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Abstract
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There are in Argentina numerous religions covering a wide range of beliefs, with their own precepts and norms which must be complied with by believers and which on some occasions are at odds with scientific rules. Jehovah's Witnesses (JW) are absolutely forbidden to receive human blood transfusion, we hereby what argentine law prescribes on the subject and some of the sentences passed by its judges. We will explain the procedure to be followed when blood transfusion or blood components are prescribed to JW, as well as possible controversy that may ensue in seeking the patient's benefit without antagonizing his creed.
METHOD and Materials JW interpretation of the Bible will be taken into account. We will look into argentine law concerning the matter in the past when they were considered member of a sect as well as nowadays when they have status of a lawfully admitted religious group. Since 1994 JW have been considered as members of a religion, but previous to this as a "sect" they had no right to refuse transfusion if necessary. The first time of JW rejected a transfusion was in 1975. The woman had just given birth, but her father authorized the transfusion. Refusal to be transfused was often likened to a suicide attempt which is unlawful an so the state authoritatively forced patients to be transfused. However item 19 of our Constitution clearly states that persons have the right to decide for themselves concerning their own body. Also international law adheres to the precept of "Human Rights". Law in most developed countries, will allow individuals freedom to decide for himself. An example is the "head case" of Marcelo Bahamondez which in April 1993, underwent several appeals before various law courts till the Nation's Supreme Court accepted this patient's objection as valid reference for future similar cases. Doctor's however have continued to have qualms about their professional responsibility in risking a patient's life. When this happens doctors appeal to a judge so as not to be held guilt of "mala praxis". This causes the patient extreme anxiety about the outcome of the controversy. What to do when a patient refuses to be transfused For years patients used to submit to whatever treatment was prescribed for them by physicians, without questioning it in the least as it must be admitted, doctors resented questioning. Anglosaxon legislation was first to uphold individual rights and it was soon followed by magistrates all over the world, the outcome "informed consent". There is a difference, though, between an emergency and a programmed surgery. The patients recorded studies must include data such as date, time signatures, etc. and a complete report of the negotiation undergone and the persons involving in requiring the consent or refusal of treatment who must not be either close friends or enemies or people to whom the patient may be in debt with. All persons involved must figure their corresponding ID numbers. If the patients is inconscious or in any way alienated, his wishes may not be taken into account. In the case of small children both parents and not just one must give their consent one way or another. The patient can be offered a variety of options. Such options exist even in the case of JW. As time runs short in emergencies one must not spend too much of it in administrative procedures. Medical assistants must act in a team. In cases when there is time, a member of JW Hospital Committee may be summoned. This agents may, in case there isn't one in the Hospital, provide their own machines for recycling blood during surgery. Often not being transfused implies a longer stay in the hospital and even, in occasions, the loss of life. JW require: a) that physicians consider other treatment alternatives; b) that other more experienced medical teams be consulted; c) that contact should be made with JW Hospital Committees; d) the transfer of the patient to another hospital better equipped; d) under extreme circumstances with a mutual agreement appeal for legal aid for both patient and physician. We do not know of any medical team that was severely penalized for not transfusing a JW once all the legal requirements has been complied with.
Language: en |