Weinberger M, Tierney W M, Greene J Y, Studdard P A
Soc Sci Med. 1982;16(19):1719-23. doi: 10.1016/0277-9536(82)90098-3.
According to their religious dogma, Jehovah's Witnesses (JW) are unwilling to accept blood transfusions, even if their own lives are at stake. This belief puts physicians, who have no consistent legal norms to guide their behavior, in an ambiguous situation. To examine the socialization process regarding the development of norms under legal uncertainty, we asked medical students, house staff and faculty physicians to discuss their actions regarding each of four case simulations (one minor child, one incompetent adult, and two competent adults). In our sample, 84% of faculty and half of the respondents overall report having had personal experience with JWs. Despite patient or parental requests to the contrary, physicians were most likey to transfuse the child (80%), followed by the imcompetent adult (63%) and the two competent adults (25 and 15%). This ordering reflects the consistency of court decisions. In addition, the physicians' decisions regarding whether or not to transfuse did not vary with either their experience with JWs or level of training; however, experienced physicians appeared to learn to take precautions to protect themselves and their hospital from legal action. The study also indicates lack of formal medical education as an information source from which medical students learn about this ethical problem.
根据他们的宗教教义，耶和华见证人即使在危及自身生命的情况下也不愿意接受输血。这种信仰使医生处于一种模棱两可的境地，因为他们没有一致的法律规范来指导自己的行为。为了研究在法律不确定情况下规范发展的社会化过程，我们让医学生、住院医生和教职医生就四个案例模拟（一个未成年儿童、一个无行为能力的成年人和两个有行为能力的成年人）中的每一个案例讨论他们的行动。在我们的样本中，84%的教职员工和一半的受访者总体上报告说有过与耶和华见证人的亲身经历。尽管患者或其父母提出相反请求，但医生最有可能给儿童输血（80%），其次是无行为能力的成年人（63%）和两个有行为能力的成年人（25%和15%）。这种排序反映了法院判决的一致性。此外，医生关于是否输血的决定并不因他们与耶和华见证人的经历或培训水平而有所不同；然而，有经验的医生似乎学会了采取预防措施来保护自己和医院免受法律诉讼。该研究还表明，作为医学生了解这一伦理问题的信息来源，缺乏正规医学教育。
