Bioethics of the refusal of blood by Jehovah's Witnesses: Part 2. A novel approach based on rational non-interventional paternalism.
Most physicians dealing with Jehovah's Witnesses (JWs) who refuse blood-based treatment are uncertain as to any obligation to educate patients where it concerns the JW blood doctrine itself. They often feel they must unquestioningly comply when demands are framed as religiously based. Recent discussion by dissidents and reformers of morally questionable policies by the JW organisation raise ethical dilemmas about "passive" support of this doctrine by some concerned physicians. In this paper, Part 2, I propose that physicians discuss the misinformation and irrationality behind the blood doctrine with the JW patient by raising questions that provide new perspectives. A meeting should be held non-coercively and in strict confidence, and the patient's decision after the meeting should be fully honoured (non-interventional). A rational deliberation based on new information and a new perspective would enable a certain segment of JW patients to make truly informed, autonomous and rational decisions.
Muramoto
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Kaiser Permanente Northwest Division, Oregon, USA. muramotosa@kpnw.org
D001803:Blood Transfusion / Q000331:legislation & jurisprudence*; D002835:Christianity; D030881:Disclosure; D034462:Dissent and Disputes; D004992:Ethics, Medical; D006126:Group Processes; D006801:Humans; D007258:Informed Consent / Q000331:legislation & jurisprudence; D033221:Jehovah's Witnesses; D026706:Paternalism; D010353:Patient Education as Topic / Q000331:legislation & jurisprudence; D010358:Patient Participation / Q000331:legislation & jurisprudence; D026684:Personal Autonomy; D010817:Physician-Patient Relations; D012068:Religion and Medicine; D016312:Treatment Refusal / Q000331:legislation & jurisprudence*