Trauma and early blood transfusion: the challenging hemorrhage management in Jehovah's Witnesses.

ABSTRACT The management of patients, such as Jehovah's Witnesses, who refuse to receive blood transfusions, is often a medical challenge, not only because of the ethical dilemma, but also because it creates a major obstacle to rapid hemorrhage control in a setting of trauma. This article explores the reasons for this conflict between the physician's duty of care and the respect for the patient's autonomy, and draws a panorama of the main understandings of the Judiciary on the subject. Finally, it is concluded that the manifestation of the patient's will, although free, is not enough to release the doctor from his (her) duty of care. In case of danger to life, the doctor must carry out a blood transfusion, regardless of the patient's consent or the permission of those responsible for the patient.

摘要：针对耶和华见证人这类拒绝接受输血治疗的患者的诊疗工作，往往是一项医学难题——这不仅源于其中存在的伦理困境，更在于此类情况会在创伤场景中为快速控制出血设置重大阻碍。本文探讨了医师诊疗义务与尊重患者自主权之间产生冲突的根源，并全面梳理了司法机构就此议题的主要认知脉络。最终本文得出结论：即便患者的意愿表达是自由自主的，这也不足以免除医师的诊疗义务；当患者生命受到威胁时，无论患者本人是否同意、抑或患者监护人是否许可，医师都必须实施输血治疗。