Forced Blood Transfusion of a member of Jehovah's Witnesses
The guidelines that are in the Belmont Report give many important principles that doctors and allied health workers should follow. The guidelines in belmont principles cover a wide variety of bioethical situations that persons working in a medical field might encounter, or rights that one might expect to receive if needing medical treatment. The four main key points included are, beneficence, justice, non-maleficence, and autonomy. What if though, as a patient, these guidelines were ignored and your rights were ignored? This is exactly what happened to someone known only as patient X.
Patient X was a seventeen year old male from Australia that was suffering from Hodgkin's lymphoma, which is a severe form of blood cancer, and was being treated at Sydney Children's Hospital. Due to the treatments and chemotherapy he was receiving, X's doctors planned on giving him a blood transfusion in order to avoid anemia and a loss of healthy red blood cells. The problem of a blood transfusion for X is that he and his family are Jehovah's witnesses. According to their beliefs, the bible forbids taking or ingesting blood so the doctors orders are out of the question. In order to increase the odds of survival for X, Doctors and the Supreme Court of New South Wales decided to take a paternal view towards this case and ignore his autonomy by legally forcing a blood transfusion.
Due to the rights one has, or should receive as a patient, I think the doctors and court system made the wrong and incorrect decision. First and foremost, the treatment that X wanted to receive was ignored which subsequently took away his freedom and autonomy. Even though one of the judges admitted to X being m...
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Davey, Melissa. "Teen Witness Must Have a Transfusion, Rules Judge." The Sydney Morning Herald. The Sydney Morning Herald, 18 Apr. 2013. Web. 16 Mar. 2014. .
Mamamia Team. "He’s 17 and He’s Refusing Life-saving Treatment. This Is What Happened Next." Mamamia, Australia, 23 Apr. 2013. Web. 16 Mar. 2014. .
"Teenage Jehovah's Witness Loses Court Bid to Refuse Life-saving Blood Transfusion." ABC News. ABC News, 28 Sept. 2013. Web. 20 Mar. 2014. .
Autonomy is a concept found in moral, political, and bioethical reasoning. Inside these connections, it is the limit of a sound individual to make an educated, unpressured decision. Patient autonomy can conflict with clinician autonomy and, in such a clash of values, it is not obvious which should prevail. (Lantos, Matlock & Wendler, 2011). In order to gain informed consent, a patient
There are many ethical paradigms through which humans find guidance and justification for their own actions. In the case of contractarianism, citizens of a state are entitled to human rights, considered to be unalienable, and legal rights, which are both protected by the state. As Spinello says, “The problem with most rights-based theories is that they do not provide adequate criteria for resolving practical disputes when rights are in conflict” (14). One case that supports Spinello is the case of Marlise Munoz, a brain-dead pregnant thirty-three year old, who was wrongly kept on life support for nearly two months at John Peter Smith Hospital in Fort Worth, Texas. Misinterpretation of the Texas Advance Directives Act by John Peter Smith Hospital led to the violation of the contractarian paradigm. Although the hospital was following the directive in order to maintain legal immunity for its hospital staff, the rights of the family were violated along with the medical fundamental principle to “first, do no harm.”
According to Terrence F. Ackerman, as of the 1980s the American Medical Association had to include the respect for a person’s autonomy as a principle of medical ethics (Ackerman 14, 1982). This includes having the physician provide all the medical information to the patient even if the information could cause negative implication onto the patient. The physician is also expected to withhold all information of the patient from 3rd parties (Ackerman 14, 1982). Although it is seen as standard in today’s world, in
In conclusion, we support the Court’s conclusion to uphold the doctor’s decision not to resuscitate Charlotte Wyatt on the grounds that she was no longer truly living and her prolonged existence and suffering did not outweigh the sum of the costs to both herself and everyone involved. Although ownership, or responsibility for a minor usually falls upon the parents or guardians, under these conditions they were unable to make an unbiased decision due to emotional investment.
Lastly, in spite of significant advances in the diagnosis and treatment of illnesses, quality of patient care is affected when the hospital's treatment team confronts a variety of ethical and medical dilemmas when treating patients with different religions do not accept all types of medical interventions. For example, the population of Jehovah’s Witnesses is approximately eight million worldwide, hence as diversity increases, hospitals will need to understand this religion to provide satisfactory health outcomes. Hospitals need to recognize and understand that Jehovah’s Witnesses refuse blood transfusions based on the bible commandment to “abstain from blood”, where people of this religion do not ingest blood (eating meat with blood in it)
Not all cases is patient autonomy the most important thing to respect and honor. There will always be situations where Medical paternalism is justified. Justifiable paternalism in a medical perspective is prolonging patients’ lives allowing them to exercise their autonomy. Failing to respect a patient’s treatment requests or denials is a violation of the autonomy at that point in time during their illness. While the previous statement is true, the medical professional is violating a patient’s future autonomy. For this reason, medical professionals have the right to act paternalistically, therefore medical paternalism is justified by means of future autonomy and obligations to promote patient
This is a fascinating case because it presents the distinction between a patient’s right to refuse treatment and a physician’s assistance with suicide. Legally, Diane possessed the right to refuse treatment, but she would have faced a debilitating, painful death, so the issue of treatment would be a moot point. It would be moot in the sense that Diane seemed to refuse treatment because the odds were low, even if she survived she would spend significant periods of time in the hospital and in pain, and if she didn’t survive she would spend her last days in the hospital. If Diane were to merely refuse treatment and nothing else (as the law prescribes) than she would not have been able to avoid the death which she so dearly wanted to avoid.
