Vignette 2: Ethical Dilemmas

The case scenario presents Mark who has been involved in a car accident. Mark has suffered significant internal bleeding and needs a blood transfusion immediately for his survival. This has been clearly stated by his attending doctor. Mark is still conscious and oriented. Mark is a Jehovah’s Witness and receiving blood is against his religion. Mark signs a Refusal of Treatment document stating his wish not to receive a blood transfusion under any circumstances. His girlfriend, Pam, wants him to receive blood and is asking the nurse to administer blood despite Mark’s refusal. This situation presents an ethical dilemma to the health professionals involved in Mark’s care. The ethical dilemma is whether to uphold his decision not to receive the blood and therefore risk his life or give him the blood to save his life despite knowing his religious status and beliefs. There are several ethical principles involved in this scenario. The ethical principles of respect for Autonomy, Beneficence, Non-maleficence, Veracity and Fidelity will be discussed in the latter part of this essay. There are also legal concepts to be considered in this scenario which are legal principles of ‘Consent’ and ‘Right to refuse treatment’ which can also be addressed as the contemporary issues that is being faced by the health practitioners these days.

People from all walks of life face many ethical dilemmas. These dilemmas have consequences. Our worldview determines how we deal with these dilemmas, and guides us to the right decisions. In this essay, I will examine an ethical issues through my Christian worldview. I will also present other viewpoints, and compare them to mine.

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.

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.

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.

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.

The nurse should of doubled or even tripled checked that the patient understood exactly what was about to happen to her body. It is a proven fact that nurses are easier to approach rather than doctors, therefore it makes sense to have to nurses more involved in informed consent. This would make the patients more comfortable rather than not wanting to feel dumb asking the doctor questions. Which it is not dumb to ask questions and have concerns but some individuals feel as though it is. The nurse is the one that is at their bed side taking care of them and that is one person medically that they trust because they see them on a regular basis. It only makes sense for part of the nurse’s job to reassuring the patient and making sure that they fully understand everything about the procedure. Also dealing with health literacy is one main question; is the child capable of making the decision themselves? This judgement depends on the child’s maturity, decision making process, and their ability to understand of medical terms. Therefore, as a nurse, one should be able to conclude if the patient, that is underage, has the ability to make this important choice on his or her

Since the patient was a Jehovah Witness she refused any treatments involving a blood transfusion because she felt that if she accepted the blood transfusion she would be going against her family and religious beliefs. Her husband who was also at her bedside agreed with his wife 's decision. Eventually her husband left to pick up their children from daycare. Her condition worsened and she decided to change her mind because she realized that she was really going to die if she did not have the transfusion and wanted to be around for her children. She then asked the nurse if she could still receive the blood without informing her husband of her decision. The nurse was so relieved with the patient’s decision and informed the healthcare provider. Because of this decision the patient and unborn child were able to make a full recovery.

As a general guideline, the Obstetrician orders the pertinent laboratories; aPTT, PT, H&H, CBC’s, Coagulation test, Type and cross match, AST and ALT, BUN & creatinine test. Additionally, its follow by a strict diet prior conception and during pregnancy like the consumption of iron 325mg per day to help with the production of red blood cells, and folic acid 400mg to help with production or red blood cells and decrease neural defects on newborn and intake of Vitamin B12 that helps to reproduce and maintain red blood cells and supports the development of the neurological system. Besides The communication, the patient also understands the risk factors and is more aware of the possible complications she and her fetus might face during the procedure. As we may already know, the patient has the right to refuse or accept treatment in accordance with her beliefs. As a health care professional, we have to respect and honor her wishes. As a nurse, we should not have the impression that all Jehovah’s Witness will refuse blood transfusion because not all often follow the same guidelines. Based-on that the Obstetrician works together with patient to prevent hemorrhagic episodes during and after delivery,

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,

Blood transfusion is a practice that breaks rules of their religion. As an adult they are allowed to refuse transfusions, even though it is said that approximately 1,000 Jehovah’s Witnesses die every year from their denial of blood transfusions (Wilson, 2005). When it comes to children in the United Kingdom, however, the doctor is allowed to do a blood transfusion, if needed, against the parent’s wishes. The protection that is behind this is the Children Act of 1989. This act states that although the parent’s rights are considered, it is ultimately the well being of the child that is the priority (Wilson, 2005). Acts like this are reassuring to see, and are a big improvement that will continue to help save the lives of

Since there is a severe blood loss, a blood transfusion should be considered when life-threaten, which need a blood test to get the correct blood type of the patient first. However, due to the patient’s belief in such a case, that the patient is not competent to make an informed decision and there is no immediately contactable family or friends, the medical practitioner can treat the patient according to a professional judgment of the patient’s best interests (Legal and Regulatory Services.2005.), or discuss possible treatment options with Hospital Liaison Committee (Australian Red Cross Blood

The tell tale vignette has some enforceable standard issues, which are standards on privacy and confidentiality, standards on assessment, standards on human relations, standards of competence and standards on therapy. In order to deal with the client’s problem, the psychologist has to use the ethical decision making process as a guide to ensure that the problem in question was solved by critically analyzing and evaluating the process to solve the problem. These are the step I would take while using the Canadian Code of Ethics for Psychologist and the Ethical Decision Making Process. The first thing to do was to identify the individuals who are involved in the situation, and in this vignette, there was Rosalinda; the six years old who had witnessed

How could Cindy can assure herself that she would not receive any blood products no matter what happened? If you read this case you would think, there is none. Cindy should have sign a second refusal consent for blood products saying that she understood all risk including death when she agree to undergo a dilatation and curettage procedure.

Amongst religions, each one holds a variety of practices and beliefs. "The religion then of every man must be left to the conviction and conscience of every... man to exercise it as these may dictate." - James Madison. This quote states that every man has their own right to believe and practice whatever they please. Child Jehovah witnesses should not be forced to be held back from undergoing blood transfusions when needed because although religious freedom exists, it is their individual uninfluenced choice and because it should not be left to the parent's decisions based on their religious beliefs'.