Blood problems in Italy

by OrphanCrow 17 Replies latest watchtower medical

  • OrphanCrow
    OrphanCrow

    In February 2017, the European Association of Jehovah's Witnesses made a "Submission to UN Human Rights Committee subsequent to the adoption of the List of Issues on the sixth periodic report of ITALY".

    The 119th Session of the Human Rights Committee is currently underway - the dates are March 6 - March 29.

    The WTS has been trying to get "intesa" status in Italy for decades and this latest submission to the UN highlights the problems the JWs are encountering in Italy concerning the blood taboo.

    This link will take you to a downloadable word document that is the WT's submission being considered:

    http://tbinternet.ohchr.org/Treaties/CCPR/Shared%20Documents/ITA/INT_CCPR_CSS_ITA_26670_E.docx

    The following court cases, concerning blood refusal, are a large part of the JW's submission that they are being unfairly discriminated against. Keep in mind that these cases are being presented from the point of view of the WT:

    32. Court of Cassation, Third Civil Division, no. 4211 of 2007: Mr Setti (one of Jehovah’s Witnesses) was admitted to the hospital fully conscious following a traffic accident. He consented to surgery but instructed his doctors that he absolutely refused blood transfusions. In disregard of that choice, he was transfused during surgery. He sued for damages; his claim was dismissed at trial and on appeal. The Court of Cassation held that his refusal of blood transfusions could be ignored because his medical condition changed during surgery and the doctors could not ‘consult’ him about that change because he was sedated. In other words, although Mr Setti had clearly and precisely instructed doctors of his firm decision to refuse blood transfusions based on his religious conscience, his competent refusal of blood was overturned because the Court of Cassation was of the view that the medical information the doctors provided to him before surgery was insufficient.

    34. Court of Cassation, Third Civil Division, judgment no. 23676 of 2008: Mr Grassato (one of Jehovah’s Witnesses) was unconscious when admitted to the hospital. He was carrying in his wallet an advance medical directive refusing blood transfusions. He was transfused while unconscious and developed hepatitis. He sued for the disregard of his personal autonomy and religious conscience. His claim and subsequent appeals were dismissed. In rejecting his appeal, the Court of Cassation ruled that a clear and precise refusal of treatment must “follow and not precede the information [given by the doctors]”. It will only be valid if it is “an ex post refusal and not an ex ante one”. Paradoxically, after holding that Mr Grassato’s advance medical directive was not valid (solely because it was made before and not after he was admitted to hospital), the court concluded: “This, however, does not mean that whenever [one of Jehovah’s Witnesses] is unconscious, he must therefore undergo a medical treatment contrary to his faith. But in such a case … the objection to the health treatment needs to be expressed either by the patient himself by carrying a detailed, accurate, and explicit statement unmistakably testifying his refusal of transfusions even at the risk of his life, or by a different person appointed by him as his agent” (emphasis in original). This was precisely what Mr Grassato had done by means of his advance medical directive.

    37. Court of Cassation, First Civil Division, judgment no. 21743 of 2016: Mr. Ciucci (one of Jehovah’s Witnesses)—age 45, married, and a business owner—admitted himself to the hospital for medical care. He instructed his doctors in the clearest of terms that he must not “under ANY circumstances” be given blood transfusions. Hours later, he was sedated for long-term treatment. The next day, Siena court Judge Paulo Bernardini ruled to authorize forced blood transfusions in total disregard of Mr Ciucci’s competent refusal. Judge Bernardini ruled that “health is a primary interest ... to the point that we have to ignore [Mr Ciucci’s] wishes”. Doctors imposed at least 15 blood transfusions on Mr. Ciucci in profound disregard of his religious conscience. Alternatives to blood transfusions (which were available and effective) were not considered. When Mr Ciucci finally regained consciousness, he joined in an urgent appeal filed by his wife and support administrator. The appeal court refused to declare Judge Bernardini’s decision unlawful and, instead, merely discontinued the proceedings. The Supreme Court of Cassation refused to intervene.

    41. Court of Milan, Fifth Civil Division, no. 6052/2015 of 13 May 2015: Doctors forcibly transfused a conscious and competent adult woman who is one of Jehovah’s Witnesses. Relying on Setti and Grassato, the court concluded that although she had repeatedly refused blood transfusions and was conscious when transfused, her refusal could only be considered valid if she had got up from her hospital bed (despite the fact she was suffering a haemorrhage) and walked out of the hospital. Because she did not, the court decided that the doctors were justified in forcing blood transfusions.


