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Bioethics Cancer Medicine Religion

Reacting to Jehovah’s Witnesses’ refusal to accept blood transfusions

Yesterday, I wrote about the overwhelmingly sad case of Dennis Lindberg, the 14-year old Jehovah’s Witness who died because of his misguided adherence to the twisted interpretation of a 3,000 year old Biblical text and the court’s acquiescence to this lunacy. So did P. Z. Myers. In response to the post on Pharyngula, I saw a comment that disturbed me greatly:

At the hospital where I work we have a procedure in place just for JW’s. We have a stack of court orders waiting. When the patient loses consciousness a doctor fills out a form declaring them no longer capable of making their own decisions, someone fills in the name and date on the court order and takes it to the judge (who is not like THAT judge), wakes him up if necessary, he signs, we give the transfusion. If parents are refusing treatment for a minor, we call the police and they are arrested for criminal neglect of a minor. If the patient lives, we drop the charges.

Sometimes, of course, this all takes too long and we lose them. But we try. Our most recent case involved a mother 22 years old who had just given birth to twins. She had bled so much she was in real danger of dying, and she knew it.

We saved her. I don’t know if she is glad, but we are.

As much as I can, as a physician, sympathize with this viewpoint, I nonetheless found it appalling.

Although I can pretty much agree with this approach in the case of minors who are Jehovah’s Witnesses and would probably have few qualms about implementing it in the case of patients under, say 14 years old (15-18 years old would be a gray area), such a policy is completely misguided and wrong when applied to adults. Indeed, as nearly all bioethicists would certainly agree, such a policy is completely unethical applied to adult Jehovah’s Witnesses.

The reason is obvious. In a free society, adults have domain over their own bodies and should be allowed to refuse treatment, regardless of the reason for their refusal, as long as their refusal doesn’t endanger others (highly contagious and deadly diseases, for example). It really doesn’t matter one whit if the reason for refusing life-saving treatment, be it transfusion, chemotherapy, or whatever, is a careful consideration of the risk/benefit ratio, a desire to pursue quackery instead of evidence-based medicine, or religious delusions based on a tortured interpretation of ancient scripture developed a mere 62 years ago, such as the teachings of the Jehovah’s Witnesses about blood transfusion–or whatever. Treating a competent adult against his or her clearly stated wishes is a profound violation of person and intolerable in a free society.

Of course, for children, it’s an entirely different matter.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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