Vuk T, Putarek K, Jukić I, Rojnić N, Balija M, Grgicević D
Hrvatski zavod za transfuzijsku medicinu, Zagreb.
Lijec Vjesn. 1997 Aug-Sep;119(8-9):243-5.
Patients who refuse blood transfusion for personal or religious reasons present complex medical, legal and moral problems. Blood transfusion has been doctrinally forbidden for Jehovah's Witnesses since 1945. Their refusal is based on the strict interpretation of several Biblical passages. A clear understanding of the philosophy of the Jehovah's Witnesses regarding blood transfusion and of the medicolegal and ethical aspects of their care is essential to clinicians who care for such patients. Various ethical principles, including the patient's autonomy, the interest of society in preserving life and the dignity of medical profession can be confronted. There are no clear guidelines which physicians can follow in deciding to treat or not treat in the presence of a patient's refusal. However, most authors agree that a competent adult has an absolute right to decline medical treatment, and that it is not morally or ethically correct to force patient to an unwanted treatment. We wished to present the experiences with the use of alternative methods in the treatment of Jehovah's Witnesses and to discuss ethical and legal aspects of treatment decisions in the presence of blood transfusion refusal.
因个人或宗教原因拒绝输血的患者会带来复杂的医学、法律和道德问题。自1945年起，耶和华见证人教派在教义上就禁止输血。他们的拒绝基于对几处圣经经文的严格阐释。对于照料此类患者的临床医生而言，清楚了解耶和华见证人教派关于输血的理念以及照料他们时涉及的法医学和伦理学方面至关重要。包括患者自主权、社会对维持生命的关注以及医学职业尊严在内的各种伦理原则可能会相互冲突。在患者拒绝的情况下，医生在决定是否进行治疗时没有明确的指导方针可循。然而，大多数作者都认同，有行为能力的成年人有绝对权利拒绝医疗治疗，强迫患者接受不必要的治疗在道德和伦理上都是不正确的。我们希望介绍在治疗耶和华见证人教派患者时使用替代方法的经验，并讨论在患者拒绝输血情况下治疗决策的伦理和法律方面。
