Running head: ETHICS FINAL
Jehovahs Witnesses and the Refusal of Blood Transfusions
ETHICS FINAL
Jehovahs Witnesses and the Refusal of Blood Transfusions
As nurses, we may sometimes find ourselves in situations which challenge our ethics. As
nurses, we will at some point in our career, encounter a patient from a religious group known as
Jehovahs Witnesses. Like any other religion, this group has its own views and beliefs about
what is acceptable and what is not. Jehovahs Witnesses do not accept blood transfusions. This
paper will summarize what is known about the issue, it will identify and discuss the ethical
dilemma, and it will also look at the relevance to health professions, points of consensus and
concerning issues, relevant ethical analysis and personal nursing professional response to the
issue.
What is known
Jehovahs Witnesses do not accept blood transfusions. The reason for this is due to
Jehovahs Witnesses translations of biblical readings. According to JW.org, Our Conduct: We
avoid practices that displease God, including the misuse of blood by taking blood transfusions.
This statement by the religious group is the main reason for their refusal of blood transfusions.
Jehovahs Witnesses believe that only god can give life and by accepting whole blood, you are
receiving life from an outside source and not by god. Blood transfusions are also believed to
be dirty because the recipient is now receiving blood or blood products from an outside source,
this means that although the recipient may be a pure and good follower of god, they cannot be
100 percent sure that the person who donated the blood is also good and pure. This basically
ETHICS FINAL
means that if the person who donated the blood or blood products is dirty, the Jehovahs
Witness or person who received the blood products is now considered dirty as well.
Ethical Dimension of the Issue
An ethical issue which is brought up by the refusal of blood transfusions by Jehovahs
Witnesses is the issue of Jehovahs Witnesses children and the parents refusal of their children
receiving blood products. According to Chand, Subramanya, and Rao, The American Academy
of Pediatrics recommends health care providers to recognize and respect the importance of
religion in personal, spiritual and social lives of patients and to avoid unnecessary polarization
when conflict over religious practices arises. The dilemma then arises of what age is a child able
to make their own decision based on their religious beliefs and health also when is it ok for a
physician to intervene. Although, a physician must usually follow what the childs parents have
said was ok to proceed with as far as treatment, It is important to convince that every attempt
will be made to avoid blood, but also convey that a doctor would not allow a child to let die for
lack of blood transfusion. It is ethically challenging for a physician to overthrow what the
parents believe religiously but Failure to give life-saving treatment to a child could render the
doctor vulnerable to criminal prosecution.
Relevance to Health Professions
This issue is relevant to all health professions because we will all encounter a Jehovahs
Witness patient at some point during our career. It gives us the ability to understand that
communication between the patient and medical team is a contributing factor in providing
appropriate care to the patient who may not be fully willing to cooperate, due to religious beliefs.
It teaches us to remain willing and open minded with our patients, in order to keep lines of
communication open so that patients are involved in their treatment process and feel that their
ETHICS FINAL
beliefs and values are being respected. This issue gives us an opportunity to collaborate with
other medical members. It gives us the opportunity to think outside the box and come up with
unique treatment specific to that patient which allows us to treat the patient but while respecting
their religious beliefs.
Points of Consensus and difference
According to Bock, Julian Savulescu and Richard W. Momeyer argue that informed
consent should be based on rational beliefs and that the refusal of blood transfusions by
Jehovahs Witnesses is based on beliefs that are irrational. This point of difference is based on
the opinion that if any religion threatens excommunication when its followers discuss their
beliefs with outsiders or ask probing questions, then this religion is not a rational one. This
means that because Savulescu and Momeyer believe that Jehovahs Witnesses are irrational, we
should take away their autonomy, their right to informed consent. The fact that Jehovahs
Witnesses do not hold values which seem normal to the rest of society does not give anyone
the right to take their rights of informed consent away. I believe that every patient has the right to
informed consent unless a case has been taken to court and the patient has been deemed
incompetent. Respect for autonomy is one of the ethical principles which we must uphold for our
patients.
