{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:41:56Z","timestamp":1753882916776,"version":"3.41.2"},"reference-count":24,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["SAGE Open Medical Case Reports"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:p> We present a 59-year-old female Jehovah\u2019s Witness patient transferred from another facility to our tertiary center as an emergency case owing to anemia due to gastrointestinal bleeding. A computed tomography scan and gastroscopy confirmed an invasion of the duodenum by a malignant process. The patient underwent a Whipple procedure and a right hemicolectomy refusing blood transfusion. On the 17th postoperative day, the patient was discharged following a successful surgery. This article\u2019s objectives are to first highlight the moral and ethical quandary and then share our surgical experiences with this particular patient population. In conclusion, Jehovah\u2019s Witnesses\u2019 management of major abdominal surgery poses considerable clinical, moral, and legal difficulties. Despite them, doctors must put the patients\u2019 needs first while also honoring their religious convictions. However, urgent situations continue to arise, forcing medical professionals to weigh their religious convictions against the need to save a patient\u2019s life. <\/jats:p>","DOI":"10.1177\/2050313x231220836","type":"journal-article","created":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T12:40:20Z","timestamp":1703335220000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Major abdominal surgery for Jehovah\u2019s Witnesses: Challenge while practicing bloodless medicine in a middle income country"],"prefix":"10.1177","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9593-2502","authenticated-orcid":false,"given":"Aleksandra","family":"Gavrilovska-Brzanov","sequence":"first","affiliation":[{"name":"Medical Faculty, University Clinic for Traumatology, Orthopaedic Diseases, Anaesthesia, Reanimation, Intensive Care and Emergency Centre, University \u201cSS Cyril and Methodius,\u201d Skopje, Macedonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darko","family":"Gjambaz","sequence":"additional","affiliation":[{"name":"Medical Faculty, University Clinic for Abdominal Surgery, University \u201cSS Cyril and Methodius,\u201d Skopje, Macedonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filip","family":"Naumovski","sequence":"additional","affiliation":[{"name":"Medical Faculty, University Clinic for Traumatology, Orthopaedic Diseases, Anaesthesia, Reanimation, Intensive Care and Emergency Centre, University \u201cSS Cyril and Methodius,\u201d Skopje, Macedonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikola","family":"Brzanov","sequence":"additional","affiliation":[{"name":"Medical Faculty, University Clinic for Traumatology, Orthopaedic Diseases, Anaesthesia, Reanimation, Intensive Care and Emergency Centre, University \u201cSS Cyril and Methodius,\u201d Skopje, Macedonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marija","family":"Jovanovski Srceva","sequence":"additional","affiliation":[{"name":"Medical Faculty, University Clinic for Traumatology, Orthopaedic Diseases, Anaesthesia, Reanimation, Intensive Care and Emergency Centre, University \u201cSS Cyril and Methodius,\u201d Skopje, Macedonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atanas","family":"Sivevski","sequence":"additional","affiliation":[{"name":"Medical Faculty, University Clinic for Gynecology and Obstetrics, University \u201cSS Cyril and Methodius,\u201d Skopje, Macedonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuzmanovska","family":"Biljana","sequence":"additional","affiliation":[{"name":"Medical Faculty, University Clinic for Traumatology, Orthopaedic Diseases, Anaesthesia, Reanimation, Intensive Care and Emergency Centre, University \u201cSS Cyril and Methodius,\u201d Skopje, Macedonia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2023,12,23]]},"reference":[{"key":"bibr1-2050313X231220836","volume":"36","author":"Murthi GS","year":"2020","journal-title":"J Anaesthesiol Clin Pharmacol"},{"doi-asserted-by":"publisher","key":"bibr2-2050313X231220836","DOI":"10.1007\/s00101-010-1701-2"},{"doi-asserted-by":"publisher","key":"bibr3-2050313X231220836","DOI":"10.4103\/0974-2700.136868"},{"doi-asserted-by":"publisher","key":"bibr4-2050313X231220836","DOI":"10.1093\/bja\/aev161"},{"doi-asserted-by":"publisher","key":"bibr5-2050313X231220836","DOI":"10.1053\/j.ajkd.2011.05.030"},{"doi-asserted-by":"publisher","key":"bibr6-2050313X231220836","DOI":"10.4174\/astr.2015.88.2.106"},{"doi-asserted-by":"publisher","key":"bibr7-2050313X231220836","DOI":"10.1016\/j.jamcollsurg.2013.05.020"},{"key":"bibr8-2050313X231220836","first-page":"33","volume":"10","author":"Trzci\u0144ski R","year":"2015","journal-title":"Prz 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