SPECIAL ARTICLE   

Minerva Medicolegale 2017 June;137(2):37-42

DOI: 10.23736/S0026-4849.17.01764-3

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Refusal of blood transfusion by Jehovah’s Witnesses in Italy: legal and ethical issues

Paola DELBON ¹, Massimo SALVETTI ², Anna PAINI ³, Maria L. MUIESAN ⁴, Emanuele CAPASSO ⁵, Adelaide CONTI ¹ ✉

¹ Public Health and Humanities Section, Department of Surgery, Radiology and Public Health, Centre of Bioethics Research, University of Brescia, Brescia, Italy; ² Department of Internal Medicine, Centre of Bioethics Research (with the contribution of IRCCS “S. Giovanni di Dio-Fatebenefratelli”), University of Brescia, Brescia, Italy; ³ Department of Internal Medicine, ASST Spedali Civili Brescia, Brescia, Italy; ⁴ Department of Internal Medicine, University of Brescia, Brescia, Italy; ⁵ Department of Advanced Biomedical Sciences, University “Federico II” of Naples, Naples, Italy

Patient blood transfusion refusal is one of the most dramatic and complicated events physicians must face. The Authors discuss ethical and legal framework for such circumstances in Italy, also in relation to the main judgements of Italian Courts and European Court of Human Rights in this field. Contrasting positions are found in case law. The main issues emerging from case law are: patients’ rights, informed consent, the right to refuse medical treatments and healthcare professional’s protective role. In the assessment of patient’s best interest, subjective components (and then respect for patient’s autonomy) cannot be neglected. The complexity of this subject and the presence still of opposing positions, even in case law, make a strong case for additional rulemaking by legislators. The role of the healthcare professional should be guiding patients to good decisions while remaining flexible in accepting autonomy.

KEY WORDS: Blood transfusion - Principle-based ethics - Jehovah’s Witnesses - Informed consent