Brezina Paul R, Moskop John C
Department of Obstetrics/Gynecology and Internal Medicine, Brody School of Medicine, East Carolina University, USA.
N C Med J. 2007 Sep-Oct;68(5):312-6.
Physicians strive to respect the autonomy of patients. The emergent care of Jehovah's Witnesses, however, leaves health care providers struggling with ethical and legal questions. These are further compounded when the patient in question is a minor.
A girl aged 15 years presented with anemia, a large ovarian mass, massive hemoperitoneum, and parents who were devout Jehovah's Witnesses who refused administration of blood products. Following discussion of the patient's condition and treatment options with the patient, her family, members of the treatment team, and consultants, the patient was transferred to a hospital that offered a blood conservation program for surgical patients. The patient received surgical management without the need for blood transfusion. Her surgeons, however, reserved the legal right to give blood if an emergent need arose despite the lack of parental consent.
Society grants considerable legal latitude in dealing with Jehovah's Witness minors, and physicians must be aware of the legal and ethical parameters surrounding the care of such patients.
医生努力尊重患者的自主权。然而,耶和华见证人的急诊护理让医疗服务提供者在伦理和法律问题上挣扎。当相关患者是未成年人时,这些问题会更加复杂。
一名15岁女孩出现贫血、巨大卵巢肿块、大量腹腔积血,其父母是虔诚的耶和华见证人,拒绝输注血液制品。在与患者、其家人、治疗团队成员和顾问讨论患者病情及治疗方案后,患者被转至一家为手术患者提供血液保护计划的医院。患者接受了无需输血的手术治疗。然而,她的外科医生保留了在紧急情况下即便未经父母同意也可输血的合法权利。
社会在处理耶和华见证未成年人问题上给予了相当大的法律自由度,医生必须了解此类患者护理所涉及的法律和伦理参数。