Ukumpontshelwa Igazi Ingabe Kuyisihluthulelo Sokusinda?
NGO-1941 uDkt. John S. Lundy wabeka indinganiso yokumpontshelwa igazi. Ngokusobala engenabo ubufakazi bezokwelapha bokumsekela, wathi uma ihemoglobin yesiguli, isakhi segazi esithwala umoya-mpilo, yehla ibe sesilinganisweni samagremu ayishumi noma ngaphansi kuleyo naleyongxenye eyodwa kweziyishumi zegazi, khona-ke isiguli sidinga ukumpontshelwa. Ngemva kwalokho lesosibalo saba indinganiso yodokotela.
Lendinganiso yamagremu ayishumi iye yabekelwa inselele iminyaka ecishe ibe ngu-30. Ngo-1988 iJournal of the American Medical Association yakusho ngokungagwegwesi ukuthi ubufakazi abusisekeli lesosiqondiso. Isazi sokuba ndikindiki kwemizwa uHoward L. Zauder sithi “igxile esikweni, ayiqondakali, futhi ayisekelwa ubufakazi bezokwelapha nobokuhlola.” Abanye bamane bayibize ngokuthi inganekwane.
Naphezu kwakho konke lokhu kudalulwa okunamandla, lenganekwane isahlonishwa kabanzi njengesiqondiso esinengqondo. Ezazini eziningi zokuba ndikindiki kwemizwa nakwabanye odokotela, izinga lehemoglobin elingaphansi kweshumi liyimbangela yokumpontshelwa igazi ukuze kulungiswe ukuswelakala kwalo. Cishe kungokuzenzekela ngokuphelele.
Ngokungangabazeki, lokho kuyasiza ekulinganiseni ukusetshenziswa ngokweqile kakhulu kwegazi kanye nemikhiqizo yalo namuhla. UDkt. Theresa L. Crenshaw, owakhonza Esigungwini Esasikhethwe Uhulumeni Ukuba Sicwaninge Ngobhadane Lwegciwane Elibulala Izakhi Zokuzivikela Komzimba Womuntu, ulinganisela ukuthi eUnited States iyodwa, minyaka yonke kwenziwa ukumpontshelwa igazi okungadingekile okuyizigidi ezimbili nokuthi cishe ingxenye yakho konke ukumpontshelwa kwegazi eligciniwe kungagwenywa. INkonzo Yezempilo Nenhlalakahle yaseJapane yakulahla “ukusetshenziswa ngokungakhethi kokumpompela igazi” eJapane, kanye “nenkolelo yokuphuphutheka yokuthi kuzophumelela.”
Inkinga yokuzama ukulungisa ukuntuleka kwegazi emzimbeni ngokumpompela igazi iwukuthi ukumpontshelwa kungase kube okubulala ngokwengeziwe kunokuntuleka kwalo. OFakazi BakaJehova, abenqaba ukumpontshelwa igazi ngokuyinhloko ngezizathu ezingokwenkolo, baye basiza ekuqinisekiseni leliphuzu.
Kungenzeka uye wabona izihloko zamaphephandaba ezibika ukuthi omunye woFakazi BakaJehova uye wafa ngenxa yokwenqaba ukumpontshelwa igazi. Ngokudabukisayo, imibiko enjalo kuyethukela ilandise indaba yonke. Ezikhathini eziningi, wukwenqaba kukadokotela ukuhlinza, noma ukuhlinza ngokushesha ngokwanele, okubangela ukufa kukaFakazi. Abanye odokotela abahlinzayo bayenqaba ukuhlinza ngaphandle kwenkululeko yokumpompela igazi uma izinga lehemoglobin lehla liba ngaphansi kweshumi. Nokho, odokotela abaningi abahlinzayo ngokuphumelelayo baye bahlinza oFakazi abanesilinganiso sehemoglobin esingu-5, esingu-2, ngisho nangaphansi. Udokotela ohlinzayo uRichard K. Spence uthi: “Engiye ngakuthola ngoFakazi ukuthi ihemoglobin esesilinganisweni esiphansi ayihlangene nakancane nokufa.”
Inala Yokunye Okungasetshenziswa
‘Igazi noma ukufa.’ Leyo indlela abanye odokotela abachaza ngayo ukukhetha okubhekene nesiguli esinguFakazi. Nokho, eqinisweni kunezinto eziningi ezingasetshenziswa esikhundleni sokumpontshelwa igazi. OFakazi BakaJehova abanaso isithakazelo ekufeni. Banesithakazelo ekwelashweni ngezinye izindlela. Ngenxa yokuthi iBhayibheli liyakwenqabela ukudliwa kwegazi, abakucabangeli ukwelashwa ngokumpontshelwa igazi njengenye indlela yokwelashwa.
