blood.

Mrs. Okorie, a 29 -year old woman, having had a delivery at a maternity on 29th July, 1991 was admitted as a patient at Kenayo Specialist Hospital for a period of 9 days from 8th August, to 17th August, 1991. She had complained of difficulty in walking and severe pain in the pubic area. At Kenayo Hospital the diagnosis disclosed a severe ailment and a day after her admission blood transfusion was recommended. The patient and her husband refused to give their consent to blood transfusion. Dr. Okafor of the hospital consequently discharged the patient, giving her a document in the following terms.

“To whom it may concern: Re: Martha Okorie”

“The patient and her husband strongly refused blood transfusion despite appeals, explanations and even threats that she may die.

The husband rather asked for his wife to be discharged and he took her away on 17/8/91”

Upon her discharge from Kenayo Hospital she was taken to JENO hospital by her husband on 17th August, 1991. There he produced to Dr. Okonkwo (“the respondent”) a card signed by the patient titled “MEDICAL DIRECTIVE / RE- LEASE” which reads as follows:

“I Martha K. Okorie, direct that no blood transfusions be given me, even though physicians deem such vital to my health or my life. I accept non-blood expanders, such as Dextran, saline or Ringer’s solution, hetastarch, I am 29 years old and execute this document of my own initiative. It accords with my rights as a patient and my beliefs as one of Jehovah’s witnesses. The bible commands: keep abstaining from blood”. (Acts 15:28,29). This is, and has been, my religious stand for 6 years. I direct that I be given no blood transfusions. I accept any added risk this may bring. I release doctors, anesthesiologists, hospitals and their personnel from responsibility for any untoward results caused by my refusal, despite their competent care. In the event that I lose consciousness, I authorize either witness below to see that my decision is held.

Sgd. Martha Okorie Date: 23/2/91

Witness Sgd. LOVEDAY C. OKORIE HUSBAND

Witness Sgd. UKWUOMA C. A. – UNCLE