    42. Court of Brescia, Second Civil Division, no. 1886/2016 of 17 June 2016: A conscious and competent adult woman who is one of Jehovah’s Witnesses was admitted to the hospital for elective surgery. She instructed doctors of her absolute refusal of blood transfusions and provided them with a copy of her advance medical directive. She was forcibly transfused during surgery. She sued for damages. In rejecting her claim, the court relied on Setti and Grossato to conclude her refusal of blood transfusions was not valid. It reasoned that during the doctors’ discussion with the patient, they incorrectly stated there was a ‘possibility’ rather than a ‘probability’ they would consider blood to be necessary during the surgery. The court asserted that this alleged lack of information meant that the adult patient could not give an informed refusal of blood transfusion and therefore these same doctors were justified in forcing blood transfusions.


    43. Genoa Court of Appeal, Third Civil Division, decision published 19 July 2016: A conscious and competent adult man who is one of Jehovah’s Witnesses, suffering from a chronic bleeding disorder, applied to the Guardianship Judge to confirm his choice of a support administrator in his advance medical directive to ensure he would not be transfused if he ever became unconscious. The Guardianship Judge rejected that application, relying on Grassato (judgment no. 23676/2008) (Doc 36, p. 2). The Court of Appeal agreed, ruling that a support administrator can only be appointed if the beneficiary is legally incapable. It also ruled that such an appointment, even if granted, could not protect the applicant from a forced blood transfusion since doctors can override such a refusal in an alleged ‘life-threatening’ situation.


    44. Genoa Court of Appeal, Third Civil Division, decision published 2 May 2015: An unconscious adult man who is one of Jehovah’s Witnesses was admitted to the hospital. He was carrying an advance medical directive refusing blood transfusions which also appointed his wife as support administrator. The wife applied to the Guardianship Judge to confirm her appointment as support administrator. The judge confirmed the wife’s appointment but, relying on Setti (no. 4211/2007) and Grassato (no. 23676/2008), prohibited the wife from refusing consent to blood transfusions notwithstanding the husband’s clear and precise refusal of blood transfusions as stated in his advance medical directive. The Court of Appeal rejected the appeal, claiming it was not within its competence. The case is now pending before the Court of Cassation.

    *************

    Out of all the cases described in the summation, I found this ruling to be the most compelling:

    "...the Court of Cassation ruled that a clear and precise refusal of treatment must “follow and not precede the information [given by the doctors]”. It will only be valid if it is “an ex post refusal and not an ex ante one”."

    This is an interesting position to take and one that bypasses the WT's erroneous information that goes into the "informed decision" process. What this ruling does is acknowledge that the WT's information that was given to the patient, before the doctor's consultation, is incomplete and cannot be enough to base a sound medical decision on.

  • Richard Oliver
    Richard Oliver

    OC you are absolutely right blood transfusions do save lives. But it should also be looked at as a slippery slope, if a government can tell you what medical procedures you should or should not accept then that is when a problem does come in. It does apply to doctors as well. It is your body you get to decide what medical treatments you allow and which you deny.

  • OrphanCrow
    OrphanCrow
    RO: It is your body you get to decide what medical treatments you allow and which you deny.

    I agree. I am all for bodily autonomy. Without question.

    With that said, though, I am also strongly in favor of correct information being given to people so that they can exercise the right of bodily autonomy based on what is real as opposed to what they think is real.

    For that reason, I am adamantly opposed to people being given incorrect medical advice. The WT does not give correct medical information. They have bolstered their "religious rights" with wrong and incomplete medical advice.

    Check this out:

    http://rationalwiki.org/wiki/Blood_Transfusions:_How_Safe

    If the WT was a bottle of pills, they would be required to display a black box warning for side effects associated with those pills. Yet, they can promote alternatives to blood transfusions and never once articulate the risks involved in choosing those over the safest medical intervention we have - a blood transfusion.

  • jwleaks
    jwleaks
    RC: blood transfusions do save lives. But it should also be looked at as a slippery slope, if a government can tell you what medical procedures you should or should not accept then that is when a problem does come in. It does apply to doctors as well. It is your body you get to decide what medical treatments you allow and which you deny.

