[Jehovah's Witnesses refusal of blood: religious, legal and ethical aspects and considerations for anesthetic management].
The refusal of Jehovah's Witnesses to agree to blood or blood product transfusion based on religious beliefs is one of the most challenging conflictive issues health care givers have to face today. Such conflict is a by product of the ideological and religious diversity in society today. The perioperative care of such patients constitutes a genuine challenge for anesthesiologists and surgeons from technical, scientific, ethical, and legal perspectives. We review the reasons why Jehovah's Witnesses refuse transfusion and discuss the ethical, legal, and anesthetic aspects of their care. The literature up to August 2005 was reviewed by MEDLINE search. The following search terms were used: Jehovah's Witnesses, anesthesia (and anaesthesia), legislation and jurisprudence, ethics, blood transfusion, alternatives, anemia (and anaemia), erythropoietin, trigger, and critical care. To further cover ethical and legal aspects, we reviewed current laws in Spain and similar practice settings.
Servicio de Anestesiología y Reanimación, Hospital Universitario Infantil La Paz, Madrid. a.perezf@teleline.es
A
A
Pérez Ferrer
E
E
Gredilla
J
J
de Vicente
J
J
García Fernández
F
F
Reinoso Barbero
D000740:Anemia / Q000628:therapy; D000758:Anesthesia / Q000941:ethics / Q000379:methods*; D001291:Attitude of Health Personnel; D016913:Blood Component Transfusion / Q000941:ethics / Q000331:legislation & jurisprudence; D001793:Blood Preservation; D001802:Blood Substitutes / Q000627:therapeutic use; D001803:Blood Transfusion / Q000941:ethics* / Q000331:legislation & jurisprudence; D001804:Blood Transfusion, Autologous; D003422:Critical Care / Q000941:ethics / Q000331:legislation & jurisprudence; D003469:Culture; D004921:Erythropoietin / Q000032:analysis; D005062:European Union; D005568:Forms and Records Control; D006806:Human Rights / Q000331:legislation & jurisprudence; D007258:Informed Consent; D007430:Intraoperative Care / Q000941:ethics / Q000331:legislation & jurisprudence; D033221:Jehovah's Witnesses / Q000523:psychology; D008499:Medical Records; D010820:Physicians / Q000523:psychology; D011182:Postoperative Care / Q000941:ethics / Q000331:legislation & jurisprudence; D011300:Preoperative Care / Q000941:ethics / Q000331:legislation & jurisprudence; D013030:Spain; D016312:Treatment Refusal / Q000941:ethics / Q000331:legislation & jurisprudence
D001802:Blood Substitutes; D004921:Erythropoietin