In open heart surgery, a blood transfusion may be necessary, writes Dr Muiris Houston
The decision of the High Court to authorise the use of blood products during an infant's cardiac surgery, despite the mother's objections, is not surprising.
Declining treatment on religious grounds occurs infrequently, but the medical profession does have a duty of care to the infant which may transcend a parental right to refuse consent for treatment.
Writing in Clinical Practice and the Law, Dr Simon Mills has summarised the rationale behind such legal decisions as: "Parents may be free to become martyrs themselves, but it does not follow that they are free in identical circumstances to make martyrs of their children before they have reached the age of full and legal discretion, when they can make choices for themselves."
The issue of the child's capacity to give informed consent for treatment, which would be a factor in a young teenager, clearly does not arise in this case.
Janice has already undergone the most hazardous part of her treatment when she had major surgery to repair the hole in her heart on March 19th. Next week's more routine operation involves the next stage in correcting her congenital heart defects.
Congenital heart disease occurs in 1 per cent of all live births. The most common problems include the presence of a hole in the dividing wall of the heart. When this occurs in the organ's upper chambers, it is called atrial septal defect. When it occurs in the lower chambers, it is referred to as a ventricular septal defect.
It appears from the information given to the court that Janice may have been born with both a septal defect and a condition known as congenital aortic stenosis.
The aorta is the main vessel taking blood from the heart to the body. In aortic stenosis it is narrowed and this prevents the adequate flow of blood to the brain and lower body. Next week's surgery will repair this defect and may also involve the replacement of the aortic valve.
Because of the extensive nature of such open heart surgery, it may be necessary to transfuse the child with blood products. It would be wrong to attempt the operation without the go-ahead to use blood.