    I agree also. But it is also worth considering that not having blood transfusions cost lives. But it should also be looked at as a slippery slope, if the Watchtower can tell you what medical procedures you should or should not accept then that is when a problem does come in. It does apply to the governing body as well. It is your body but as a Jehovah's Witness you do not get to decide what medical treatments you allow and which you deny.

  • dubstepped
    dubstepped
    I have to say that I might actually agree with RO on this one, though I also agree with OC's input that people should have bodily autonomy but with the caveat being that they're given accurate information. Still, lots of people make medical decisions based on all kinds of quackery available online, and it isn't anyone's responsibility to get accurate information but the person who is undergoing the medical procedure. In my view, this isn't right. You can't put blood in these people that don't want it. If they choose to make stupid decisions and die then that's their right. People do it every day without blood even being involved. If Jehovah's Witnesses choose to be misinformed and choose to bow to a cult and die because of misinformation, that's on them. Governments shouldn't have a say in that, nor should doctors, unless a child is involved, in my opinion. I have no problem with children having transfusions to save their lives despite their parents' views. If the parents want bad things for themselves, that's up to them.
  • Richard Oliver
    Richard Oliver

    I only used the Government and Doctors in my discussion because that is the issue is in the Original Post, even though OC is just using it as an example of what Watchtower is using in their defense of a persecution. But it is relatively common for either doctors, hospitals or governments to decide what patients will get, mostly though what they will not get. The most common is that of abortions and family planning needs. Catholic hospitals have refused to either provide abortions when a mother's life is in danger or will refuse to provide sterilization to a woman even though a doctor may feel that her life is in danger if she becomes pregnant. Doctors in certain states are legally allowed to assist a terminally ill patient to end their suffering sooner, but there are doctors who have a moral reason to refuse to do so causing that patient to suffer more and more. And I understand that in most cases the patient can just go somewhere else, but that is not in all cases. Many people live in communities where there is only one hospital or a limited number of doctors to treat patients.

  • Richard Oliver
    Richard Oliver

    This reminds me of what a doctor who taught a class for me gave all of the students a scenario. A man goes into a comma and is on a ventilator, he has no living will or DPA, he has a wife who he has been estranged from for 5 years but never divorced, three grown children, a girlfriend for 3 years, then you throw in the Hospital Ethics department. The doctor is confident that the man won't come out of the coma with any normal function. The doctor is told by the wife to pull the plug, the girlfriend is telling him to keep him alive and two of the kids says to pull and the third says to keep him alive. This instructor asked, who does the doctor listen too. Everyone in the class gave answers, most said the wife because she would be the next-of-kin and what she wants is the only one that matters. He told us that we were all wrong. He said the person that gets to decide is that man. It is what the doctor believes that man wanted to be done to him in that situation, and whoever can articulate his feelings is, that is what the doctor will do.

    Also, I remember another instructor saying if you do something against a patient's will even doing CPR if there is a POST issued DNR, you have just committed assault on that patient.

  • steve2
    steve2

    Richard Oliver, I agree with your views on this (i.e., it is ethically and morally wrong to impose a treatment on an adult who refuses that treatment.

    OrphanCrow also makes an excellent point: Clients who refuse treatment need to be provided balanced, medically-informed and supported information so that they at least have the opportunity to change their minds (and, yes, they cannot be forced to consider such information).

  • Richard Oliver
    Richard Oliver

    I completely agree that a Doctor should give a patient as much information as needed to make an informed decision. But that raises two questions, who determines when there has been enough information given to the patient, each case is different? Second, who will determine if the decision was made by the patient only since the doctor provided the information or if it was a predetermined decision, obviously I am not meaning DPAs but a mental decision was come to only following the full disclosure.

  • jwfacts
    jwfacts
    But it should also be looked at as a slippery slope, if a government can tell you what medical procedures you should or should not accept then that is when a problem does come in. It does apply to doctors as well. It is your body you get to decide what medical treatments you allow and which you deny.

    You are using two classic Rhetorical fallacies (slippery slope and strawman), and your argument is totally misguided. The government of Italy is not deciding what treatments can be denied, it is saying that a person has a right to informed choice, something violated by Watchtower through forcing the refusal of blood by theologically incorrect doctrine, and misinformation on blood.

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