Conclusion of BLOOD: WHOSE CHOICE AND WHOSE CONSCIENCE?

Is it not true that the vast majority of cases physicians have confronted, or likely will, can be managed without blood?  What we studied and know best has to do with medical problems, yet patients are human beings whose individual values and goals cannot be ignored.  They know best about their own priorities, their own morals and consciences, which give life meaning for them.

Respecting the religious consciences of Witness patients may challenge our skills.  But as we meet this challenge, we underscore, valuable liberties that all of us cherish.  As John Stuart Mill aptly wrote:  "No society in which these liberties are not, on the whole, respected, is free, whatever my be its form of  government . . . Each is the proper guardian of his own health, whether bodily, or mentally and spiritual.  Mankind are greater gainers by suffering each other so as to live  as seems good to themselves, then by compelling each other to lvie as seems good to the rest." 

1. Appelbaum PS, Roth L.H. Patients who refuse treatment in medical hospitals.  JAMA 1983: 250:1296-1301.

2. Macklin R: The inner workings of an ethics committee: Latest battle over Jehovah's Witnesses. Hasting Cent Rep 19 88: 18 (1): 15-20. 

3. Bouvia v Superior Court, 179 Cal App 3d 1127,225 Cal Rptr 297 (1986), in re Brown, 478 So 2d 1033.

4. In re Storar, 438 NYS 2d 266, 273, 420, NE 2d 337, 343 n 6 (NY1981). 

5. Rivers v Katz, 504 NYS 2d 74, 80 n 6, 495 NE 2d 337, 343 n 6 (NY 1986).

6. Dixon JL, Smalley MG: Jehovah's Witnesses. The surgical/ethical challenge. JAMA 1981; 246:2471-2472. 

7. Kambouris AA: Major abdominal operations on Jehovah's Witnesses. AM Surgical 1987; 53:350-356.

Next time: "Buy Truth and Never Sell It"

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