Drew N C
J Med Ethics. 1981 Sep;7(3):137-9. doi: 10.1136/jme.7.3.137.
The prospect of dealing with a rapidly and inexorably bleeding patient fills most medical practitioners with alarm. When that patient is a Jehovah's Witness, the knowledge that a blood transfusion is likely to be refused turns that alarm into a state of acute anxiety and conflict. This state is further heightened when the patient is young and otherwise healthy--a situation found particularly in obstetric practice with the occurrence of ante- and post-partum haemorrhage, and ectopic pregnancy. In the last 25 years in England, Wales, Scotland and Northern Ireland, there has been one maternal death in which the refusal to accept a blood transfusion has been considered to be an avoidable factor. In this article I have attempted to identify the magnitude of the problem in obstetric practice and have sought to clarify the moral and legal aspects.
面对一位出血迅速且难以遏制的患者,大多数医生都会感到恐慌。当该患者是耶和华见证会成员时,由于很可能会拒绝输血,这种恐慌就会演变成极度焦虑和冲突的状态。如果患者年轻且其他方面健康,这种状态会进一步加剧——这种情况在产科实践中尤为常见,比如产前和产后出血以及宫外孕。在过去25年里,在英格兰、威尔士、苏格兰和北爱尔兰,有一例孕产妇死亡被认为拒绝接受输血是一个可避免的因素。在本文中,我试图确定产科实践中这个问题的严重程度,并力图阐明其中的道德和法律层面。