Hönig J F, Lilie H, Merten H A, Braun U
Abteilung für Kiefer, und Gesichtschirurgie, Universitätsklinik Göttingen.
Anaesthesist. 1992 Jul;41(7):396-8.
The limited understanding of a patient, such as a Jehovah's Witness, who has consented to an operation but refuses a blood transfusion for personal or religious reasons, places the physician in a moral dilemma. According to Article 2 II of the German Constitution, the fact that the patient has withheld or expressly refused his consent, i.e., in writing, mandates that the legal right of physical integrity be upheld with final legal effect, even in the case of an emergency. If this right to self-determination is abused, the person giving treatment is guilty of bodily harm in the sense of section 223 of the German Penal Code. Intraoperative haemodilution, the cell-save procedure, and colloidal and crystalloid volume replacement represent alternative methods of blood transfusion for Jehovah's Witnesses.
对于像耶和华见证人这样出于个人或宗教原因同意手术但拒绝输血的患者，医生对其了解有限，这使医生陷入道德困境。根据德国宪法第2条第2款，患者已隐瞒或明确拒绝同意，即书面拒绝，这意味着即使在紧急情况下，身体完整性的合法权利也应得到维护并具有最终法律效力。如果这种自决权被滥用，给予治疗的人在德国刑法典第223条意义上构成身体伤害罪。术中血液稀释、细胞回收程序以及胶体和晶体容量替代是耶和华见证人输血的替代方法。
