Blood transfusion in children: the refusal of Jehovah’s Witness parents’

Abstract

<jats:title>Abstract</jats:title><jats:p>In Italy, both parents have parental responsibility; as a general principle they have the power to give or withhold consent to medical procedures on their children, including consent for blood transfusion; however these rights are not absolute and exist only to promote the welfare of children.</jats:p><jats:sec id="j_med-2018-0016_s_006_w2aab3b8d472b1b7b1aab1c15b2Aa"><jats:title>Methods</jats:title><jats:p>The Authors discuss ethical and legal framework for Jehovah’s Witness parents’ refusal of blood transfusion in Italy. They searched national judgments concerning Jehovah’s Witness parents’ refusal of blood transfusion – and related comments – in national legal databases and national legal journals, and literature on medical literature databases.</jats:p></jats:sec><jats:sec id="j_med-2018-0016_s_007_w2aab3b8d472b1b7b1aab1c15b3Aa"><jats:title>Results</jats:title><jats:p>In the case of Jehovah’s Witness parents’ refusal of blood transfusion for their child, Italian Courts adopt measures that prevents the parents from exercise their parental responsibility not in the child’s best interest.</jats:p></jats:sec><jats:sec id="j_med-2018-0016_s_008_w2aab3b8d472b1b7b1aab1c15b4Aa"><jats:title>Discussion</jats:title><jats:p>In the event that refusal by the parents, outside of emergency situations, exposes the child’s health to serious risk, health workers must proceed by notifying the competent authority, according also to the Italian Code of Medical Ethics.</jats:p></jats:sec><jats:sec id="j_med-2018-0016_s_009_w2aab3b8d472b1b7b1aab1c15b5Aa"><jats:title>Conclusion</jats:title><jats:p>When the patient is a minor, the child’s best interest always come first.</jats:p></jats:sec>

Trauma e transfusão sanguínea precoce: o desafiante manejo de hemorragias em Testemunhas de Jeová.

“…On its turn, the right to life is not absolute 13 her own values and legal limits), and justice (equitable distribution of medical resources, considering that everyone is equally entitled to them) (1,18,19 . Figure 1 This understanding still has support in the exists only to protect the minor and provide the necessary conditions for his (her) welfare 16 . It can never be exercised in a way that endangers the minor's life.…”

“…It can never be exercised in a way that endangers the minor's life. Some authors even consider the refusal of the transfusion by the parents as a clear form of child abuse, child neglect, or lack of attention to the rights of the child, and, because of these reasons, they justify the judicial limitation of the power of the father, when there is a risk situation for the minor 16 .…”

“…According to this system, the refusal of transfusions constitutes a rule of conduct to be observed, even if society ignores or belittles it19 . This positioning is valid only as long as there is no risk of impending death associated with the patient's condition[15][16][17][18][19] .If there is risk of death, the border of the autonomy of the patient's will ends and the autonomy of the doctor's duty to act begins20 . Aspreviously stated, to constrain the patient to accept a therapeutic measure with which he (she) does not agree, being under a condition in which he (she) becomes vulnerable, is a crime, with the exception directly related to the medical practice, defined in the 3 rd paragraph of the aforementioned article 146 (Penal Code): "It is not understood in the provision of this article: the medical or surgical intervention without the patient's consent or his (her) legal representative's consent, if justified by an imminent risk of death.".…”

“…It is believed that this autonomy should be exercised in its entiretywithout prejudicing the rights of third parties, even authorizing the individual to refrain from receiving the medical care he (she) needs for reasons of religious belief 14 . This may be visualized in the context of the denial of blood transfusion in Jehovah's Witnesses, and, beyond, in the hospital context in general, since the physician should, whenever possible, abide by what his (her) patient decides, respecting his (her) autonomy 15 .It is true that because life is inviolable, so is the body; so, it is necessary to request the consent of the patient regarding the performance of transfusion procedure, discarded the hypothesis of danger to life[15][16][17] .By making the maximum commitment to give life to save lives, the physician also commits himself (herself) to the welfare of the fellow in such a way that he (she) spends all efforts on this toil.…”

A importância da bioética na prática odontológica: considerações atuais da literatura

“…Vale ressaltar que a bioética não pode estar atrelada nem à intolerância, nem à moral do "não", ela deve, pelo contrário, apontar para o "fazer", mais do que para o "proibir"; deve discutir o que fazer, com quem, a quem, com quais meios, com que objetivos, de forma que as relações entre ética e ciência biomédicas sejam marcadas pela liberdade do homem e pelo respeito a todos os seres humanos 7 .…”