Monday, 2 September 2013

Opinion: Overruling Extremist Opposition to Expert Medical Opinion

The Blood Transfusion Debate Again
Almost six years ago, I could not find the words to describe and condemn the needless death of someone by reason of extreme religious beliefs where a simple medical procedure would have saved life, avoided sorrow and provided essential parental and matrimonial succour to the children and the husband of the victim. [AkinBlog]
Then a 22-year old having given birth to twins had lost so much blood that she needed a transfusion but because she was a Jehovah’s Witness, she and her husband refused treatment that could have saved her life, she exsanguinated.
Against Expert Medical Opinion
Recently, this issue of religious belief attempting to override good medical practice came to the courts in Northern Ireland where a judge decided that a man with severe learning abilities had the right by reason of not being able to understand the consequences of adhering to a belief system that could endanger his life to be protected by the state. [CourtsNI]
He was to undergo a number of dental surgery proceedings that had outcomes that might require the use of blood products that Jehovah’s Witnesses proscribe, particularly, blood transfusions – in my 2007 blog, I did suggest that it was pragmatic to obtain blood transfusions from a patient’s bloodline.
Personal Consent is Fundamental
Crucial to this decision was that, he “is not capable of consenting to his own medical treatment” due to “a history of global developmental delay of unknown aetiology”, his mother was seeking the right to decide on his behalf positing that, he “seems to enjoy attending church and has positive social contact as a result”, thereby, he is as much bound by the belief systems she espouses to be accorded the strictures that constitute the dogma of the sect. [Wikipedia]
The judge, based his views on the ECHR suggesting ‘At least two articles of the European Convention on Human Rights (ECHR) were relevant, the judge noted: the second, which guarantees the right to life, and the third, which outlaws "inhuman and degrading" treatment. But legal precedents indicated that a treatment aimed at preserving life could not be considered cruel.’ [Economist]
Anachronisms of Ancient Thought in Modern Times
Now, whilst a religious sect might have scriptural basis for whatever belief systems they espouse, as the Economist notes, “transfusion for medical reasons did not exist in Biblical times; this is one of the many difficulties that arise when codes of ethics that were devised for life in the pre-modern desert are applied to the 21st century.”
I could not have put that better in determining the reasonableness of context, application and perspective necessary for a common-sense decisions today.
The conflict between treatment necessary to preserve life and the religious freedom to determine whether to take such treatment should not exist if the person concerned is able to comprehend and use the information under medical guidance to appreciate the consequences of their decision.
Incapacity Defaults to Medical Opinion
That is usually catered for in an Advance Health Care Directive also known as a living will which “is a set of written instructions that a person gives that specify what actions should be taken for their health, if they are no longer able to make decisions due to illness or incapacity.” [Wikipedia]
However, this requires the person be full aware and capable of making the decisions in the directive prior to incapacity. Where the directive is challenged, it there is precedent where the judge has denied the execution of the Power of Attorney, requiring the patient be able to decide for themselves, failing which the law will side with expert medical opinion. [RTE]
An Uneasy Compromise
I am wont to believe that the Jehovah’s Witnesses exhibit an unsavoury kind of religious fundamentalism and extremism based on teachings and new interpretation of Scripture dating back only to 1870, even if they aver that they are “a millenarian restorationist Christian denomination with nontrinitarian beliefs distinct from mainstream Christianity.” [Wikipedia]
Much as I will like a situation where religious beliefs do not overcome reasonable medical intervention, the Economist ends their piece with this – “a consensus is emerging that people of more-or-less sound mind can, if they so choose, put their lives at risk by refusing certain treatments; but they cannot impose that risk on dependants who for one reason or another cannot decide for themselves.”
It is an uneasy compromise but the decision not to follow medical advice or extricate oneself from procedure by reason of conscience must be made by the individual concerned and should never be transferred to someone else.

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