Woolley S
Bristol Royal Infirmary/Bristol Royal Hospital for Children, Bristol, UK.
Emerg Med J. 2005 Dec;22(12):869-71. doi: 10.1136/emj.2004.023382.
The Jehovah's Witnesses Society is best known to outsiders for its refusal of blood products, even when such a refusal may result in death. Since the introduction of the blood ban in 1945, Jehovah's Witness (JW) parents have fought for their rights to refuse blood on behalf of their children, based on religious beliefs and their right to raise children as they see fit. Adolescent JWs have also sought to refuse blood products based on their beliefs, regardless of the views of their parents. Adult JWs have fought to protect their autonomy when making both contemporaneous and advance treatment refusal. The refusal of blood products by JWs raises ethical and legal dilemmas that are not easily answered. Do an individual's rights (namely bodily control, right to privacy, right to decide about life/death issues, right to religious freedom) outweigh society's rights (namely the preservation of life, the prevention of suicide, the protection of innocent third parties, and the maintenance of the ethical integrity of the medical profession)? Does the right to choose outweigh the value of human life? For doctors, conflict occurs between the desire to respect patient autonomy and the need to provide good medical care. The Watchtower Society (the JW governing body) imposes a strict code of moral standards among its members, and it is unlikely that individual JWs are making truly autonomous decisions about blood transfusions. While young children and adolescents are protected by the courts and conscious adults are afforded autonomy, dilemmas still arise in the emergency situation. This article examines the rights of young children, adolescents, and adults, focusing in the latter half on adults in the emergency situation.
耶和华见证人协会最广为人知的是其拒绝接受血液制品,即便这种拒绝可能导致死亡。自1945年实施血液禁令以来,耶和华见证人(JW)的父母基于宗教信仰以及按照自己的意愿抚养孩子的权利,为代表子女拒绝输血的权利而抗争。青少年耶和华见证人也基于自己的信仰寻求拒绝接受血液制品,而不顾其父母的观点。成年耶和华见证人在当下和提前拒绝治疗时努力捍卫自己的自主权。耶和华见证人拒绝接受血液制品引发了一些难以回答的伦理和法律困境。个人权利(即身体控制权、隐私权、决定生死问题的权利、宗教自由权)是否超过社会权利(即保护生命、预防自杀、保护无辜第三方以及维护医疗行业的道德完整性)?选择权是否超过人类生命的价值?对医生而言,在尊重患者自主权的愿望与提供良好医疗护理的需求之间存在冲突。守望台圣经书社(耶和华见证人的管理机构)在其成员中推行严格的道德标准准则,因此耶和华见证人个体不太可能在输血问题上做出真正自主的决定。虽然幼儿和青少年受到法院保护,有行为能力的成年人享有自主权,但在紧急情况下困境依然存在。本文探讨了幼儿、青少年和成年人的权利,后半部分重点关注紧急情况下的成年人。