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Summary LMDF4814 - Blood transfusions and religious objections

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Medicina Forensis (LMDF4814) EXAM & TEST summaries including case discussions.

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2018/2019
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Unit 13
Blood transfusions and religious objections:


Adult patients:


 The basic principle of medical intervention is that a patient must give informed consent to any medical
treatment/operation
 Medical interventions violate a patient’s right to physical integrity and privacy
 Its expected from health care personell that informed consent be obtained fro patients who can’t form
an intention before medical treatment
 An adult person has a right to self-determination

Castell v De Greef:
 The courts have consistently refused to afford recognition to a professional right to heal on the doctor’s
part
 They have instead preferred to proceed from the cardinal premise of the patient’s right to self-
determination = this is the right to decide for himself whether to undergo/refuse medical treatment to
save his life/preserve health
 At the end of the day = the decision whether or not to submit to a medical intervention is the patients
and not the doctors
 To allow doctors to administer medical treatment against the patients will on the basis of “doctor knows
best” and patient’s best interest would be like endorsing medical paternalism at the expense of patient
autonomy
Duty:
 When obtaining consent from a patient = the doctor has a duty to inform the patient in understandable
lay terms what the intended medical intervention comes down to
 He must give an indication of the possible benefits and risks attached to the intervention
 He must explain alternative methods of treatment and possible consequences when condition is left
untreated

The declaration of lissabon 1981 – accepted on 34th congress:
 The patient has a right to accept/refuse treatment after receiving adequate information
 This principle implies that normally the patient is free to choose treatment or no treatment at all or
partial treatment
 Example = a patient may refuse a blood transfusion because of his religious beliefs OR fear of an
infection

Adult patient refuses but blood transfusion is given:
 When an adult patient refuses to have a blood transfusion and its still administered = the
physician/nurse is exposed to criminal and civil lawsuits
 A charge of assault may be laid and a claim of damages and injury can be instituted

Freedom of religion:
 Freedom of religion, belief and opinion is a right in S 15 of the Constitution
 S 15 = Everyone has the right to freedom of conscience, religion, thought, belief and opinion
 This section supports religious denominations like Jehovah’s witnesses that no one must decide on
their behalf concerning medical interventions because they consider it their own personal responsibility
before God


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