Case Study - Quiz #4

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Cégep John Abbott College *

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235

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Philosophy

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Jan 9, 2024

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PHIL 235 | Tatyana Pillay – Noel (40291166) Treating Jehovah’s Witnesses: Navigating Medical stigmas surrounding their beliefs. Medicine in today’s world may not be what it once was, commonly known as helping those who are sick or making one feel comfortable when the quality of life is not ideal. Perhaps we are wired to think that medicine should be a certain way and that different values of medical decisions are morally wrong because they don’t agree with what we learned in the past or present. One’s beliefs can have a huge role to play in medical decision making which raises questions of whether or not in life-threatening situations where the patient is unconscious, it's morally right to respect the decision of the patient, or if the HCP should make the final decision. Should beliefs that have been chosen by parents for their kids be respected if it means refusing life-threatening treatment since the child did not necessarily choose this belief themselves? The case of Jehovah’s Witnesses will be explained throughout this essay and show both sides of this ethical debate. One could argue from one side that freedom of choice where the patient is coherent and able to state that he does not want treatment which could eventually lead to the end of their life is morally sound, for example refusing blood transfusions in the case of Jehovah’s Witness. Forms of communicating their refusal of a medical treatment can be verbally, on a card, or on a bracelet that they wear, and once the patient has expressed their opinion on the medical treatment offered if they refuse it the healthcare practitioner must respect their wishes no matter how wrong they believe the patient is. However, there are cases where this may be conflicting, When a patient is unconscious they are not in a state to make an informed decision and the medical decision they
had made based on their beliefs may change once their life is threatened if they don’t receive the treatment offered. Many make decisions based on beliefs, but many also decide to change their decisions later on since people’s beliefs can change. Therefore, when it comes to medical decisions, how do we know if a patient wouldn’t change their medical decision because it’s now a decision between life or death? In cases where children are involved and are not of legal age to consent to medical decisions and their parents follow a certain belief that refuses treatment, their cases are brought directly to court and are decided by a judge. “In the case of Jehovah’s Witness parents’ refusal of blood transfusion for their child … and can therefore ask immediately for the ordinance of judicial authority to authorize the transfusion.” (Conti & Capasso, 1997) Since the role of a parent is to protect and be responsible for making health decisions for their child, is it moral to let the parents decide based on their beliefs since their child may not want to refuse the treatment so that they can live? One may argue in favor of the side of healthcare practitioners, where they should be able to make the final decisions in cases where a patient may not do so. HCPs go through extensive education to have the knowledge in order to best treat their patient and can believe that because of this they know what’s best for their patient even if the patient has beliefs that go against the practitioner. As stated in an article, “… it is common for Jehovah’s Witnesses in critical need of blood transfusions to choose death over acceptance of blood products.” (Brezina and Moskop, 2007), as this might go against the values of the healthcare practitioner they may be inclined to step in and perform the procedure regardless and risk the consequences after. If physicians were given the final say on medical decisions, laws put in place for freedom of choice would be reversed and the medical world would go back to its paternalistic ways. The issue when it comes to a medical paternalistic model is that the autonomy and individualism of a person are stripped away, 2
violating one’s freedom of choice because following the HCP values would be deemed unethical. In a case where the patient is dying because they need a blood transfusion but they are unconscious and unable to refuse or accept the treatment, the HCP should have the final say since parents might only think of their image in Jehovah’s Witness and refuse because they don’t want to be shunned. If a patient refuses the treatment but the HCP still wants to give them a blood transfusion because they think it’s the best option for the patient without seeking other possible medical options then this is going against the patient's right to autonomy and this is where we can see conflicts with HCP’s holding the final decisions. To conclude, both sides have reasonable and valid points to argue in this debate and since there is validity to both sides, we cannot disregard either of them since it would violate the right to autonomy. Thus, if the person making the decision is mature and, in a state, where they can understand the consequences of the decision they are about to make, then they should have the right to refuse the blood transfusion even if it goes against the morals of their HCP. However, if the patient is underage or in a state where they cannot make an informed decision, then the decisions of the parents should be taken into consideration. Still, the final decision should be that the HCP does everything possible to keep that patient alive until the point where they are able to make a decision for themselves. The final decision for an underage patient should come from a judge who has the best interest of the child if the parents and HCP cannot come to an agreement with the healthcare plan since it goes against the values of the physician and the beliefs of the parents. Medical decisions are hard and therefore decisions should also be made on a case-by- case scenario. 3
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References 1. Harrison, C., Kenny, N. P., Sidarous, M., & Rowell, M. (1997, March 15). Bioethics for clinicians: 9. involving children in medical decisions . CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1227047/ 2. Urgentmedicaldecisionmakingregardinga Jehovah’Switnessminor. (n.d.). https://ncmedicaljournal.com/api/v1/articles/53593-urgent-medical-decision-making- regarding-a-jehovah-s-witness-minor-a-case-report-and-discussion.pdf 4