Koshy R M, Kane E G, Grocock C
University Hospital Coventry and Warwickshire, Coventry, UK.
University of Liverpool, Liverpool, UK.
Ann R Coll Surg Engl. 2020 Oct;102(8):566-570. doi: 10.1308/rcsann.2020.0114. Epub 2020 Jun 15.
The UK is an increasingly multicultural society. This change coincides with an increasing use of animal products in medicine and surgery and a change in the UK law of consent. The refusal of Jehovah's Witnesses to accept blood products is well known, but the use of animal products in surgery is a neglected topic. As society becomes more diverse and medicine becomes ever more advanced, there is increasing potential for a mismatch between what is medically possible and what is acceptable from a religious perspective.
Surgical products were identified by searching the literature and contacting manufacturing companies. Literature was identified by using PubMed and OVID (MEDLINE). Religious views were established by contacting national bodies for each group.
The views of common UK religious groups and the constituent parts of biological meshes are summarised in tables intended to be used as a reference during clinical practice. On an elective basis, the Islamic, Hindu. Sikh and Jain leaders contacted had strong views on avoiding animal derived products. The Christian and Jewish leaders contacted did not. All religious leaders contacted accepted the use of mesh derived from human tissue. All products, including those of porcine and bovine origin, were acceptable to all leaders contacted if the procedure was performed to save life. The highlighting of this issue should prompt earlier consideration and discussion in the surgical planning and the consenting process with all final decisions taken by both the surgeon and the individual patient.
英国正日益成为一个多元文化的社会。这一变化与医学和外科手术中动物产品使用的增加以及英国同意法的变化相吻合。耶和华见证会拒绝接受血液制品是众所周知的,但外科手术中动物产品的使用却是一个被忽视的话题。随着社会变得更加多样化且医学日益进步,在医学上可行的与从宗教角度可接受的之间出现不匹配的可能性越来越大。
通过检索文献和联系制造公司来确定外科产品。利用PubMed和OVID(医学文献数据库)检索文献。通过联系每个群体的国家机构来确定宗教观点。
常见英国宗教团体的观点以及生物补片的组成部分总结在表格中,旨在供临床实践时参考。在择期手术方面,所联系的伊斯兰教、印度教、锡克教和耆那教领袖对避免使用动物源性产品有强烈观点。所联系的基督教和犹太教领袖则没有。所有联系到的宗教领袖都接受使用源自人体组织的补片。如果手术是为了挽救生命,所有联系到的领袖都接受包括猪和牛来源的所有产品。突出这一问题应促使在手术规划和同意过程中更早地进行考虑和讨论,最终决策由外科医生和患者个人共同做出。