Issues of Patient Autonomy in Cases of Transfusion Refusal due to Religious Belief(<SPECIAL ISSUE>Social Environment Surrounding Neurosurgery)

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  • Nakajima Hiromu
    Department of Clinical Laboratoy, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka Prefectural Hospital Organization
  • Iihara Koji
    Department of Neurosurgery, National Cardiovascular Center
  • Miyamoto Susumu
    Department of Neurosurgery, National Cardiovascular Center

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  • 宗教上の理由から輸血を拒否する事例における患者意思の問題(<特集>脳神経外科医療と社会環境)

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Abstract

Refusal of blood transfusion due to religious belief such as with Jehovah's Witnesses, has brought about many clinical conflicts. To guarantee one's right of autonomy is important and so, in ordinary cases where patients themselves demand transfusionless treatment, physicians understand without much confusion and therefore, whether the doctors accept this request or not, can discuss the matter to the point. However, it may be difficult to resolve if the patient, who is not a believer, is unconscious and the patient's relatives request transfusionless treatment according to their own belief. We here show our own recently experienced case of a deep-coma due to acute cerebellar hemorrhage in a 67-year-old man, and consider the matters around his transfusion refusal and patient autonomy. We also discuss the recently released Japanese guideline for dealing with transfusion refusal cases due to religious reasons.

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