The physicians and nurses spent some time trying to explain to the patient’s daughter how a blood transfusion was not necessarily a life saving measure, but a way to make the patient more comfortable. To me, it seemed like a possible ethical issue. The daughter obviously viewed it as a lifesaving measure which went against her mother’s wishes. Cori and I, for the most part, stayed out of the blood transfusion discussion. Instead, we focused on how the daughter was going to manage her mother’s care once they left the hospital. Previously, the patient was living alone, in the country, approximately 20 miles from the nearest rural community. The daughter lived in the community, with no other support close by to help. There was no way the patient could return to her home alone
Instead they compromised on a combination treatment of the herbal treatment the family found and also care from a oncologist that may involve some radiation. This was the best outcome for both the family and the state. In the articles it constantly points out that Abraham is a very “smart and thoughtful” but still his is a minor (Caplan, 2006). Since he is a minor, the parents are left to make the decision of what they think he should do and in this case it was not the treatment that best guaranteed his survival. Future cases like this one I think can only be settled in court, especially when the rate of survival with the medically recommended treatment is so high. The right decision was made from this case and it took the state and the family coming together and working on a compromise to make that happen. I think even though Abraham is a minor he should have a right to say what goes in his body. However, the decision should be made with guidance from the doctors and his family because they both are looking out for the patient best interests (Caplan,
Mark a 28 year old Jehovah’s Witness is found bleeding internally after a car disaster. He needs an immediate blood transfusion of 3 units of blood as it is crucial for him to recover his current blood loss. A Refusal of Treatment document is signed by Mark as he was still conscious and mindful of his surroundings. His companion Pam which is his girlfriend urged the nurse to reject the document and give the blood transfusion or else she would file a case to the hospital if there will be no treatment given to Mark. In this scenario there are ethical complications that are spotted and proper principles that need to be considered. There are some possible conclusions in which the nurse should think of before executing his/her choice. His girlfriend Pam may or may not have proper rights to charge the hospital for refusing to provide blood to Mark.
Disclosure of pertinent medical facts and alternative course of treatment should not be overlooked by the physician in the decision making process. This is very important information impacting whether that patient will go along with the recommended treatment. The right to informed consent did not become a judicial issue ...
The Donald (Dax) case could have been handled well if the medical professionals allowed Dax to make his own decisions regarding his treatments and gave
One of the major ethical issues in this case is the fact that there is a lack of informed consent. Doctors are not talking clearly with their patients they are not giving the right to patients to know about the potential risks and alternative procedures they could make. Instead, doctors are practicing defensive medicine and ordering extra tests and individuals they know have no hope. Another major issue is the fact that individuals are not given the right to self-determination. Every human being of adult with a sound mind has the right to determine what shall be done with his or her own body, and unfortunately, are not respecting people’s rights.
In two cases, decided three years apart, blood transfusions were decided to be invasive and therefore greatly violative of bodily integrity. In re Brown, 294 Ill.App.3d 159, 171 (1997). Logically this would cause the parens patrie power of the State to be less effective. However, Brown has not been cited for the blood transfusion determination since it was handed down. It even conflicts with a case in the same appellate district that found blood transfusions to be a “relatively non-invasive and risk-free procedure” especially as compared to a caesarean section. In re Baby Boy Doe, 260 Ill.App.3d 392, 402 (1994). While the case law is conflicting, giving grounds for a judge to possibly choose between the determinations, Baby Boy Doe did leave the determination of whether or not a non-invasive blood transfusion may be forced upon a religiously objecting person by a court. Id. Depending on how the court wishes to proceed, Brown might have answered that
Mark is still conscious and oriented and informs the nurse that he does not wish to receive a blood transfusion under any circumstance because he is a Jehovah’s Witness and receiving a blood transfusion goes against his religion. Mark presents the nurse will a signed Refusal of Treatment document. Pam, Mark’s girlfriend insists that the nurse ignore the document and administer the blood. She threats to sue the nurse and the doctor for negligence if Mark is not given the blood. The ethical dilemma is therefore whether the nurse should act to support Mark’s right to make his own decision (by not administering the blood transfusion) or to act to save his life (according to Pam’s wishes) by administering the blood