NgoJune 1988, iReport of the Presidential Commission on the Human Immunodeficiency Virus Epidemic yasikisela ukuthi zonke iziguli zinikezwe lokho kanye oFakazi abebelokhu bekucela iminyaka eminingi: “Ukuvunyelwa okunokwaziswa kokumpontshelwa igazi noma izakhi zalo kumelwe kuhlanganise incazelo yezingozi ezihilelekile . . . kanye nokwaziswa ngezindlela ezifanelekile zokwelapha ezingefani nokwelapha ngokumpontshelwa igazi lomunye umuntu.”
Ngamanye amazwi, iziguli kumelwe zinikezwe ukuzikhethela. Okunye ukuzikhethela okunjalo uhlobo lokwelapha ngokusebenzisa igazi laso kanye isiguli. Igazi laso siqu isiguli liyalondolozwa ngesikhathi sokuhlinzwa bese libuyiselwa emithanjeni yesiguli. Lapho inqubo enjalo imane nje iwukwandiswa kwesimiso sokujikeleza kwegazi, iyemukeleka kakhulu koFakazi abaningi. Odokotela abahlinzayo bagcizelela futhi ukubaluleka kokwandisa isilinganiso segazi lesiguli ngezandisi ezingafakiwe igazi nezivumela umzimba ukuba uzakhele wona amangqamuzana abomvu. Izinqubo ezinjalo ziye zasetshenziswa esikhundleni sokumpontshelwa igazi ngaphandle kokwandisa inani labafayo. Eqinisweni, zingathuthukisa ukulondeka.
Isidakamizwa esithembisayo esibizwa ngokuthi irecombinant erythropoietin muva nje kuye kwavunyelwa ukuba sisetshenziswe ngokulinganiselwe. Sisheshisa ukukhiqiza komzimba amangqamuzana abomvu egazi, ngenxa yalokho sisiza umuntu ukuba andise igazi lakhe.
Izazi zesayensi zisafuna enye into ephumelelayo engasetshenziswa esikhundleni segazi engase ibe namandla aphawulekayo okuthwala umoya-mpilo njengabo. EUnited States, abenzi bezinto ezinjalo ezingase zisetshenziswe bakuthola kunzima ukuthola ukuvunyelwa kokusetshenziswa kwemikhiqizo yabo. Nokho, njengoba omunye umenzi onjalo aphikisa: “Uma wawucabanga ngokuletha igazi kuyiFDA [Food and Drug Administration (UMnyango Wezokudla Nezidakamizwa)] ukuze livunyelwe, ubungeke uwenze umthandazo wokuthi kazi liyoke lihlolwe yini ukuthi liwubuthi kanjani.” Namanje, makhulu amathemba okuthi ikhemikhali ephumelelayo iyotholakala eyovunyelwa njengento engasetshenziswa ethwala umoya-mpilo esikhundleni segazi.
Ngakho kukhona ukuzikhethela. Lokhu okushiwo lapha okumbalwa kwalokho okukhona. Njengoba uDkt. Horace Herbsman, uprofesa wesibhedlela sokuhlinza abhala ephephabhukwini iEmergency Medicine: “Kusobala . . . kakhulu ukuthi sinazo ezinye izindlela zokwelapha ezingasetshenziswa esikhundleni segazi. Ngempela, mhlawumbe okuhlangenwe nakho kwethu koFakazi BakaJehova kungase kuchazwe njengokusho ukuthi akudingeki ukuba sincike ekumpompeleni igazi, nazo zonke izinto eziyinkimbinkimbi ezingase zivele, kakhulu kunalokho esake sakucabanga.” Yebo, akukho kulokhu okusha ngempela. Njengoba iAmerican Surgeon yaphawula: “Iqiniso lokuthi ukuhlinza okukhulu kungenziwa ngokuphephile ngaphandle kokumpontshelwa igazi kuye kwasekelwa kakhulu ngobufakazi obulotshiwe eminyakeni engu-25 edlule.”
Kodwa uma igazi liyingozi, futhi zikhona ezinye izindlela eziphephile ezingasetshenziswa, khona-ke kungani izigidi zabantu zimpontshelwa ngokungadingekile—abaningi babo bengazi, abanye eqinisweni ngokumelene nentando yabo? Umbiko wenhlangano kandunankulu ephathelene nengculaza ngokwengxenye uphawula ukwehluleka ukufundisa odokotela nezibhedlela ngezinye izindlela ezinokusetshenziswa. Usola esinye isici futhi: “Ezinye izikhungo zegazi zesifunda bezingabaza ukuthuthukisa amasu anciphisa ukusetshenziswa kokwelapha ngokumpontshelwa igazi, njengoba inzuzo yabo yokuhlinza itholakala ekuthengisweni kwegazi nemikhiqizo yalo.”
Ngamanye amazwi: Ukuthengisa igazi kuyibhizinisi elikhulu.