Mother’s death raises ethical debate
Choice to reject transfusion was hers, report says
• The day before she went into labour with her first child, an excited Éloïse Dupuis had spoken to her aunt. “She said, ‘Do you realize, Auntie, that in a few days I will be holding my life’s dream in my arms?’ ” Manon Boyer recounted Tuesday.
After hemorrhaging following a caesarian birth, Dupuis, 27, a Jehovah’s Witness, repeatedly refused the blood transfusions that could have saved her life. Her baby was healthy, but Dupuis’ vital organs failed, and she was dead within a week.
News of her Oct. 12, 2016, death sparked debate in a province grappling with limits on religious freedom. Critics said her life had been sacrificed for twisted religious beliefs, and there were suggestions she had been pressured to forego treatment. But in a report made public Tuesday, Quebec coroner Luc Malouin concluded that Dupuis chose freely to refuse transfusions with full understanding of the consequences.
“I have no doubt that the medical staff tried everything to get Ms. Dupuis and her family to change their minds about the need to use blood products to save her life,” the coroner wrote. He noted the family members were all Jehovah’s Witnesses. “In accordance with their religious principles, they refused the only medical treatment available to prevent death.”
Malouin wrote that early in her pregnancy, Dupuis advised staff at the birthing centre in Lévis, Que., that she would not accept transfused blood, which Jehovah’s Witnesses believe is forbidden by the Bible.
After complications during her labour, Dupuis was transferred on Oct. 6 from the birthing centre to Hôtel-Dieu Hospital in Lévis, where a C-section was performed and her baby was delivered in good health.
But soon after she began hemorrhaging and was transferred to intensive care. She was diagnosed with anemia — a shortage of red blood cells — and doctors performed a hysterectomy.
In studying her medical records, Malouin found five occasions when Dupuis told doctors she did not want a transfusion, even as her condition deteriorated. “Refusal of transfusion even if death is the result,” one note said the evening after she gave birth.
After she was sedated, her husband and parents maintained the refusal to provide Dupuis with blood. She died Oct. 12 of multiple organ failure caused by loss of blood.
The coroner noted her death struck a chord in Quebec, where the practice of Catholicism has been largely abandoned and strongly held religious beliefs are often viewed with suspicion.
“At a time when a majority of Quebecers do not actively practise any religion, this notion of respecting religious rules seems to come from a different era,” Malouin wrote. “There was a time in Quebec when such rules were very present and governed the lives of all. It is no longer the situation today, but the choice to adhere or not to religious rules must be respected.”
In a second case from last year studied by Malouin, doctors in a Montreal hospital had to wait six hours before providing transfusions to Mirlande Cadet, also a Jehovah’s Witness.
She had indicated at admission that she did not want transfusions, and when her condition deteriorated after a caesarian birth, her husband maintained the refusal. He relented after the woman’s parents intervened, but Cadet died on Oct. 3.
Malouin said it was impossible for him to determine whether the delay in transfusing played an important role in her death from a pulmonary infection.
In his report on Dupuis’ death, Malouin said the law is clear that adults of sound mind are free to refuse medical treatment. The same is not true of minors. Last September, the Quebec Superior Court authorized the McGill University Health Centre to give blood transfusions to a 14-year-old cancer patient, who had refused the treatment because of her beliefs as a Jehovah’s Witness.
Dupuis’ husband, Paul-André Roy, sent a message to media Tuesday saying his wife’s refusal of transfusion “was out of respect for her convictions, to which she attached a great price.”
But Boyer believes the price was too high.
“I agree with freedom of religion, but not at any cost,” she said. “Her son Liam had the right to have a mother. He had the right to feel secure. He had the right to be breastfed. He got nothing.”
THE CHOICE TO ADHERE OR NOT TO RELIGIOUS RULES MUST BE RESPECTED.
Éloïse Dupuis, 27, a Jehovah’s Witness, would not consent to blood transfusions after a caesarian birth in 2016. Her baby survived, but she died. Quebec coroner Luc Malouin concluded that Dupuis chose freely to refuse transfusions with full understanding of the consequences.