Jehovah’s Witness Parents’ Refusal of Blood Transfusions, Research Paper Example

The issue of the hypothetical scenario is the presence of Jehovah’s Witness blood refusal card in Jim’s pocket, and yet he had bled heavily blood needing a life-saving transfusion. Moreover, he was unconscious due to excessive hemorrhage. To determine the best course of action, it is critical to evaluate several ethical and legal considerations. There are several ethical and legal problems that create moral dilemmas among nursing practitioners regarding blood transfusion to patients with Jehovah’s Witness blood refusal card. The moral and legal issues regarding refusing blood transfusion in a life-threatening event are theatrical.

Nursing Provisions Relevant to the Issue

Provision two of the American nursing provisions are relevant to the scenario. It states that a nurse has a fundamental role that should be directed towards the patient (American Nurses Association, 2019). The nurse has the role of committing his/her efforts towards helping the patients even if Jim had a blood transfusion refusal card. Besides, section three gives the nurse the obligation to promote, advocate and champions for the total welfare of the patient. Therefore, the nurse practitioner had the responsibility of advocating for the patients by reporting to the physician about the case so that the correct course of action can be taken. With this provision, the nurse can protect the safety and health of Jim by acting on questionable practices.  Provision one of the code of ethics for nurses talks about respect for human dignity and the right to self-determination (American Nurses Association, 2019). The issue of refusal of blood transfusion touches on human dignity and the right to self-determination that the practitioner had to consider when dealing with the patient.

Ethical Principles Regarding the Issue

Patient autonomy is one of the nursing ethical principles that need to be protected. Autonomy is expressed in terms of informed consent, and it a vital value in bioethics (Butts, & Rich, 2019). Self-determination an ethical principle that helps patients to protect their privacy and decision not to get a blood transfusion. Therefore, the physician cannot intervene when the patient has not freely consented to the issue at hand. In the case scenario, the RN was faced with the problem of addressing the issue of life-saving transfusion because Jim was unconscious and had a Jehovah witness card refusing transfusion (Butts, & Rich, 2019).

There are two main nursing theories mainly applied to ethical decision making. They include utilitarianism and deontology (Butts & Rich, 2019).  One of the nursing theories that are relevant to the scenario is deontology. Unlike utilitarianism which focuses on the outcomes, and eventualities of actions, deontological ethics focus on the duties and what people do and their actions. This nursing theory holds that people have duties to do the right thing even if it produces more harm or bad results than doing the wrong thing (Butts, & Rich, 2019). Based on deontology undermining patient autonomy and going ahead to give blood transfusion would be wrong and unethical. It is thus, fair to respect the religious belief of Jim and respect the decision to have a blood transfusion. However, because the patient was unconscious, then it was the duty of the physician to take the right step by issuing blood transfusion to save the life that was in danger. The unconsciousness of Jim mandated the physician to act in the best possible way to fulfill his/her duty as a protector of the patient’s life in such scenarios.

Legal Analysis Regarding the Hypothetical Issue

The law provides that no person will be allowed to undergo treatment without the provisions of the law (Hoffman, 2016). It also hinders the physician from intervening even when the life of the patient is in danger without the patient’s consent. However, in scenarios where the patient is incompetent, the physician is legally bound to intervene as per the principle of beneficence. It is paramount to note that in such an event the healthcare practitioner should be informed by the need to respect the physical integrity of the patient (Hoffman, 2016). On this ground, it is plausible to assert that the medical care expert delivers care in accordance with the needs and preferences of the patient. The expressed wishes of Jim based on his card are that he should not receive blood, although he had lost a lot of blood during the accident until he became unconscious. In this case, the physician can avoid life-saving transfusion to respect his dignity (Hoffman, 2016).

In the United States, the code of autonomy also means respect for one’s privacy and the right of the person to live in peace. Article 1 of the Florida constitution suggests a strong right to privacy. However, the fourth district court of Florida weakened the above constitutional right by holding that a competent adult can undergo blood transfusion even if that is against his/her wishes and religious beliefs (Jennifer L. Bamonte and Cathy Bierman, 2016). The European approach towards autonomy hinders the duty of assisting and saving people in life-threatening situations. Laws exist regarding pre-treatment declarations. Article 9 of the convention of human rights provides that the previously expressed wishes concerning medical intervention by the patient who is unconscious must be taken into account (Grace, 2017). Therefore, based on the convection, when the patient unconscious, the physician musts take into account any of the previous documents’ wishes. When a patient refuses transfusion when his life is in danger the physician gets himself in a critical ethical and legal position. If the physician does not intervene, he can be liable for civil and criminal offenses of negligence. Also, should the patient die, the physician will be charged with culpable homicide (Grace, 2017).

