From the Guidelines
Jehovah's Witnesses typically refuse blood transfusions, and medical professionals must respect this decision while exploring alternative treatments, such as bloodless medicine options, to prioritize their morbidity, mortality, and quality of life outcomes. When considering blood transfusion in Jehovah's Witnesses, it is essential to discuss alternative treatments early, document the patient's specific wishes, and prepare advance directives 1. Bloodless medicine options include erythropoietin to stimulate red blood cell production, iron supplements to treat anemia, cell salvage techniques to collect and reinfuse a patient's own blood during surgery, volume expanders like saline or Ringer's lactate to maintain blood pressure, hemostatic agents to control bleeding, and minimally invasive surgical techniques.
Some key points to consider when dealing with Jehovah's Witnesses who refuse blood transfusions include:
- Respecting their decision while exploring alternative treatments
- Discussing alternative treatments early and documenting the patient's specific wishes
- Preparing advance directives to ensure the patient's wishes are respected
- Considering bloodless medicine options, such as cell salvage techniques, to minimize blood loss and transfusion requirements
- Being aware of the patient's individual preferences and values, as some may accept certain blood fractions or components, such as albumin, immune globulins, or clotting factors 1.
In emergency situations involving unconscious patients or minors, legal and ethical considerations become more complex, often requiring court intervention to determine appropriate care while balancing religious freedom with medical necessity. However, the patient's right to refuse blood transfusion is virtually unlimited, unless their decision-making capacity is impaired or their refusal constitutes a threat to public health 1. Ultimately, the goal is to prioritize the patient's morbidity, mortality, and quality of life outcomes while respecting their autonomy and religious beliefs.
From the Research
Blood Transfusion in Jehovah's Witnesses
- Jehovah's Witnesses refuse blood transfusions due to their religious beliefs, which can lead to conflicts with medical staff and ethical dilemmas 2, 3.
- The refusal of blood products by Jehovah's Witnesses raises questions about individual rights versus society's rights, and the value of human life 3.
- In emergency situations, the presumption is to render life-saving treatment, but a written advance directive can be developed to respect the religious convictions of Jehovah's Witnesses and the ethical and legal responsibilities of physicians 2.
Clinical Strategies
- Clinical strategies for the medical care of Jehovah's Witnesses include the use of bloodless medicine, blood substitutes, and surgical advances to minimize blood loss 4.
- A team approach and good communication between physicians are essential for successfully caring for Jehovah's Witness patients who refuse red blood cell transfusions 4.
Ethical Considerations
- Psychologists in medical settings may be confronted with Jehovah's Witness parents refusing blood transfusions for their children, and must consider ethical principles and standards to provide informed and ethical consultations 5.
- The values of the Jehovah's Witness community and the origin of the blood transfusion taboo must be understood to provide appropriate support and guidance 5.
- Medical and legal professionals have approached this dilemma in various ways, and psychologists must be aware of these approaches to provide effective support 6, 5.