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Haitian's views on unplanned pregnancy and viral infections
The St. Fleur family is well respected in the Haitian community because they are religious, faithfully practice Jehovah's Witness, and have great moral values. Rhonda, the youngest daughter of this family, is 17 years-old and lives at home with her mother and father. Recently, she began having fevers and subsequently developed severe abdominal pain. She was admitted to the hospital, where laboratory tests were hCG and COVID-19 positive. Rhonda was in shock when the doctor informed her that she was pregnant and COVID-19 positive. She confessed to the doctor that she has been sneaking out during the Pandemic to see her boyfriend, but swears that she uses sexual prevention techniques. However, as her symptoms have de-compensated, she is rushed to the OR with a diagnosis of Ectopic Pregnancy. The family is at the bedside and reminds the surgical team that Rhonda's faith prevents her from receiving any blood products due to her religion and cultural beliefs.
What are Haitian's views on unplanned pregnancy and viral infections?
What are Haitian's views on blood transfusions?
What are your procedures/responsibilities as a Nurse Anesthetist if the family refuses blood products for Rhonda's emergency surgery?
Viral Infections (COVID-19):
View: Perceptions of serious viral illnesses vary. While formal medical systems are respected, many Haitians also rely on traditional remedies or spiritual explanations for disease.
Fear/Stigma: The COVID-19 diagnosis, coupled with the unplanned pregnancy, adds layers of fear and potential stigma, which can increase the family's stress and reliance on non-medical protective measures, including rigid adherence to religious directives.
2. Jehovah's Witnesses and Haitian Views on Blood Transfusions
The key conflict here is driven by religious doctrine, not Haitian culture, although the family's cultural background reinforces the strength of their moral commitment.
Jehovah's Witness Doctrine: Jehovah's Witnesses rigidly refuse whole blood transfusions (red cells, white cells, platelets, and plasma) based on their interpretation of biblical verses (e.g., Acts 15:28, 29).
Haitian Views on Blood: While Haitian cultural views on blood transfusions are not singularly prohibitive, the deeply ingrained respect for family, authority, and faith within the Haitian community means the family's adherence to the Jehovah's Witness tenet is likely non-negotiable and supported by the community.
Consequence: The refusal is absolute and applies even in life-threatening emergencies. The family will insist on blood management techniques that avoid homologous (donor) blood, such as intraoperative cell salvage (if accepted by the faith) or specific blood fractions (which are sometimes permitted).
Sample Answer
This clinical scenario presents a complex challenge involving cultural, religious, legal, and ethical conflicts in an emergency pediatric setting. As a nurse anesthetist (CRNA), your primary responsibility is to the patient's immediate safety and survival.
1. Haitian Views on Unplanned Pregnancy and Viral Infections
Haitian views on health and social issues are diverse, rooted in a mix of Catholicism, Vodou (Voodoo), and strong family/community ties.
Unplanned Pregnancy (Especially Teen Pregnancy):
View: Unplanned pregnancy, particularly among unmarried adolescents, is generally a source of shame and disappointment for the family, especially within a strict, conservative, or religious household like the St. Fleur family.
Social Impact: It often creates immediate family tension and potential isolation. The family's "great moral values" are perceived to be compromised, leading to secrecy, denial, and extreme stress for the pregnant teen, Rhonda.