NUS-150 Jersey College, School of Nursing – Develop an ethical position on the nursing care of a client who is a Jehovah’s Witness who, for religious reasons

QUESTION

Develop an ethical position on the nursing care of a client who is a Jehovah’s Witness who, for religious reasons, is refusing the blood transfusions needed to keep him alive. The client, a resident of a nursing home, has chronic leukemia and would need transfusions every few weeks. What should the health care team do about the client’s refusal? What ethical principles have a bearing on this situation?

ANSWER

Ethical Considerations in Nursing Care for Jehovah’s Witnesses Refusing Blood Transfusions

Introduction

In the realm of healthcare, ethical dilemmas can arise when patients’ personal beliefs conflict with recommended medical interventions. This essay explores the ethical position concerning the nursing care of a Jehovah’s Witness client who, due to religious reasons, refuses the blood transfusions necessary to sustain their life. Specifically, we will discuss the actions the healthcare team should take and the ethical principles relevant to this situation.

Respect for Autonomy 

Respect for autonomy is a foundational ethical principle that recognizes an individual’s right to make decisions about their own body and treatment. In the case of a Jehovah’s Witness who refuses blood transfusions, their autonomous choice should be respected. Nurses must provide the patient with comprehensive information about the risks and benefits of alternative treatments, ensuring they have a clear understanding of their decision’s implications (Petrini, 2014). Ultimately, the patient’s right to self-determination should be upheld, even if it leads to potentially life-threatening consequences.

Beneficence and Non-Maleficence

The ethical principles of beneficence and non-maleficence emphasize the healthcare professional’s duty to act in the patient’s best interest and avoid causing harm. In the context of a Jehovah’s Witness refusing blood transfusions, healthcare providers must explore alternative treatments that align with the patient’s religious beliefs while still aiming to provide the best possible care. This may involve identifying alternative therapies, such as blood substitutes or medications that stimulate red blood cell production, to mitigate the risks associated with anemia and support the patient’s well-being.

Fidelity and Trust

Fidelity refers to the ethical obligation to uphold trust and maintain the therapeutic relationship between healthcare providers and patients. In the case of a Jehovah’s Witness who refuses blood transfusions, nurses should foster open and honest communication, establishing trust and a mutual understanding of the patient’s values and beliefs (McInroy, 2005). Building a strong therapeutic alliance allows nurses to advocate for the patient’s best interests and explore viable alternatives, ultimately ensuring that care is provided in a manner consistent with the patient’s religious convictions.

Cultural Sensitivity and Diversity

Cultural sensitivity plays a crucial role in providing ethical nursing care. Healthcare teams should strive to understand and respect the unique cultural and religious backgrounds of their patients. In the case of a Jehovah’s Witness client refusing blood transfusions, nurses should educate themselves about the patient’s religious beliefs and practices (Swihart, 2022). This knowledge enables healthcare providers to provide culturally competent care, accommodating the patient’s needs while upholding their rights and dignity.

Conclusion

Nursing care for a Jehovah’s Witness client who refuses blood transfusions requires a delicate balance between respecting the patient’s autonomy and providing appropriate care. Ethical principles such as respect for autonomy, beneficence, non-maleficence, fidelity, and cultural sensitivity are crucial in navigating this complex situation. By promoting open dialogue, exploring alternative treatment options, and demonstrating cultural competence, healthcare professionals can provide ethical care that upholds the patient’s religious beliefs while ensuring their overall well-being. It is vital to approach these cases with sensitivity, respect, and a commitment to the patient’s autonomy and dignity.

References

McInroy, A. (2005). Blood transfusion and Jehovah’s Witnesses: the legal and ethical issues. British Journal of Nursing. https://doi.org/10.12968/bjon.2005.14.5.17663 

Petrini, C. (2014). Ethical and legal aspects of refusal of blood transfusions by Jehovah’s Witnesses, with particular reference to Italy. PubMed. https://doi.org/10.2450/2013.0017-13 

Swihart, D. L. (2022, November 14). Cultural Religious Competence In Clinical Practice. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK493216/