Ethical Implications in Nursing

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.

Nurses rely on personal knowledge and their professional skills to provide ethical care (Creasia & Friberg, 2011). In everyday practice, nurses must balance the needs of their patients against those of the organization, society and themselves. They strive to deliver the highest level of care for patients, but adjusting for limited organizational and personal resources often requires difficult decisions. This paper explores the following scenario suggested by Maville and Huerta: “You are a nurse providing home care to a mother, and you suspect child abuse after observing the mother’s reaction to her child” (as cited by Arizona State University, 2014). When faced with a moral dilemma, a competent nurse incorporates ethical, bioethical and legal considerations. In the proposed story, incorporating the nursing ethics of advocacy, beneficence, nonmaleficence and collaboration will guide the nurse towards an appropriate and legal course of action.

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.

Jehovah's witnesses’ faith allows them to seek medical help; however, they do not accept blood transfusions. This belief arises from a biblical passage that states "Only flesh with its soul- its blood-you must not eat (Genesis 9:3-4), "You must not eat the blood of any sort of flesh, because the soul of every sort of flesh is its blood. I will set my face against that person who eats blood...Anyone eating it will be cut off” (Leviticus 17:10, 13-14). These passages are interpreted by Jehovah's witnesses as forbidding the transfusion of any blood products. The following presentation will address legal and ethical issues that can arise from this scenario.

Allowing someone to die: Some religious affiliations (Jehovah’s witness) will not receive a blood transfusion. They have decided not to take advantage of medical technology to preserve life. If such person is in a life & death situation and required a blood transfusion in order to survive the choose to die vs. receiving a blood transfusion.

Notably, Jehovah Witness patients’ religious teachings prohibit their believers from Blood transfusion, euthanasia, autopsy and Artificial insemination. These medical practices are against the Biblical teachings of the Jehovah Witness since they consider them to be unholy. Further, they believe the medical interventions to interfere with God’s intentions for human life hence they disallow their followers from practicing

For many people Christianity is the religion of choice and a way of life. Jehovah?s Witnesses are one subgroup of the Christian faith. The JW religion was founded in 1872 by Charles Taze Russell. They comprise 1.2 million of the U.S. population (Campbell, Y., Machan M., & Fisher, M., 2016). They present a unique challenge to the medical community because of their stance on blood transfusions. Part I will provide a

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

I have had patients with cultural belief of refusing blood products. When getting report I was told the nurse tried to convince them to receive the blood transfusion. They refused even when told they could die without it.

For this paper I interviewed a fairly new nurse who faced an ethical dilemma involving medical treatment of a Jehovah Witness. The dilemma she faced was that her patient was dying and needed a blood transfusion in order to survive. The patient was a 29-year-old female who was pregnant with her third child. She was brought to the hospital suffering from the effects of a car accident. It was suspected that she was bleeding internally as well as having a broken arm, and contusions to her head. The nurse informed the patient of the critical nature of her condition and that the plan of care for her was an immediate blood transfusion.

Jehovah witnesses believe in medical care but they do not believe in blood transfusions. Their belief stems from certain passages in the bible that say to abstain from blood. These passages include, “Only flesh with its soul-its blood-you must not eat” (Genesis 9:3-4); “Abstain from…fornication and from what is strangled and from blood” (Acts 15:19-21). “ You must not eat the blood of any sort of flesh, because the soul of every sort of flesh is its blood. I will set my face against the person who eats blood…Anyone eating it will be cut off” (Leviticus 17:10, 13-14)(Catlin, 1996, p. 195).” They have the ideation that if they receive blood they will not be able to enter into kingdom of heaven. Jehovah witnesses generally carry a form of identification with them incase of an emergency indicating that they do not want to receive blood transfusions. This identification can be a medical bracelet or necklace, a card in their wallet, or possibly even a tattoo that identifies them (Catlin, 1996).

Ethical issues in nursing will always be an ongoing learning process. Nurses are taught in nursing school what should be done and how. Scenarios are given on tests with one right answer. However, there are situations that nurses may encounter that may have multiple answers and it is hard to choose one. “Ethical directives are not always clearly evident and people sometimes disagree about what is right and wrong” (Butts & Rich, 2016). When an ethical decision is made by a nurse, there must be a logical justification and not just emotions.

"You shall not eat the blood of any creature, for the life of every creature is its blood" (Lev. 17:14). This is just one of the several scriptures found in the bible from which the Jehovah Witnesses base their beliefs. To summarize the above excerpt, Jehovah Witnesses strongly believe that contributing to the health of their bodies by way of any type of blood material is not intended by God’s will. However in dire cases, ethical questions need to be raised regarding the patient’s mental capacity and legal competence. In particular cases concerning minor patients, where mental capacity is accounted for, parents should not have the dominant opinion about how their child wants to receive surgery based on their own personal beliefs.

The ethical dilemma is a situation by which it’s difficult to determine whether a situation is can be handled without disappointing both sides. Therefore, an ethical dilemma exists when the right thing to do is clear or when members of the healthcare team cannot agree on the right thing to do. Ethical dilemmas require negotiation of different points of view (potter, Perry, Stockert, & Hall 2011pg 78).