Análisis bioético del embarazo en testigos de jehová y el rechazo transfusional
Casas-Martínez, María de la Luz
Cuadernos de bioética : revista oficial de la Asociación Española de Bioética y Ética Médica 2010 Sep-Dec; 21(73): 327-39
In Mexico, Jehovah's witnesses present letters to their doctors that exonerate them in case of a patient's decease if hemotherapy was not applied. Although those letters have no legal validity in Mexico, this topic is a hot spot for debate, especially when dealing with competent adults. Bibliography exists, both pro and against this posture, but, an empty gap is observed in the case of pregnancy. With pregnancy, we doctors, find ourselves, both in the medical and ethical area, upon two patients: mother and son. Doctors have the same therapeutical responsibilities upon them. What alternatives would be presented in our country if the Jehovah's Witness transfusional negative was accepted, and we had a pregnant patient in the need of one? Juridically, the acceptance of an adult Jehovah's Witness thesis is included under the acceptance of moral objection, however: 1) Moral objection is not a general right, but exceptional, with a justified reason. 2) It cannot produce any possible harm to third parties. The conflict of interest mother/fetus in hemotherapeutical urgencies can be tackled under three possibilities: a) Total respect to mother's autonomy. Result: high death possibility for both mother and fetus. b) Not to respect mother's autonomy. Result: high life possibilities for mother and fetus. c) Respect mother's negative to be transfunded and to operate maneuvers for fetal rescue. Result: high death possibilities for mother and relative life possibilities for fetal life. The physician, when dealing with a pregnant woman, has a responsibility with two patients. As a first intention, the doctor should always offer a proper handle of the case, according to the pregnant patient's beliefs as much as possible, nevertheless he must never forget his compromise to the embryo's/fetus's life.
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