Ethical Dilemma Involving Medical Treatment Of A Jehovah Witness

Ethics Dialogue Assignment: These next 6 links are to a variety of articles on ethics. They move from Secular Ethics, to Christian Ethics, then on to Medical Ethics, and finally arrive at the subject of this course, Christian or Biblical Medical Ethics. 1. Construct a 50 - 75 word, strong definition of each area of ethics - Secular, Christian, Medical, and Christian Medical. 2. Write 175 - 200 words comparing AND contrasting secular and Christian ethics. 3. Write 175 - 200 words comparing AND contrasting medical and Christian medical ethics. 4. Write 100 - 150 words as to why a solid Biblical Worldview is critical to have before you can be guided by Christian Medical Ethics?

In taking care of a patient, it is important for nurses to respect the patient, their beliefs, and their right to autonomy. Provision One in the Code of Ethics states “the nurse practices with compassion and respect for inherent dignity, worth, and unique attributes of every person” (ANA, 2015, p. 7). With a Jehovah’s Witness patient, the nurse must first acquire information regarding their religion and how it may impact their care and their wishes related to their healthcare. Once their patient’s beliefs are noted and understood, the nurse must establish a professional and therapeutic relationship with their patient without bias to their religion and the associated beliefs. The duty to act without bias can be found outlined in Provision 1.2 (ANA, 2015).

If a Jehovah witness comes into the hospital in need of a blood transfusion the doctors and nurses must respect the patient’s wishes not to have a blood transfusion.

Working in the field as health care professionals, we are faced with ethical dilemmas almost always. Although each individual posses different values, there are specific codes of conduct to abide by, despite personal beliefs. Without the use of a structural code, individuals in the health care field would make decisions based on their own personal beliefs in accordance to their culture and religion. In the case of Marion and the pacemaker, we witness the desires of the patient at hand, Marion, and her family, be interrogated by the floor nurses. Although the intent behind the actions of the floor nurses can be described as morally just, thinking they are helping preserve the life of Marion, based on medical ethics, their behavior is of some degree to be questioned. This paper will focus on the boundaries we witness crossed by floor nurses and how they go against the medical ethics approved, and what effects they have on patients and their care givers.

The purpose of this paper is to identify the characteristics, values and beliefs of Jehovah’s Witness group. It will discuss their reasoning for refusal to accept blood transfusions. The paper will elaborate on the best approach to offer appropriate care, advice and education while treating patients with respect in regards to their religious beliefs. British Journal of Nursing (2009) suggests that good, honest communication, without any element of coercion or scare tactics, is the key in the management of Jehovah’s Witness patients.

In the case where the patient makes their strong religious beliefs verbal to the healthcare provider they have an obligation to make certain there is no documented religious preference in their previous records or if the patient has a Living Will on file. The recent admission documentation may have been entered incorrectly or the patients religious preference many have not been transcribed. If this was my patient and he expressed his strong objections to a blood transfusion. I would have documented this and brought this to the attention of his doctor prior to the procedure. Also, I would exhaust every avenue to insure that this patient had no documents on file. The healthcare provider should feel an obligation to check all prior admission documentation available in unique situations. I believe this is incumbent that personnel make the best choice possible in sensitive cases. Also, contacting the patient’s primary care physician may offer some missed documentation concerning the patient’s religious preference. If no religious preference past or present has been documented. I would ethically have a problem with the blood transfusion based on my conversation with the

Julian Savulescu and Richard W. Momeyer, wrote an article expressing their theories on informed consent being based on rational beliefs. The article constructed around Jehovah Witnesses rejecting blood transfusions, and how it is theoretically irrational. Both pressed the reasoning of irrationality due to fear being based on an interpretation inconsistent with all passages of the Bible and Christian practices. Thus leading to the concussion Jehovah Witnesses are uninformed of the conflicting Biblical passages, and not fully autonomous in their decision making. Suggesting when patients act on their autonomy while regarding medical care, it must derive from rational beliefs or it will be false autonomy.

