The Jehovah's Witness and blood: new perspectives on an old dilemma.
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The attitude of a Jehovah's Witness patient refusing a blood transfusion during an exsanguinating episode can raise important ethical problems. Various ethical principles, including the patient's autonomy, the sanctity of life and the dignity of the medical profession can be confronted. A total of 242 doctors, members of the European Society of Intensive Care Medicine, answered a questionnaire indicating that 63% would transfuse in those circumstances. However, 26% would never inform the patient about this. Only 45% considered the blood transfusion as appropriate, of whom 25% were unable to define the best option. Doctors from France and Italy more commonly transfuse while those from The Netherlands, the United Kingdom and Scandinavia more commonly withhold transfusion. These data stress the need for a definition of the appropriate medical attitudes towards the patient refusing blood transfusion.
Public policy is, and ought to be, concerned with the welfare of human beings across a broad spectrum of circumstances and conditions. A Catholic moral theologian analyzes his involvement as a public policy consultant on in vitro fertilization. Evaluative judgements made by the Ethics Advisory Board are not edicts; they leave matters open for reconsideration and revision, while providing a basis for policy decisions for the present.
The theology of John Calvin has deeply affected the American mentality through two streams of thought, Puritanism and Jansenism. These traditions formulate moral problems in terms of absolute, clear principles and avoid casuistic analysis of moral problems. This approach is designated American moralism. This article suggests that the bioethics movement in the United States was stimulated by the moralistic mentality but that the work of the bioethics has departed from this viewpoint.
This article explores the theological foundations of both classical and contemporary Jewish ethics, with special reference to biomedical issues. Traditional views concerning God's revelation to Israel are shown to underlie the methodological orientation of classical Jewish ethics, which is both legalistic and particularistic. Contemporary Jewish ethicists, by contrast, have tended to embrace more liberal views of revelation which have mitigated both the legalism and the particularism of their approach. Apart from methodological considerations, much of the content of Jewish medical ethics has also been shaped by theological concerns. Specifically, a Jewish theology of creation provides basic norms and values which inform Jewish responses to a range of contemporary biomedical issues. Finally, it is suggested that the theological roots of this ethical tradition do not disqualify it from making a significant contribution to the wider discussion of biomedical issues in our secular, pluralistic society.
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This article uses the case of presenile and senile dementia to discuss ethical concepts that have potential to guide nursing action. The concepts of 'sanctity of life' versus 'quality of life' or 'dignity' are both unsatisfactory for directing nursing intervention whenever proxy judgment is necessary. Guidelines for action must evolve from research, the search for clinical knowledge. As an underlying attitude and additional guide the author describes a Jewish ethical perspective which defines dependence and interdependence as an essential part of human existence and accepts the inevitability of living with moral uncertainty.
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Jehovah's Witnesses are not allowed to accept a blood transfusion. According to the Watch Tower Bible and Tract Society this therapy is a transgression of divine precepts. Additionally, in the judgement of the believers, secular proof is abundant these days; to them AIDS is a powerful justification to abstain from blood. Founded on the work of the anthropologist Mary Douglas, it is argued that the rejection of this medical therapy is based on perceptions of pollution and purity inherent in the Watch Tower Society's ideological concept of anti-worldliness. Rooted in the movement's pre-war opposition to vaccination the implementation of the taboo was triggered by the prevailing social-political climate surrounding the Society during the Second World War, resulting in this intriguing and controversial religious proscription. For the community of Jehovah's Witnesses the blood transfusion taboo still functions as a significant mechanism of sectarian boundary maintenance.
Physician-assisted suicide is a form of euthanasia. As such, it is contrary to one's ethical responsibility to self, community, and God. Religious tradition, medical tradition, and modern psychology attest that physician-assisted suicide does not solve any human problem.
Efforts to study patient care from the perspective of Catholic ethics date back four centuries. In the course of this history, a prominent issue has always been management of pain and the efforts to avoid pain. Thus, Catholic theologians were concerned about the effects of pain medication upon the psychic function and considered whether or not hastening death for suffering people was allowed and the ethical norms for using opioids to remove pain when death is imminent. Moreover, the issue of "overmedication" for difficult or elderly patients has been a concern. The President's Commission on Ethics in Medicine and Human Research has utilized many of the principles developed by Catholic theologians when considering the matter of pain relief for dying persons.
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