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关于文化偏好与内科医学的思考:耶和华见证人的案例以及输血阈值的变化

Reflections on Cultural Preferences and Internal Medicine: The Case of Jehovah's Witnesses and the Changing Thresholds for Blood Transfusions.

作者信息

Sagy Iftach, Jotkowitz Alan, Barski Leonid

机构信息

Division of Internal Medicine, Soroka University Medical Center, Beer-Sheva, Israel.

Clinical Research Center, Soroka University Medical Center, 84101, Beer-Sheva, Israel.

出版信息

J Relig Health. 2017 Apr;56(2):732-738. doi: 10.1007/s10943-016-0353-1.

DOI:10.1007/s10943-016-0353-1
PMID:28035631
Abstract

Jehovah's witnesses oppose receiving blood transfusions based on religious grounds. This refusal raises complex medical, legal and ethical issues for the treating medical staff. In the past physicians attempted to force patients and children to accept transfusions when deemed medically necessary through the use of court orders. However, in recent years the threshold for blood transfusion has been gradually raised by medical experts as expressed in consensus guidelines, which means that Jehovah's witnesses' aversion to transfusion would have been partially justified medically. This article will further discuss these current trends.

摘要

耶和华见证人基于宗教原因反对接受输血。这种拒绝给治疗医护人员带来了复杂的医学、法律和伦理问题。过去,医生在认为输血在医学上必要时,试图通过法庭命令强迫患者和儿童接受输血。然而,近年来,正如共识指南所表明的,医学专家逐渐提高了输血门槛,这意味着耶和华见证人的输血厌恶在医学上有一定的合理性。本文将进一步讨论这些当前趋势。

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Reflections on Cultural Preferences and Internal Medicine: The Case of Jehovah's Witnesses and the Changing Thresholds for Blood Transfusions.关于文化偏好与内科医学的思考:耶和华见证人的案例以及输血阈值的变化
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Severe Acute Anemia After Liver Transplantation in an Elderly Jehovah's Witness Treated With High-dose Erythropoietin and Ferric Carboxymaltose: A Case Report.老年耶和华见证会信徒肝移植后发生严重急性贫血,接受高剂量促红细胞生成素和羧基麦芽糖铁治疗:一例报告
Transplant Proc. 2015 Oct;47(8):2548-51. doi: 10.1016/j.transproceed.2015.09.014.
2
Cardiovascular surgery in Jehovah's Witness patients: The role of preoperative optimization. Jehovah's Witness 患者的心血管手术:术前优化的作用。
J Thorac Cardiovasc Surg. 2015 Oct;150(4):976-83.e1-3. doi: 10.1016/j.jtcvs.2015.06.059. Epub 2015 Jun 30.
3
Transfusion of fresher versus older red blood cells for all conditions.
针对所有情况输注较新鲜与较陈旧的红细胞。
Cochrane Database Syst Rev. 2015 May 12(5):CD010801. doi: 10.1002/14651858.CD010801.pub2.
4
Restrictive versus liberal transfusion strategy for red blood cell transfusion: systematic review of randomised trials with meta-analysis and trial sequential analysis.限制与宽松输血策略用于红细胞输血:系统评价随机试验的荟萃分析和试验序贯分析。
BMJ. 2015 Mar 24;350:h1354. doi: 10.1136/bmj.h1354.
5
Jehovah's Witness parents' refusal of blood transfusions: Ethical considerations for psychologists.耶和华见证会信徒父母拒绝输血:心理学家的伦理考量
J Health Psychol. 2016 Aug;21(8):1556-65. doi: 10.1177/1359105314558896. Epub 2014 Dec 4.
6
Doctors need not give blood transfusion to mentally ill Jehovah's Witness, judge rules.法官裁定,医生无需给患有精神疾病的耶和华见证人输血。
BMJ. 2014 Apr 27;348:g2950. doi: 10.1136/bmj.g2950.
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Living-related donor kidney transplantation in Jehovah's Witness patient: the importance of EPO preconditioning.耶和华见证会患者的亲属活体供肾移植:促红细胞生成素预处理的重要性。
Int Urol Nephrol. 2014 Mar;46(3):669-70. doi: 10.1007/s11255-014-0666-5. Epub 2014 Feb 15.
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An update on mortality and morbidity in patients with very low postoperative hemoglobin levels who decline blood transfusion (CME).拒绝输血的术后血红蛋白水平极低患者的死亡率和发病率最新情况(继续医学教育)
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Impact of more restrictive blood transfusion strategies on clinical outcomes: a meta-analysis and systematic review.更严格的输血策略对临床结局的影响:荟萃分析和系统评价。
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