On March 7, 1998, 55 year old Mrs. Jadine Russell and her daughter were involved in a minor automobile accident. While on the side of the road assessing the damage, Jadine, her daughter, and two police officers, were taken by surprise, when alleged drunk driver Keith Cook lost control of his pickup hitting Jadine’s car. The vehicles then “Plowed” into the four victims as they stood there. “All were hurt, but Jadine suffered the most severe injury when the car pinned her against a fence and ruptured her spleen, causing massive internal bleeding and leaking blood into her abdomen” (BloodOath). Jadine, in need of serious medical attention, refused a blood transfusion. Her religious views, as a Jehovah’s Witness, kept her from receiving the blood transfusion--despite the warning from the attending physician that she would die without it. Jadine died a few hours later.

The Jehovah Witness faith forbids them from receiving blood transfusions (Panico, Jenq, & Brewster, 2011). If a member accepts a transfusion, they are shunned and forfeit their membership in the faith community and eternal life (Panico, et al, 2011). This is important to understand because this can be a life-saving ethical dilemma for many health care providers. Knowing that a person refuses a blood transfusion in an emergency is essential, because if a transfusion is given while the patient is unable to speak, the physician can be charged (Panico, et al,

When she was just a few weeks old she already showed many physical problems and receive many medical treatments. Which her parents, the appellants allowed. The physicians did not use any blood transfusions at the parent's request. As Jehovah’s Witnesses, the parents objected to it for religious reasons. They also claimed it was unnecessary. When the child, S.B. was one-month old her haemoglobin levels had dropped dramatically and the doctors believe a blood transfusion may be necessary to treat her potential life-threatening heart failure. Following a hearing on short notice to the parents the Family Division in the Provincial Court gave the Children’s Aid Society a 72-hour wardship. Two doctors testified saying that even though the child condition had improved, they still wanted to maintain the ability to do the blood transfusion in case

In the case of In re Sampson, the trial court was concerned with a 15 year old boy who was afflicted with a medical condition called neurofibromatosis, also known as Recklinghausen’s disease. Although this disease is considered non-life threatening, it had caused a massive deformity that covered the right side of the boy’s face and neck. As a result of this deformity, the boy not only became withdrawn emotionally but would not attend school which also caused him to become virtually illiterate (Hines, Malley-Morrison, Dutton, 2013 ppp440). The mother, a Jehovah’s Witness, consented to the corrective plastic surgery, however, refused to consent to a blood transfusion to accompany the surgery should it had been needed.

Nurses, who deals with Jehovah’s Witnesses, faces difficulty. The best approach is an open communication between the patient and the caregiver (Edelen 2014). The purpose is to explain in full details of the cause of refusing blood based treatment and alternative treatment. Witnesses often carried “No Blood” card, and arrange “No Blood” wristband throughout the treatment. If no alternative treatment some even rather die than receive blood treatment. For surgical emergency, it is the professional’s duty to choice option best fitted the patient wishes (Effa - Heap 2009). For medical emergency, it is best to use any option to minimize the amount of blood usage as possible. Best option is to lower the amount of blood usage and to fit the patient

You either obey Elizabeth’s father about talking to her out to get the transfusion and disobey her religion or disobey him and respect Elizabeth’s choice of obeying her faith. The doctor is also in a dilemma to either continue treating her or just tell the truth (Goldie & Lawrence 1982) and let her

Therefor they place themselves in a highly stress environment in order to provide the best care possible (Jensen,& Key,2009.p 32). However, at times there are many factors could interfere with one’s conscience and sometimes questioning. These factors cause the person to unable or failing to provide for the care that the patient require. For example, a nurse working in an emergency department might encounter a patient who is a Jehovah’s witness who is in need for blood transfusion, but due to their belief and teaching, the producer cannot be done. The nurses in this situation might feel conflicted with their conscience as they cannot do anything to help. In a prolong situation it can leads to the nurses felling useless, frustrated anger, burnout job dissatisfaction out, emotional detachment from patients which could lead to deteriorate the patient-caregiver relationship, as there is nothing that they can do but rather than to respect their choices and provide best care possible by (Genuis, & Lipp,

According to the first principle, nonmaleficience, it would not be appropriate as a professional to practice medicine based on his or her own beliefs and not consider the patients feelings about the operation. In this particular case, regarding religious constrictions the doctor must decide if the patients’ needs outweigh the ethical belief of nonmaleficience. Asserting empathy in this case could prove to be a problem. How does a person wholly understand the beliefs of another when they have not been exposed to those beliefs and culture that supplied this person with their values of living? Understanding a patient’s background can significantly impact a decision. If a doctor were to treat a Jehovah Witness with blood they need to understand the impact they would be having on their patient’s life.