CHICAGO - Any nurse can walk into a bad situation. The one Luanne Linnard-Palmer can't forget came as she readied a little boy for a blood transfusion only to be told by his mother "You know you're damning his soul to hell!"

The child's mother was a Jehovah's Witness, a faith that rejects blood transfusions. Her son had sickle cell anemia and had become extremely weak.

"It blew me away," Linnard-Palmer recalls years later. "I worried not only about my own reaction but what was going to happen to this child with a lifelong disease."

The incident planted the seeds for a newly published book by the California nurse, "When Parents Say No: Religious and Cultural Influences on Pediatric Healthcare Treatment," published by Sigma Theta Tau International.

In the case that was seminal to the book, doctors went to court and got a four-hour guardianship of the child so they could carry out the transfusion against his mother's will.

The boy went home after the transfusion and the nurse who had been so affected by the case has no idea what happened to him after that.

"American families move, change jobs. There are no longitudinal studies looking at this, at what happens the next time they receive medical care," she said in an interview.

The challenges she recounts are both religious and cultural.

A 14-year-old Muslim girl with severe burns on her arm from a cooking oil spill was recovering after surgery until her parents heard the surgeon talk about a graft made with pig skin. They demanded it be removed and the girl was ultimately left with almost no function in her lower arm.

A preteen girl with a large and rapidly growing neck tumor was recommended for immediate chemotherapy but her family said they needed three to five days to pray with their Christian congregation beforehand. After officials threatened to take guardianship of the child, she was brought back for treatment after just one day.

"But the family had been willing to risk, not maybe death, but the need for immediate treatment in order to fulfill their duties spiritually," Linnard-Palmer said.

"Just recently we had an Hispanic mother who said through interpreters.