Ethical Analysis
When treating Jehovahs Witnesses patients, we must remember all ethical principles:
fairness, justice, truthfulness, and respect for autonomy, non-maleficence and beneficence. These
principles give us certain guidelines to follow, which allow us to provide the best treatment
possible while also giving the patient the respect and right to autonomy they deserve.
ETHICS FINAL
Ethical theories involve systematizing, defending and recommending concepts of right
and wrong behaviors. For the sake of this issue, Jehovahs Witnesses and the refusal of blood
transfusions, I believe that individualism must be highly considered as the care for these patients
is very individualized and the needs of each person are more important than the needs of the
whole society. This to me is basically saying that we must take care of this patient as an
individual and follow or create a plan specific to them because either way they are not following
societies norms so they have a more individualized plan of care and at that point in time when
care is being provided to this patient, that patient is what matters, not what society thinks.
Legal ethics or ethical law is used to describe a code of conduct governing proper
professional behavior, which establishes the nature of obligations owed to individuals and to
society. This goes hand-in-hand with ethical principles and also with the rules set by the
institution you work for. We must follow rules which are in place in order to protect ourselves,
our patients and other medical staff working with or around us.
For standards of practice, we must follow the rules set by the ANA. This definitive guide
tells us how to carry out our responsibilities while providing quality care and meeting ethical
obligations. It tells us what is in a nurses scope of practice, such as, who, what, where,
when, why and how.
All of these rules and regulations are set in place to not only protect us as nurses but to
protect the patient, first and foremost, also to protect everyone involved in the care of the patient.
These rules protect and set a guide for us to follow which allows for best practice.
Nursing Response
With the knowledge that weve gained through research, we can now move forward with
a better understanding of what blood products are or are not allowed by Jehovahs Witnesses. We
ETHICS FINAL
can create a care plan appropriate for the specific patient according to their beliefs and encourage
them to have an active role in their care. We can suggest having a DNR or other advanced
directives in place in order to prevent any problems during future hospital stays. We can provide
better care for our patients and not be as judgmental now that we have a better understanding of
what they practice and why.
Conclusion
Overall, I feel that I have gained a lot from the research that went into this issue. I now
have a better understanding of what a Jehovahs Witness actually is and what they believe. I feel
that I will be better equipped to handle a situation involving a Jehovahs Witness, if or when I
encounter this during my nursing career. I have a better understanding of the ethical concerns and
the treatment and management of these patients who are not the typical patient. I have definitely
changed my personal opinion on Jehovahs Witnesses and their religious beliefs, now that I have
a better understanding of why they believe what they do. I hope that this may be insightful to my
fellow classmates as well.
ETHICS FINAL
7
References
Alam, A., Lin, Y., & Callum, J. (2012). The variation of acceptable blood products and
procedures amongst Jehovah's Witness patients: analysis of a hospital pre-transfusion
discussion tool. Canadian Journal of Anesthesia = Journal Canadian D'anesthesie,
59(12), 1148-1149. Doi: 10.1007/s12630-012-9784-7
Kiran Chand, N., Bala Subramanya, H., & Venkateswara Rao, G. (2014). Management of
patients who refuse blood transfusion. Indian Journal of Anesthesia, 58(5), 658-664.
doi:10.4103/0019-5049.144680
Burbank, L. (2007, November 30`). Jehovah's Witness Kid Dies after Refusing Medical
Treatment. Retrieved June 19, 2016, from http://www.npr.org/templates/story/story.php?
storyId=16763280
(Current). What do Jehovahs Witnesses Believe? Retrieved from
https://www.jw.org/en/jehovahs-witnesses/faq/jehovah-witness-beliefs/
Bock, G. (2012). Jehovah's Witnesses and Autonomy: Honoring the Refusal of Blood
Transfusions. Journal of Medical Ethics, 38(11), 652-656 p. 5 doi: 10.1136/medethics2012-100802
