Over my dead body: Self-determination, proxy consent, and proportionate reason in the treatment of a Jehovah's Witness patient with severe traumatic hemorrhagic shock. (December 2021)

• Record Type: Journal Article
• Authors: Alouidor, Reginald; DePergola, Peter A.; Lopez-Garena, Milagros; Bungash, Yasmin; Kelly, Edward; Jabbour, Nicolas
• Is Part Of: Clinical ethics. Volume 16:Number 4(2021)
• Page Start: 371
• Page End: 377
• Publication Date: 2021-12
• Subjects: Hemorrhagic shock -- Jehovah's Witness -- medical ethics -- proportionate reason -- self-determination -- trauma surgery; Medical ethics -- Periodicals; 174.205
• DOI: 10.1177/14777509211034540
• Languages: English
• ISSNs: 1477-7509

Abstract

When a Jehovah's Witness patient is traumatically injured, the lack of uniform professional consensus guidelines and the cultural knowledge deficit of many clinicians adds an additional layer of legal and ethical complexity to the inherent difficulty of managing a critically ill patient. We present here the case of an incapacitated Jehovah's Witness patient with severe traumatic hemorrhagic shock. We go on to discuss the historical and contemporary case law on proxy refusal of blood transfusion for the incapacitated adult, as well as the ethics of self-determination and the application of the principle of proportionate reason in the management of the critically injured Jehovah's Witness patient.