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Justice and Respect for Autonomy: Jehovah's Witnesses and Kidney Transplant
Paul J Cummins1, Federico Nicoli2
1Medical Education, Icahn School of Medicine Mount Sinai, New York, New York USA. paul.cummins @mssm.edu.
The Journal of Clinical Ethics
|January 4, 2019
Summary
Jehovah's Witnesses may refuse blood transfusions, raising ethical questions in organ transplantation. Excluding them from transplant waiting lists is unethical if outcomes are similar and resources aren't risked.
Area of Science:
- Medical Ethics
- Transplant Surgery
- Religious Studies
Background:
- Jehovah's Witnesses' refusal of blood transfusions is ethically accepted due to respect for autonomy.
- Advances allow bloodless organ transplants, enabling Jehovah's Witnesses to receive this treatment.
- Ethical dilemmas arise when Jehovah's Witnesses need transplants but lack directed donors.
Purpose of the Study:
- To analyze the ethical considerations of including Jehovah's Witnesses on organ transplant waiting lists.
- To examine the fairness of allocating organs to patients who refuse transfusions.
- To present a case study illustrating the ethical challenges in transplant centers.
Main Methods:
- Review of the Jehovah's Witness stance on blood transfusions.
- Analysis of medical literature on accommodating religious beliefs in healthcare.
- Examination of outcomes data for organ transplants with and without blood transfusions.
- Ethical analysis of resource allocation principles in transplantation.
Main Results:
- Bloodless organ transplant outcomes are comparable to traditional methods.
- Existing ethical rationales for exclusion (cost of lives, standard of care) do not apply.
- No data suggests that including Jehovah's Witnesses risks transplant resources.
Conclusions:
- It is unethical to exclude Jehovah's Witnesses from organ transplant waiting lists.
- Inclusion is ethically permissible when transplant outcomes are similar and resources are not compromised.
- Transplant institutes exhibit varied policies regarding the inclusion of Jehovah's Witnesses.