School of Languages, Cultures and Linguistics, Faculty of Arts Monash University, Building 11, Clayton Campus, Clayton, VIC, 3800, Australia.
J Relig Health. 2012 Sep;51(3):837-53. doi: 10.1007/s10943-010-9393-0.
This manuscript studies in detail, following a discourse analytical approach, medical consultations in which a patient's religious belief does not allow blood transfusion to be administered. The patient is a young Jehovah's Witness suffering myeloid leukaemia who is being treated in a Catholic cancer hospital where the practice of blood transfusion forms part of the standard protocol to treat the disease. The consultations under analysis take place in a Chilean cancer clinic where mainly the oncologist and a Jehovah's Witness Representative (JWR) present discuss and negotiate expert information on the substitute methods to be used. The exchange dynamics of the consultations differ from the usual visits where the medical knowledge and expertise is primarily in the hands of the medical practitioner. In these encounters, the JWR shares vital information with the oncologist providing the basis of the treatment to be used. This shifting of the balance of power-which could have been a cause of tension in the visit and a contributing factor in the disruption of communication-has instead brought light to the encounter where the negotiated treatment has been achieved with relative ease. The patient's future is in the hands of the oncologist and the JWR, and their successful negotiation of treatment has made it possible to cater for the particular needs of a JW patient. Sharing different medical practices has not been an obstacle, but an opportunity to find out ways to deliver equity access and well-informed practices to a non-conventional patient.
本手稿详细研究了在医疗咨询中，当患者的宗教信仰不允许输血时所涉及的问题。该患者是一名年轻的耶和华见证会信徒，患有骨髓性白血病，正在一家天主教癌症医院接受治疗，而输血是治疗该疾病的标准方案之一。分析中涉及的咨询发生在智利的一家癌症诊所，主要由肿瘤医生和耶和华见证会代表（JWR）讨论和协商替代治疗方法的专家信息。与通常的就诊不同，这些咨询的交流动态中，医疗知识和专业知识主要掌握在医疗从业者手中。在这些就诊中，JWR 与肿瘤医生分享重要信息，为治疗提供依据。这种权力平衡的转变——本来可能是就诊中的紧张根源，也是沟通中断的因素之一——反而为就诊带来了转机，使相对轻松地达成了协商治疗方案。患者的未来掌握在肿瘤医生和 JWR 手中，他们成功地协商了治疗方案，为 JW 患者的特殊需求提供了可能。分享不同的医疗实践并不是障碍，而是为向非传统患者提供公平的准入和知情的实践提供了机会。
