Jehovah's Witnesses and autonomy: honouring the refusal of blood transfusions

Abstract

This paper explores the scriptural and theological reasons given by Jehovah's Witnesses (JWs) to refuse blood transfusions. Julian Savulescu and Richard W Momeyer argue that informed consent should be based on rational beliefs and that the refusal of blood transfusions by JWs is irrational, but after examining the reasons given by JWs, I challenge the claim that JW beliefs are irrational. I also question whether we should give up the traditional notion of informed consent.

Pharmacotherapy in Acutely Anemic Jehovah’s Witnesses: An Evidence-Based Review

“…2 The blood ban and its implications are associated with numerous legal and ethical considerations for health care providers. [2][3][4] The right of adults with decision-making capacity to refuse medical treatment is well established in the United States, provided that informed consent is obtained and the decision is autonomous. 1 JW generally carry wallet-sized advanced directives delineating their wishes to medical personnel; however, even these documents are subject to controversy.…”

Posttonsillectomy Hemorrhage in a Pediatric Jehovah's Witness and the Decision to Transfuse

“…If an adult JW does not wish to undergo a blood transfusion, he or she has the right to decline this treatment due to religious belief according to the principle of patient autonomy. 2,3 However, this is not the case for pediatric patients who have not yet reached agency, where the picture is murkier. Current US legal precedent is from a 1944 case indicating that JW parents are not able to ''make martyrs of their children before they have reached the age of full and legal discretion.''…”

“…Thus, it is accepted that adult Jehovah's Witnesses have a right to refuse blood transfusions even if it will lead to death. 18 For Witnesses, refusing transfusion is an issue of religious freedom, a fundamental human right grounded in the principle of autonomy. Ethically, the state must prove that it understands the child's best interest more than the child's parents to override the parental prerogative to choose what is best for their child.…”

El rechazo en las transfusiones de sangre y hemoderivados: criterios éticos, deontológicos y médico-legales

“…Debe informar de forma clara y con un diálogo sereno y respetuoso sobre la enfermedad y las consecuencias del rechazo a la transfusión, así como de las posibles alternativas 27,28 . A nivel internacional se invita a explorar las razones para la negativa a la transfusión y en el caso de los testigos de Jehová, algunos autores llegan a recomendar la lectura de textos de testigos de Jehová que han aceptado transfusiones 29,30 . El médico es igualmente el responsable de comprobar la competencia que tiene el paciente para entender la situación y decidir conforme a dicha comprensión, debiendo velar porque la decisión que tome sea coherente con su manera de pensar y asuma las consecuencias que de ella se puedan derivar.…”