ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Friday, November 22, 1996 TAG: 9611250118
SECTION: VIRGINIA PAGE: A-1 EDITION: METRO
SOURCE: LAURENCE HAMMACK STAFF WRITER
Doris McDaniel showed slight signs of improvement Thursday, one day after a Roanoke judge took the rare step of authorizing blood transfusions for the gravely ill patient despite her earlier religious objections.
After receiving the blood hours after Judge Robert P. Doherty's decision, McDaniel opened her eyes and acknowledged her husband's presence for the first time since Nov.7.
"The blood helped her some, but she's still got a long way to go," Richard E. McDaniel said.
McDaniel remains in the intensive care unit of Carilion Roanoke Community Hospital - unaware of an unusual court battle that pitted a hospital that wanted to honor her wishes against family members who say they are trying to save her life.
McDaniel, a 72-year-old Jehovah's Witness, had said repeatedly - both in signed forms and in conversations with doctors - that she did not want to receive blood during her stay at the hospital for colon surgery.
But her husband and three children maintained that McDaniel changed her mind once she developed complications after surgery and was facing death. At their request, Doherty granted an emergency order Wednesday that authorized doctors to give her the transfusions.
Lawyers for Carilion Health System had opposed the request, contending that McDaniel - who was sedated, unable to speak and on a ventilator at the time - was unable to make an informed decision the day her family said she authorized the transfusions by nodding "yes" to them.
Although Richard McDaniel had said the hospital was advocating "legal murder" by not providing the blood transfusions, there was no guarantee that even with them she would live.
"She has so many other coincidental medical conditions, it is still possible she may die regardless," McDaniel's physician, Dr. Daniel Donato, wrote in a memo that was introduced as evidence during Wednesday's hearing in Roanoke Circuit Court.
"Obviously, a blood transfusion would not harm her, and may help her overall condition. However, based on her emphatic and unwavering refusal of blood products when previously in 'sound mind,' I have not gone against her wishes to date," Donato wrote in the memo, dated Monday.
The hospital has maintained that it was ethically bound to follow the wishes of an informed and competent patient who has the right to refuse treatment. In making his decision, Doherty noted that the Virginia Supreme Court has not addressed the issue.
Hospital lawyers were considering an appeal, but no decision had been made Thursday.
"There is some feeling that as it stands right now, the legal issues are not clear," said Briggs Andrews, general counsel for Carilion. "Because there are no state cases, that may make it a better candidate for appeal, just to try to come up with a little more guidance on how to proceed in other cases like this."
"But on the other hand, we don't want to drag the family through a whole lot."
Andrews said that in the 61/2 years he has served as Carilion's counsel, this is the first time the hospitals have encountered a situation like McDaniel's.
On Nov. 7, tempers flared when doctors balked at the family's position that McDaniel had changed her mind about the transfusion. The hospital convened an ethics consultation team to discuss the issue.
The team, which consisted of doctors, nurses, and the hospital chaplain, met with the McDaniel family to review her medical history and discuss the dilemma about whether she should receive blood.
But after the hospital defended its position not to give McDaniel blood, her husband abruptly left the conference room, saying the meeting "would not do his wife any good."
According to the team's report, which was introduced in court, Richard McDaniel reportedly "had been badgering his wife for some time before she relented to this decision. The siblings acknowledged that their mother probably was nodding in agreement just to stop her husband from continuing to bother her about the issue."
McDaniel's husband and children do not share her religious beliefs.
Many Jehovah's Witnesses refuse blood transfusions on religious grounds based on biblical passages urging people to "abstain from blood" (Acts 15:28). Among them is Leviticus 17:10, which reads: "Whatsoever man eats any manner of blood, I will cut him off from among his people."
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