Legal and Administrative Issues Related to Transfusion‐Free Medicine and Surgery

Henderson, Randy; Jabbour, Nicolas; Zeger, Gary

doi:10.1002/9780470994788.ch1

Cited by 5 publications

(7 citation statements)

References 7 publications

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“…Most Jehovah's Witnesses firmly refuse blood product administration because of religious reasons, 12 and this is often documented before surgery (as in this scenario). While moral and ethical arguments about a physician administering blood to these patients continue, legal precedents in Canada, 13 the USA, 14 and the UK 15 have found physicians who followed this course of action to be guilty of battery. Medical cases involving blood transfusion and a Jehovah's Witness' right to autonomously refuse blood are prototypical ethical dilemmas and are taught extensively during medical school and anaesthesia training from both ethical and legal standpoints.…”

Section: The Scenariomentioning

confidence: 99%

Challenging authority during a life-threatening crisis: the effect of operating theatre hierarchy

Sydor

Bould

Naik

et al. 2013

British Journal of Anaesthesia

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This study did not show a significant effect of OT team hierarchical structure on trainee's ability to challenge authority; however, the results are concerning. The challenges were suboptimal in quality and there was an alarming high rate of blood checking and administration in both groups. This may reflect lack of training in appropriately and effectively challenging authority within the formal curriculum with implications for patient safety.

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Section: The Scenariomentioning

confidence: 99%

Challenging authority during a life-threatening crisis: the effect of operating theatre hierarchy

Sydor

Bould

Naik

et al. 2013

British Journal of Anaesthesia

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“…If prior instructions prohibiting blood transfusion were accepted from a donor, then allowing situation A to occur without subsequent approval from that (conscious, competent, and communicating) donor would constitute a violation of the patient's right to bodily self‐determination and informed consent. Conversely, a donor's decision to refuse transfusion under any circumstance may result in situation D. Independent of the action taken and/or the resultant outcome, the key objectives are to maintain and uphold the decisions made on a patient's right to personal privacy and self‐determination by completely and explicitly documenting the wishes of the donor regarding rescue transfusion, and to follow through on his/her directives [21].…”

Section: Discussionmentioning

confidence: 99%

Living related donor nephrectomy in transfusion refusing donors

et al. 2007

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Summary Many transplant programs are averse to evaluate potential kidney donors with preferences against accepting human blood products. We examined the donor and graft outcomes between our transfusion‐consenting (TC) and transfusion‐refusing (TR) live kidney donors to determine whether a functional or survival disadvantage resulted from the disallowance of blood product transfusion during live donor (LD) nephrectomy. From July, 1999 to August, 2005, 82 live donor nephrectomies were performed, eight of who were TR donors (10%). Blood conservation techniques were utilized in TR donors. Demographics, surgical and functional outcomes, admission and discharge hematocrit, and creatinine were compared between TC and TR donors. No donor mortalities occurred. Two TC donors received blood transfusions (2.7%), and each study group experienced a single, <1‐year graft loss. Intra‐operative blood losses were significantly less in TR donors (298 ± 412 vs. 121 ± 91 ml, P < 0.03). No differences were noted between donor demographics, intra‐operative events, and graft and patient survival. Successful donor nephrectomy from TR patients has the potential to expand the kidney allograft pool to include the TR donor population. Precautionary blood conservation methods allow the informed and consenting TR individual to donate a kidney with acceptable risk and without compromise to donor or graft outcomes.

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“…These examples show that neither solution protects the doctor against possible legal proceedings and stress the importance of a thorough documentation and argumentation of all decisions and actions in this context [40][41][42].…”

Section: Witness Refusal In Emergency Situation (Non Elective)mentioning

confidence: 99%

Jehovah's Witnesses and transfusion: where do we stand in Europe?

Loix

Henin

Descamps

et al. 2020

ISBT Science Series

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Transfusion refusal expressed by Jehovah's Witnesses has always been questioning for medical community. However, abundant literature exists treating about how to manage difficult medical bleeding situations in Jehovah's witnesses, there is a few information available on the legal and ethical aspects of transfusion refusal. Since 1994, Europe has putted a spotlight on patient's right. The question of patient's autonomy and consent have taken a predominant place in care. In order to summarize the actual situation in Europe, this work intends to draw a global view on legal, ethical and medical aspects of transfusion refusal expressed by Jehovah witnesses.

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Legal and Administrative Issues Related to Transfusion‐Free Medicine and Surgery

Cited by 5 publications

References 7 publications

Challenging authority during a life-threatening crisis: the effect of operating theatre hierarchy

Challenging authority during a life-threatening crisis: the effect of operating theatre hierarchy

Living related donor nephrectomy in transfusion refusing donors

Jehovah's Witnesses and transfusion: where do we stand in Europe?

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