Death by Denomination 1

Death by Denomination

Precious So

National University
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When it comes to issues involving the Jehovah’s Witness patient’s refusal of blood

products, it becomes an ethical dilemma because a person’s autonomy may conflict with the

nurse’s obligation to uphold the principles of beneficence and non-maleficence. Most Jehovah’s

Witnesses routinely refuse blood transfusions even if it means endangering their own lives or the

lives of their children. For health care professionals, especially nurses, who are the main

caregivers of these children, this decision is extremely difficult to accept. Refusal of blood

transfusions by Jehovah’s Witnesses is distressing to the nurses and physicians because, from a

clinical perspective, the benefits of transfusion are greater than the risks. Although competent

adults are given the right to refuse life-saving treatments, I don’t believe they have the right to

decide for their children in such vital matters as those affecting their right to life. As nurses, our

goal to each and every patient is to preserve and maintain life, and children suffering from

critical illnesses are just as entitled to living a full life with the help of blood transfusions,

regardless of what their parent’s beliefs may be.

According to a Jehovah’s Witness, taking blood into the body is specifically forbidden in

the Bible and is, therefore, a sin. On their website, the official position is explained, “Is it wrong

to accept a blood transfusion? Remember, Jehovah requires that we abstain from blood. This

means that we must not take into our bodies in any way at all other people's blood or even our

own blood that has been stored. (Acts 21:25) So true Christians will not accept a blood

transfusion. They will accept other kinds of medical treatment, such as transfusion of nonblood

products. They want to live, but they will not try to save their life by breaking God's laws.—

Matthew 16:25” (Watchtower, 1996, para. 6). By law, everyone is entitled to freedom of choice

and religion, and although parents and the medical professionals may not share the same beliefs
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or value systems, an individual’s rights are to be respected. This is understandable as people of

different ethnic and cultural backgrounds are becoming more commonplace in the hospital

environment.

Religion is another universal difference and faith is the most personal and important act

of conscience. I believe it should be honored wholeheartedly, regardless of what one’s belief is,

unless it harms others, especially children. Adults who have made their wishes clear as to

refusing blood treatments sign a document stating their refusal of blood transfusion services

under all conditions. If medical personnel were to proceed with the treatments, they would be

violating one’s rights, as well as breaking the law. But in the case of children whose lives are at

stake, a parent’s beliefs should not stand in the way of potentially saving their child’s life.

Oftentimes, children are pushed to get baptized, sometimes before they are even teenagers.

Regardless of their age at the time, once they are baptized, they are expected to abide by all of

the same rules and prohibitions that apply to adult members. This means that they are required to

resist any attempts to give them blood transfusions and if they do willingly receive blood, then

they are “disfellowshipped” from the congregation of believers. This is a heavy load for a child

to take, and pressure from their parents and the Jehovah’s Witnesses community definitely play a

huge role in influencing their decision. Regardless of their belief, a child may actually want to be

saved and is secretly in favor of the blood transfusion, knowing that there was an 85% chance of

survival. Parents who disregard this fact should not be deemed as competent parents as their

personal reasons are not based on their child’s best interest, rather for the satisfaction of adhering

to their beliefs.

Parliament introduced the Human Rights Act 1998 and under Article 2 it reads: The

Right to Life. Wilson (2005) has also added, “Public authorities are not only required to refrain
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from actively killing people but must also take steps to ensure that a vulnerable child's rights

under are protected from persons (including parents) who may not be acting in the child's best

interests. Therefore, healthcare organizations and professionals are required to take every step to

ensure the Jehovah's Witness child is given every chance to live. Failure to do so would result in

violation of the child's rights under national and international law” (para.15). I am highly in favor

of this last statement and wish that our country were as strict and consistent with these same laws

and policies. The matter of the fact is that children have the same right to life as an adult and the

courts can and will override the parent’s refusals to administer blood because the life of a child is

considered of greater value than the parent’s right of refusal based on religious beliefs.

A nurse’s role as the patient’s advocate is important in situations like these. We are the

supporters of our patients and should speak on their behalf to live. In the article written by Ellis

(2000), she quotes Gillon (1994) and Beauchamp and Childress (1989), “Nurses and other

professionals are taught four ethical principles which guide their practice: to respect for

autonomy, beneficence, non-maleficence and justice (Gillon 1994). To act morally, the nurse

should do and promote good, protect from harm by preventing and removing harmful conditions,

not inflict harm and act fairly” (Beauchamp and Childress, 1989). Acting to promote the parent’s

choice can be supported under the principle of autonomy. However, since the life of the child is

at risk, non-maleficence to the child should outweigh the ethical code to respect parents’

autonomy. The child is, in fact, the patient, not the parent, and what we do is in the best interest

of our patients. Yes, we are expected to respect the values, customs, and spiritual beliefs of those

we are providing care to; however, we are also responsible for our practice and in using our best

judgment in providing care. In any of these situations, my best judgment would be to save the
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life of the child without risking it. If a child’s chances for survival greatly outnumbered the risks,

it is my obligation to do all that is possible to ensure their life.

As long as parents respect the well-being of their children, they should have legal and

ethical rights to make such life-threatening and profound decisions. It is only morally right to do

what we can to save a child’s life, especially if the outcome is promising. It is almost a natural

impulse to help a child, and I find it cruel and inhumane not to provide such life-saving

treatments because of a parent’s deeply held convictions. Having to sit back and watch your

child die when you know that there was something you could’ve done to spare them, is beyond

me. In a way, it seems like involuntary manslaughter because it is unreasonable and could have

very well been prevented. Nurses follow a code of professional conduct, and although, respecting

a person’s autonomy is included, a child’s life is much more valuable. As I’ve stated earlier, we

act in our patient’s best interest and life and death decisions concerning children are not to be

made for the parents’ benefit. Lo (2005) quotes a court who declared that parents are “not free to

make martyrs of their children” (p. 77).

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Works Cited

American Nurses Association. (2009). Code of ethics for nurses with interpretive statements.

Retrieved March 1, 2009 from the American Nurse’s Association, Inc.:

http://nursingworld.org/ethics/code/protected_nwcoe813.htm

Ellis, A. (2000). Consent and the teenage Jehovah's Witness. Paediatric Nursing, 12(3), 29.

Retrieved March 1, 2009, from ProQuest Nursing & Allied Health Source database.

(Document ID: 54120208).

Lo, B. (2005). Refusal of treatment by competent, informed patients (3rd ed.). Resolving ethical

dilemmas (pp. 77). Baltimore, MD: Lippincott Williams and Wilkins.

Watchtower: Official website of Jehovah’s Witnesses. (2006). Showing respect for life and

blood. Retrieved March 1, 2009 from the Watchtower’s Web site:

http://www.watchtower.org/e/rq/article_12.htm

Wilson, P. (2005). Jehovah's Witness children: When religion and the law collide. Paediatric

Nursing, 17(3), 34-37. Retrieved March 1, 2009, from ProQuest Nursing & Allied

Health Source database. (Document ID: 824161841).

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