Fineschi V, Albano M G, Turillazzi E
Institute of Legal Medicine, University of Foggia, Italy.
Med Sci Law. 2001 Apr;41(2):141-6. doi: 10.1177/002580240104100210.
The Jehovah's Witnesses (JWs) patient's refusal of a lifesaving transfusion creates a conflict for the physician. In Italy, we are met with a great disparity of behaviour among physicians; the JW's eventual refusal for transfusional therapy often necessitates the physician's recourse to the court. Jurisprudence has thus arrived at an analysis of the juridical value of so-called advance directives. The analysis demonstrates a noteworthy argumentative coherence and reflects a specific doctrinaire development in transfusional therapy. In fact, in Italy most of medicolegal doctrine recognizes, in the JW's blood refusal, the physician's limited position whereby, it seems, he or she must submit legally to an expressed therapeutical dissent even when the patient is in a condition of incompetence and is no longer capable of expressing his or her refusal, or else must risk an indiscriminate violation of the patient's right to religious freedom and choice. According to the Constitutional Chart, the physician's duty to respect the JW's refusal of blood transfusions is absolute in order to avoid any treatment that is in conflict with the religious faith that each patient is free to profess.
耶和华见证人的患者拒绝接受挽救生命的输血，这给医生带来了冲突。在意大利，医生的行为存在很大差异；耶和华见证人的患者最终拒绝输血治疗往往使医生不得不诉诸法庭。因此，法理学对所谓的预先指示的法律价值进行了分析。该分析显示出值得注意的论证连贯性，并反映了输血治疗中特定的学说发展。事实上，在意大利，大多数法医学说都承认，在耶和华见证人拒绝输血的情况下，医生的处境有限，也就是说，即使患者无行为能力且不再能够表达拒绝，医生似乎也必须在法律上服从明确表达的治疗异议，否则就有可能随意侵犯患者的宗教自由和选择权。根据宪法图表，医生尊重耶和华见证人拒绝输血的义务是绝对的，以避免任何与每位患者自由信奉的宗教信仰相冲突的治疗。