On the contrary, when the healthcare professional executes duties counter to the patient’s preferences, such actions may lead to legal charges of trespass against the physical integrity of the patient. Also, the physician may be charged with a violation of the patient’s self –determination. The case laws of this situation are contradictory. In-state v. Herbert case the court ruled that when the person was incompetent, the decision to get transfusion may be done by a family member or guardian. However, physicians are protected by law. One school of thought is that when the unconscious and the physical integrity is in immediate and serious threat, and the doctor has a responsibility to interfere and provide blood transfusion (American Nurses Association, 2019). Jim was in a life-threatening situation due to bleeding as a result of the accident. Although the patient had the Jehovah’s wittiness’s transfusion refusal care, the physician had the duty to intervene. Thus he cannot be charged for trespassing the physical integrity of the patient. This doctrine is based on the “state of necessity,” which overlooks the patient’s accord. Thus, the right to self-determination is ignored, and life-saving intervention is pondered (Hoffman, 2016).

Although the state of necessity is mostly applied in scenarios the patient is unconscious, it can also apply when the conscious patient is in danger of death or severe harm for refusing transfusion (Florida statues). This concept is anchored on the legal duties of physicians and the need to safeguard human life. The principles governing the conduct of the healthcare professionals are found in the international code of medical ethics of the world medical association (Florida Statutes). Notably, the case at hand, was a Jehovah’s Witness’s patient is declining blood transfusion is raising a moral dilemma.  According to Grace, 2017, the maters associated with reducing blood transfusion, particularly, Jehovah’s witnesses reflect the conflict between various moral issues in society. Ethical principles that become in dispute in this situation include respect for autonomy, beneficence, non-malfeasance, and justice. Mostly, in the case of refusing a blood transfusion, freedom, which is the right of the patient’s consent and beneficence, which is the duty of care of the physician are contradictory (Bamonte and Bierman, 2016).

Contradiction exists between the patient’s autonomy, blood transfusion refusal, and the physician’s duty of care (Grace, 2017). However, some scenarios can be adopted to find the best cause of action. To begin with, considering the absolute priority of the life of the previously documented patient wishes. Considering blood transfusion, several questions can arise such as the complete duty of the physician to take care of the patient in the case of refusal of blood transfusion via intervention. This scenario also raises certain moral issues but of a different nature (Hoffman, 2016).

Mediation can be the last approach to addressing the issue of declining blood transfusion (Bamonte and Bierman, 2016). In this case, refusing blood transfusion can be considered legal. However, when the life of the patient becomes threatened and is unconscious, the physician is compelled to act to avoid criminal and civil charges. Physicians have a duty to protect life in life-saving situations particularly when the patient is unconscious (Bamonte and Bierman, 2016). The approach is grounded on the law of necessity that permits healthcare practitioners to intervene when the patient is unconscious to make an informed decision regarding their medical care (Grace, 2017). It may also be correct to say that the physician who decides to respect the wishes of the patient by not intervene in the life-threatening situations should not be liable for civil of a criminal offense (Florida Statutes). One of the ethical theories that lead the Jehovah’s Witnesses to refuse life-saving transfusion is based on religion. According to them, it is against Godly principles to eat blood or receive blood from another person. However, there is a group of Jehovah witnesses that do not agree with the idea that blood transfusion is wrong.

Conclusion

From the analysis of the legal provisions and the ethical principles and theories, the physician has the right to intervene and proceed to provide blood to both Jim and max Jones. Although the principle of autonomy applies in ethical dilemmas like in this scenario, the unconsciousness of the patient allows the physician to intervene and provide care in life-threatening events like this. The intervention of the physician to offer care against the previous wishes of the patient do not amount to any criminal or civil reliability. The doctor will rely on the principle beneficence and the state of necessity law to provide transfusion to the patients against their wishes. Therefore, Jehovah’s Witness patients should undergo transfusion even if they have not given informed consent to save their life when it is in danger.

References

American Nurses Association (2019). ANA Code Of Ethics With Interpretive Statements Pages. Retrieved from: https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/coe-view-only/

Butts, J. B., & Rich, K. L. (2019). Nursing ethics. Jones & Bartlett Learning.

Florida Statutes governing Advanced Directives (Organ donation section is optional. Retrieved from http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0765/0765.html

Grace, P. J. (Ed.). (2017). Nursing ethics and professional responsibility in advanced practice. Jones & Bartlett Learning.

Hoffman, A. (2016). Jehovah’s Witness parents’ refusal of blood transfusions: Ethical considerations for psychologists. Journal of Health Psychology, 21(8), 1556-1565.

Jennifer L. Bamonte and Cathy Bierman (2016). In re Dubreuil: Is An Individual’s Right to Refuse a Blood Transfusion Contingent on Parental Status? Retrieved from https://nsuworks.nova.edu/cgi/viewcontent.cgi?article=2268&context=nlr/