Devine R J
Health Prog. 1989 Jun;70(5):68-72.
The Jehovah's Witnesses base their belief that they must not submit to blood transfusions on a biblical prohibition against consuming blood. It is a fundamental religious conviction for the Witnesses, one that has the most profound consequences for them: eternal salvation. In their zeal to promote health and save lives, however, some healthcare institutions have reacted to a patient's refusal to receive a blood transfusion by appealing to the courts. In a few cases, this action sought a clarification of professional obligations and responsibilities. In others, however, the institution sought authorization from the court to give a blood transfusion to a patient against his or her will. In several instances over the past 25 years, the courts did not consider the cases in light of the First Amendment right to freedom of religion, despite the fact that the constitutional issue clearly lies at the heart of the controversy. Because the free-exercise clause deserves the "preferred status" of First Amendment liberties, only a compelling state interest could justify its limitation. Where the courts tried to balance interests, they have adduced various concerns to justify state interference. The question is more than legal, however; it is profoundly religious. Vatican II's "Declaration on Religious Freedom" proclaimed that all people have a fundamental right to religious freedom and an inherent freedom from coercion based on human dignity. In Ethical and Religious Directives for Catholic Health Facilities, the bishops say, "The total good of the patient, which includes his higher spiritual as well as his bodily welfare, is the primary concern of those entrusted with the management of a Catholic health facility."
